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Overcoming Hair Loss: Exploring The Root Causes and Treatments

Millions of people have thinning hair and because of chronic stress caused by the pandemic it’s only gotten worse. Miracle Noodle founder, Jonathan Carp, M.D. explores the different types of hair loss, contributing underlying factors and therapeutic options.   

Anybody frustrated by thinning hair or hair loss should watch episode 76 of Wednesday Night Live, Miracle Noodle President, Dr. Jonathan Carp’s natural health education series. But in case you want a summary of the very informative 45-minute presentation, read on…

As a board-certified dermatologist, Dr. Carp combines diagnostic testing, diet, supplements, pharmaceutical treatments and the latest non-invasive surgical treatments to help patients overcome hair loss. 

Dr. Carp’s presentation does not include the sobering statistics that reveal how extensive thinning hair is. So if you have anxiety because of your thinning hair, take comfort that you’re not alone. 

Hair loss is estimated to occur in roughly 80 million Americans. And the people most affected by and large by hair loss are not men. In fact, anywhere from 40% to 50% of women experience hair loss by middle age. Hair loss is a major cause of anxiety and a stressor for both men and women.

Different Types of Hair Loss Patterns

Alopecia areata is an autoimmune disease. For people with this cause of hair loss, there can be circular areas on the scalp that are completely bald. Why this condition develops in the first place is not well understood and it ranges in severity, from tiny spots to the more advanced alopecia totalis, in which the scalp is completely devoid of hair.

Even more advanced is alopecia universalis, in which a person with this disease has absolutely no hair from head to toe. If you don’t have this condition, be grateful that you have eyelashes and eyebrows to prevent dust and sweat from causing severe irritation to your eyes. 

Alopecia areata can be treated with cortisone injections in the scalp. Dr. Carp also recommends that everybody, regardless of their hair health, supplement with zinc at a dose of 15-25 mg per day. (Anymore than 25 mg could cause copper depletion.). In addition, make sure that your vitamin D levels are at 40 ng/dl or higher. Both zinc and vitamin D can help support hair and skin health. 

Psoriasis and dandruff may also cause temporary hair loss. Dr. Carp explains that these two skin imbalances cause rashes that accelerate hair shedding. When treated, the rashes go away and the hair comes back.

Androgenic alopecia is the most common type of hair loss in men, accounting for roughly 95% of male hair loss cases. Females are also susceptible to this pattern, which is known as “female pattern hair loss,” and causes a widening of the hair part.  Dr. Carp explains that Polycystic Ovarian Syndrome or PCOS is often a root cause of this type of hair loss. In addition, hypertension and diabetes can contribute to or exacerbate this genetic type of hair loss. 

Telogen effluvium is another common pattern that Dr. Carp sees in his patients, even more so these days because of the COVID-19 pandemic. Having the novel coronavirus may indeed cause hair loss, but it’s a sudden, major stress that causes telogen effluvium. With this type of hair loss, the hair drastically shifts from the growing or resting phase into the shedding phase.

3 Phases of Hair Growth

In the normal hair cycle, some of your hair will grow in the anagen phase. This phase lasts only 3-5 years. As you get older, the growing phase shortens. During the resting phase, the hair that is not growing or shedding will remain dormant for a few months. Then, the shedding phase will last several weeks. 

When you undergo a major form of stress, be it positive (the birth of a child) or negative (surgery, death in the family) with telogen effluvium, a larger than normal amount of hair can be shifted into the shedding phase.

The good news is that when the pass stresses or becomes more manageable, most of the hair, if not all will grow back. Keep in mind that the abnormal hair loss may not occur right when you experience the major stressor. Because of the hair-cycle phase, the hair loss can occur a few months after the event. 

Pharmaceuticals That Can Contribute To Hair Loss

Dr. Carp says that beta blockers, which are hypertension drugs, are a common trigger of hair loss. In addition, oral contraceptives, anti-seizure drugs and anti-depressants may induce hair loss.

Other Causes of Hair Loss

In addition to PCOS, Dr. Carp says that imbalance hormones can be a major contributing factor for thinning hair. That’s why he recommends comprehensive bloodwork to assess thyroid function, iron, vitamin D, zinc, DHEA-s, free testosterone and ANA or antinuclear antibodies; if these are present in your blood test, you may have an autoimmune disease.

Radical weight-loss diets can also cause hair loss. In his practice, Dr. Carp has seen first hand how low-calorie crash diets can result in accelerated hair loss. Ultra-low protein diets can also be problematic because the health of your hair’s chief protein, keratin, depends upon getting adequate protein from the diet.

Eating lots of processed foods and consuming rancid vegetable- and seed oils (which are prominently used in packaged foods) may deplete the scalp of nutrients and blood supply. Dr. Carp recommends a whole-food plant based diet consisting of leafy greens, nuts, seeds and beans.

Not consuming enough essential fatty acids can also accelerate hair loss. Processed foods contain far too many omega-6 fatty acids. If you have dry skin or a dry scalp, (eczema), it’s an indication you need to consume more healthy sources of fatty acids with a good Omega-3 to Omega-6 ratio. Dr. Carp suggests hemp seed oil to fit that bill.

As for biotin supplements, dermatologists typically don’t recommend them because they can interfere with blood tests.

It’s worth noting that having braids and using hot combs or rollers can also cause hair loss.

Hair Loss Treatments

In addition to the nutritional and supplementation recommendations listed above, Dr. Carp suggests vitamin E (mixed tocopherols) along with matcha green tea.

As for prescription solutions, there’s the leading therapy, Rogaine (minoxidil), which is available over-the-counter at 2% for women and 5% for men. Although the 5% solution may cause side effects for women, Dr. Carp recommends it for advanced hair loss. Just be mindful that if you apply it at night, you may cause some of the Rogaine to accumulate on parts of your face that you don’t want hair like your cheeks. That’s because when you shift your head on the pillow, some of the Rogaine can accumulate on the fabric.

To avoid this hirsute conundrum, oral minoxidil is available.

As for the second-leading prescription for hair loss, Propecia (finesteride) is usually recommended for postmenopausal women with no family history of breast cancer, explains Dr. Carp.

Other hair-growth remedies mentioned in the presentation include:

  • Dutasteride
  • Spironolactone
  • Cyproterone Acetate
  • Bimatoprost/Latanoprost
  • LLLT (low level laser therapy)
  • PRP (platelet rich plasma)
  • Microneedling with other topicals
  • Ketoconazole antifungal shampoo (which can decrease DHT, an enzyme that contributes to hair loss, especially in men)

Hair Loss Tips For Men

For men with a genetic pattern of hair loss, Dr. Carp recommends getting DHEA, testosterone, thyroid-stimulating hormone (TSH), total iron binding capacity (TIBC), and transferrin levels tested.

Dr. Carp suggests that all men take pumpkin seed oil and saw palmetto, both of which support prostate health and may help to reverse hair loss. And in addition to the treatments not mentioned above, men may also benefit from topical retinoids, hair transplants, topical caffeine (don’t dump a cup of hot coffee on your head) and botox, the latter of which relaxes the muscles of the scalp to increase fresh blood flow.

For best results with his patients, Dr. Carp prescribes a compounded treatment of 6% minoxidil, with 0.1% finasteride and 0.125% tretinoin (retin-A). Long-term usage is critical if you’re genetically-predisposed to hair loss. A final cautionary note if you’re thinking about using Propecia: in up to 4% of users, it may cause sexual dysfunction, and in some of those cases, the dysfunction can be permanent. Propecia has also been linked to depression in some instances.

Conclusion

No matter your age or gender, hair loss or thinning hair can be a major trigger of anxiety and in some cases can contribute to depression. A holistic approach, including diet, stress management, diagnostic testing, nutritional supplementation and FDA-approved therapies, is required to overcome this common affliction. 

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