Hair is often a defining feature of our appearance and can be a powerful expression of ourselves to our peers. Hair can be a form of social language, and different hair styles often communicate universal symbols for different groups, trends and even stereotypes. [1] Because of this, hair loss can be daunting and have significant effects on psychological well-being, particularly in men with both severe hair loss and early-onset androgenic alopecia. [2]
What is the average age for hair loss?
Hair loss may occur at any age but typically begins to present itself of become noticeable in men from age 20-39 years old and women aged 60-69 years old. [3] It has been found to affect up to 85% of men, and 33% of women at some point in their life. 95% of hair loss reported is caused by androgenetic alopecia with the main symptom being gradual thinning of hair. [4]
What is hair and why do we have it?
Human hairs across the body and scalp are thought to assist in stabilising body and even brain temperature. [5] They are are thin, thread-like structure that grows from follicles in the skin. It’s mainly formed of tightly packed keratin proteins, similar to nails. [6] Hair growth has four phases in a cycle. This cycle can last anywhere from two to eight years but will vary from person to person.
What are the biggest causes of hair loss?
Hair loss is a common complaint and a clinical challenge for GPs and dermatologists. A few of the main reasons for hair loss are telogen effluvium, and androgenic alopecia. [7] Medications can also lead to hair loss. This includes amphetamines, SSRIs, ACE inhibitors, beta blockers, and hormone medications including the contraceptive pill or HRT, among others. Some blood thinning, cholesterol management, and weight managements drugs have increased risk of hair loss too. Additionally, chemotherapy used to treat some cancers often leads to total hair loss. [8] [9]
Androgenic alopecia is the most common form of hair loss and is caused by genetics and hormonal sensitivity to androgen hormones such as dihydrotestosterone (DHT) that leads to a change in hair follicles over time. This includes both male and female pattern hair loss. Hair loss will occur over a long period of time, with men commonly experiencing a receding hairline and thinning crown, and women experiencing a widening part and thinning over the top of the scalp. This is a gradual shedding, with thinner and shorter hairs replacing ‘normal’ hairs. [10]
Menopause can affect every woman differently and one of the symptoms can be hair loss. Oestrogen and progesterone are involved in the hair growth phase, and when these hormones decline significantly the growth phase shorten, and more hairs move to the shedding phase. Menopause also sees a rise in testosterone levels, and this too can cause hair loss. Similar to androgenetic alopecia, increased testosterone levels will see an increase in DHT, which over time can cause hair follicles to shrink. [11] This is a form of nonscarring alopecia, characterised by diffuse, thinning across the entire scalp often as large amounts of acute hair shedding typically short term. It is excessive shedding of hairs of the resting phase after some metabolic stress, hormonal changes, emotional or physical stress, illness, nutritional deficiencies, thyroid dysfunction, environmental factors, or medications. [12]
Emotional stress is linked with hair loss, though the mechanism is currently not fully understood, a clear trend is present with psychological stress and hair loss. It is thought that corticotropin-releasing hormone (CRH) is the driving factor. The proposed mechanism is that CRH causes hair regeneration disorders and dysregulates the hair cycle. [13]
Promoting hair growth and supporting hair health
Regular consumption of vitamins, minerals, omega oils and herbal extracts either incorporated into the diet or by supplementation may help to support hair health and even hair growth. There are some nutrients that have clinical evidence showing they may help support hair growth or hair health.
Nutrients for hair growth and hair health
Millet seed extract has gathered a lot of interest recently. Two clinical trials have reported significant improvements to hair growth. The results found that there was regrowth on the frontal region of the head, as well as overall hair thickness increasing from baseline and compared to the placebo following supplementation. [14] [15]
Pumpkin seed is thought to inhibit the production and action of DHT. A 24-week study found that supplementation of pumpkin seed oil led to self-reported improvements to hair health and thickness, as well as up to 40% increase to hair count. [16]
Saw palmetto may also reduce serum DHT. Supplementing 400mg of saw palmetto extract reduced hair fall by 29% and increased hair density by 5%, significantly reduced DHT levels following a 4-month study period. [17]
Horsetail is an ancient, silica rich herb, which is up to 25% silica by total weight. There has been research into horsetail for its potential effects for strengthening strands and reducing breakage. Silica has a positive effect on improving hair’s tensile strength, elasticity, and break load compared to baseline. Because hair breaks less, it resulted in thicker hair. [18]
Pine bark naturally contains oligomeric proanthocyanidins (OPCs), which act as an antioxidant in the body. Oxidative stress may contribute to hair loss as it can damage hair follicles and shorten the growth cycle. Pine bark extract can increase antioxidative capacity. Pine bark extract has been shown to increase hair density by up to 30%. The mechanism behind this that pine bark improves blood flow to the scalp and therefore nutrients to the hair follicles. [19]
Vitamin E has been shown to help maintain hair growth. A clinical trial supplemented participants with vitamin E for 8 months and the results showed hair growth had increased by 34.5% compared to the control group. The mechanism is thought to be that the vitamin E helps to reduce lipid peroxidation and oxidative stress in the scalp which is linked with alopecia. [20]
Methyl sulfonyl methane (MSM) is a naturally occurring nutrient in plants and dairy products and is a good source of dietary sulphur. This is one of the essential building blocks for keratin and has been reported that it may increase hair growth, density, and thickness. A study found that supplementing MSM for 45 days lead to 92% of participants observing new hair growth, and after 120 days 80% of participants saw an increase in hair count and thickness. [21] [22]
Omega oils may help support thyroid function. Thyroid dysregulation is associated with poor skin health and hair loss. [9] One factor in supporting thyroid function is managing systemic inflammation. Omega oils may help reduce inflammation and provide the body with a stable environment to produce and regulate thyroid hormones. [23] Omega 3 specifically has been found to reduce perceived stress [24] [25], reduce systematic inflammation and cortisol levels, as well as boosting the repair mechanisms of the body. [26]
Vitamin C has many different functions in the body, including supporting skin health, and maintaining normal function of the immune system. This can help support scalp health by reducing and managing oxidative stress and inflammation and supporting the immune system. [27] Collagen supplementation alongside vitamin C has been found to improvement in skin collagen hydration and elasticity and scalp health. There was an average 11% improvement in scalp scaling and a reported total hair count increased by 27.6% compared to the placebo. [28]
The impact of nutritional deficiencies on hair health
Deficiencies of key nutrients may also increase hair loss. Iron deficiency is strongly associated with increased telogen hair loss. [29] Additionally, human clinical trials report that low zinc and vitamin E levels are linked with a higher risk of developing alopecia. [30] [31] Biotin (vitamin B7) helps to maintain healthy hair as it is involved in the production of keratin and therefore supports the structure and strength of hair. [32] [33] Omega 3 fatty acid deficiency can lead to poor hair quality. Omega 3 helps to keep the hair hydrated as it aids in the retention of moisture in the hair shaft and prevents it from becoming brittle, leaving the hair softer and smoother. [34]
Lifestyle factors that help hair health
Scalp massaging has been found to increase hair thickness. A study found that 4 minutes of standardised scalp massage for 24 weeks increased the thickness of hair. The mechanism is thought to be increased expression of hair cycle genes and down regulation of hair loss related genes. [35] Using a topical hair oil can help support growth alongside massaging. Cold pressed oils such as castor, black seed, pumpkin oil, and other essential oils including lavender, thyme and rosemary, may help stimulate hair growth and promote a healthy scalp. [36] [37] [38]
Regular exercise, from gentle activities such as yoga and walking to more intense activities such as sports and resistance training, may help relieve stress. [39] Physical exercise can help promote healthy blood flow to the scalp, (such a running, swimming, and cycling) by improving cardiovascular health and therefore blood circulation. A study found that 6 months of any exercise, including aerobic, resistance training, yoga, or lifestyle exercise for at least 60 minutes a day helped to delay the progress of androgenic alopecia. Exercise also improved sleep quality, scalp health, and mental well-being compared to the reported baseline. [40]
Conclusion
Hair loss can affect anyone, and there are a lot of different causes and reasons. While there is no one size fits all treatment for hair loss, ensuring the body gets the nutrients it needs to function properly can help rule out some simple nutritional gaps and aid the body to grow healthy hair and support a healthy scalp.
Author: Will Jordan, BSc (Hons) MSc, is a Nutrition Advisor at Viridian Nutrition. He holds a Master’s degree in Sports and Exercise Nutrition, BSc in Food and Nutrition.
The information contained in this article is not intended to treat, diagnose or replace the advice of a health practitioner. Please consult a qualified health practitioner if you have a pre-existing health condition or are currently taking medication. Food supplements should not be used as a substitute for a varied and balanced diet.
References
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