Hair today, more tomorrow? What causes hair loss, which treatments work and what do they cost?
Hair’s something we often take for granted: as the cliche goes, you don’t know what you’ve got till it’s gone. But hair loss isn’t just about vanity. It can seriously damage our self-esteem and self-confidence and cause great anxiety.
Some of us would do anything to solve it. Unfortunately that means it’s a subject that attracts its fair share of cranks and snake-oil salesmen, peddling pseudoscience, home-spun wisdom, old wives’ tales and other bollocks to people who’ll try anything. In most cases we know what causes hair loss, we know what kinds aren’t reversible, and we have reliable evidence of what works and what really doesn’t.
Here are the most common kinds of hair loss, what you can do about them and how much the treatments can cost. It’s in your genes The most common cause of hair loss is androgenic alopecia, AKA male or female pattern baldness. In men it means a receding hairline and a thinning crown; in women, thinning hair. It’s hereditary, so if a close relative has it you may get it too. More than 50% of men over 50 have some degree of androgenic alopecia, and in the US it affects more than 50million men and 30million women. Such hair loss can be slowed with medication. More of that in a moment.
It’s your hormones If your hormones are out of whack, for example because you have thyroid or insulin issues or because you’re pregnant, hair loss may result as your body prioritises other factors over hair growth. This is often temporary. It’s a reaction Hair loss may be a reaction to medication you’re taking, or to treatment you’re undergoing, such as cancer treatment. It’s a medical condition One form of baldness, alopecia areata (AKA spot baldness) is believed to be an autoimmune disease.
Hair loss can also result from an iron deficiency. If you experience sudden hair loss, see your doctor just in case it’s a symptom of something. You’re stressed (Picture: Ella Byworth for Metro.co.uk) Stress can be a direct or indirect cause of hair loss: it can change your body’s production of hormones or lead you to a diet with poor nutritional value. Or it can cause trichotillomania, where you pull out hair without realising you’re doing it. There’s also a stress-related condition known as telogen effluvium, which puts hair follicles into a resting phase rather than a growth phase. Reduce the stress and you may reduce the symptoms. You’ve been working it too hard Traction alopecia affects some people who wear their hair in tight styles such as braiding or cornrows, or who regularly wear hair extensions or weaves. It’s wear and tear on your hair, or rather on your follicles. It’s temporary in the short term but over years it can cause permanent hair loss. What you can do about it: look after yourself Not all hair loss is permanent.
Stress-related hair loss often regrows once the stress has been removed, although it takes a while, and the same applies to hormonal hair loss and some reactions to medication. What you can do about it: get meds Most of the supposed treatments for hair loss are wishful thinking, but some do work. The most commonly used hair loss treatments that aren’t bunkum are Finasteride and Minoxidil. Finasteride is the active ingredient in the hair loss treatment Propecia, and Minoxidil is the active ingredient in Rogaine. They work in slightly different ways and Finasteride has higher success rates. Finasteride reduces the level of a hormone called dihydrotestosterone, or DHT for short, which attacks hair follicles. Minoxidil is more mysterious. The most likely explanation for its effects is that it dilates blood vessels around your hair follicles. Neither treatment is magic. Finasteride arrests hair loss, and may lead to modest regrowth around the crown, but if hair no longer grows in part of your head it isn’t coming back. It’s a similar story with Minoxidil, which appears to be at its most effective in the earliest stages of hair loss. In both cases if you stop taking the treatments, hair loss will resume.
What you can do about it: get a weave or a wig Weaves can help to hide the signs of hair loss, but you need to weigh up the pros and cons: the weight of the weave can damage the hair it’s joined to. The lighter the extensions, the less stress they put on your follicles. Wigs can do the same job without damaging anything and you can have more than one if you fancy having different looks to choose from. Cheap ones are awful but good ones aren’t hot or heavy and look just like the real thing. Good wigs can be expensive – expect to pay about £200 for a good synthetic one and considerably more for a human hair wig – but synthetic ones are good for around nine months and human hair ones a year-plus. Also, they don’t require expensive trips to the hairdresser, although they can often be styled and straightened if you wish. Just make sure that if it’s synthetic, it’s heat-resistant and your straighteners aren’t too hot for it.
If you qualify for NHS assistance, a synthetic wig is £70.15 and a real hair wig £271.70. What you can do about it: get a transplant or tattoos We’ve all seen Wayne Rooney’s post-transplant hair, and a growing number of people are turning to hair transplant surgery to get their luscious locks back. There are two popular procedures:
FUT (follicular unit transplantation) and FUE (follicular unit extraction). The former procedure takes a strip from the back of the scalp, removes the hair follicles and transplants them in the desired location; the latter skips the strip and takes the follicles out individually. Pricing depends on how many follicles are involved and can range from as little as £1,000 for a minor procedure to £30,000. It’s appropriate for male or female pattern baldness and scarring, but isn’t usually recommended for spot baldness.
There’s another, cheaper option: tattoos, or scalp micropigmentation (SMP). SMP uses small ink dots to create what looks like a stubbly shaved head and it’s used to cover balding areas or scars. Prices range from about £500 for scar treatment to more than £3,000 for a full scalp, and maintenance is required every few years.