Losing our hair is no picnic and most of us feel distressed if we see our locks on our pillows, in our brush or collecting on the shower drain. Worse yet is the emerging bald patches or receding hairline we see in the mirror. For centuries, our society has equated luxurious, thick hair with youth, vitality, health and beauty. For many of us, hair loss signals the irreversible inevitability of aging and the end of our youth. Hair loss can make us feel less attractive and confident, which can lead to depression, anxiety and social phobias. Statements about hair loss become embedded in our rhetoric, to be repeated and passed down through generations — some true, some partially true and others completely false. We’re going to dig into common beliefs and myths about hair loss — and separate fact from fiction.
#1) Permanent Hair Loss Mostly Affects Men
False: The most common type of hair loss is called androgenetic alopecia (AGA). AGA causes the predictable hair loss pattern in men — the “M” shaped receding hairline and balding along the crown (top) of the head. About 85 percent of men will experience some degree of AGA in their lifetime. AGA also develops in women at about the same rate, but the pattern of hair loss is harder to detect. In women, AGA causes a diffused hair loss pattern, meaning all over the scalp, so the pattern is less noticeable than in men. The frontal section (above the forehead) and the parietal section (between the top and the back) lose the most hair. Unlike men, women with AGA rarely go bald. The early stages of AGA in women usually show up as a widening part instead of a bald spot.
Hair loss can be even more devastating for women than men for several reasons. First, society accepts baldness as a normal part of aging in men, but not in women. Women are less likely to seek treatment, partly due to embarrassment — and because treatments are marketed more heavily to men. As a result, women aren’t as aware of their treatment options. And last, many women view their hair as an essential part of their self-worth and attractiveness, so when their hair begins thinning, their self-esteem suffers. Learn more about the psychological impacts of hair loss in this post.
#2) Permanent Hair Loss Only Happens to Older People
False: Men and women can begin losing hair in their 20s. In fact, by the age of 35, about 66 percent of men will experience visible hair loss. By the age of 40, about 40 percent of women will notice hair loss. Women who suffer from polycystic ovary syndrome (PCOS), a hormone disorder, often develop AGA. PCOS affects about 5 to 10 percent of women of reproductive age, meaning from about age 14 to 45. While it’s true that hair loss due to AGA and normal aging accelerates as we approach retirement age, hair loss under the age of 50 is very common in both genders. Generally, our hair loss isn’t noticeable to others until we lose about 50 percent of it, although we often notice much sooner as we’re washing and grooming our hair.
AGA also causes our new hair strands to be thinner. Hair grows from follicles, tiny cavities embedded in our skin and scalp. Some of us have follicles that bind more easily to a testosterone byproduct called dihydrotestosterone (DHT). DHT stored in scalp tissue causes follicles to shrink, so they can no longer grow a normal-sized hair strand. Eventually, hair follicles shrink to the point they can no longer grow hair.
#3) Permanent Hair Loss Treatments Are Expensive and Involve Surgery
Partially True: Some hair loss treatments are expensive — hair transplant surgery, which involves moving healthy hair follicles from one section of the scalp to a balding area, can run anywhere from $4,000 to $25,000. Learn more in our post, Read This Before Having Hair Transplant Surgery. Another surgical procedure called scalp micropigmentation, which is somewhat like a tattoo where a technician injects dot-sized pigment into the scalp to mimic hair follicles, costs about $400 to $1,000 per treatment. Since both treatments are usually considered cosmetic, insurance companies will not cover them. As with any surgical procedure, they also carry risks such as infection.
However, many treatments are far less invasive and costly. A topical formula containing an FDA-approved drug Minoxidil is a low-cost, easy treatment you can do at home without a doctor’s prescription. Oral prescription medication such as Finasteride, sold as Propecia and Proscar, can also help men with AGA, but often with unpleasant side effects such as low libido and erectile dysfunction.
#4) We Inherit Hair Loss Genes from Our Maternal Grandfather
Partially True: We inherit chromosomes, thread-like molecules that serve as the “blueprint” for how our bodies form, from our parents. Men do inherit a gene related to hair loss that resides on the X chromosome, aka the female chromosome, which they inherit from their mothers. There is a 50 percent chance our mothers inherited the gene from her father. However, research has discovered that this well-known hair loss gene is only one contributor to AGA. Multiple genes that reside on gender-neutral chromosomes (called autosomes) contribute to hereditary hair loss far more than the one that resides on the X chromosome.
#5) Sometimes Hair Loss Is Reversible
True: If treated early with Minoxidil-containing treatments, which stimulate the growth cycle, and treatments that prevent DHT from shrinking follicles, AGA-related hair loss can be somewhat reversible. You won’t have the full head of hair you had at 18, but you can help hair regrow provided the follicles are not damaged. The earlier you start treatment, the better — because hair can only regrow in healthy follicles. Some injuries such as burns, scalp infections and illnesses permanently damage hair follicles. Once a follicle becomes irrevocably damaged, it can no longer grow hair.
Many forms of temporary hair loss are reversible too. Our hair grows in three phases, an active (anagen), a transitional (catagen) and a resting (telogen) phase. Hair follicles release hair strands during the resting phase, so it’s sometimes called the shedding phase. It’s normal to shed between 50 and 100 hairs daily, and about 10 percent of our hair follicles are in the resting phase on any given day. The active period lasts between two and six years, so once a hair follicle sheds its hair in the resting phase, it cycles back into the active phase. People who can’t grow their hair long usually have shorter anagen phases than those who can grow long locks.
#6) Aging Is the Only Reason We Lose Hair
False: AGA and hair loss due to normal aging are by far the most common reason for hair loss. However, several medications, medical conditions, high fevers, illnesses, severe infections, physical or emotional trauma, nutritional deficiencies and hormonal changes due to menopause, pregnancy and birth control can cause a type of hair loss called telogen effluvium (TE). In TE, our hair follicles remain in the resting (telogen) phase for longer than usual — or an abnormally high number shift into the telogen phase and shed hair at a faster rate. This hair loss can be sudden or gradual, but hair usually grows back once the triggering event and subsequent shedding phase has passed. Minoxidil-containing formulas can accelerate hair growth for many of these temporary hair loss causes.
#7) Baldness Means We Have a Lot of Testosterone
False: As we noted earlier, DHT is a derivative of testosterone, and DHT shrinks hair follicles in some people. Many assume that if we have a high level of DHT in our bodies, we must have a lot of testosterone. It turns out that testosterone and DHT levels don’t really correlate with hair loss. Testosterone levels typically drop as we age, yet hair loss accelerates.
Studies have found that some people can have elevated DHT levels, but minimal AGA hair loss. And the flip side is true to — some people with relatively low DHT levels can develop AGA. Our genes mostly determine how much DHT affects hair follicles. Some of us inherit genes that make our hair follicles more likely to store the damaging DHT. This genetic component is what primarily drives AGA hair loss, not testosterone or even DHT levels.
#8) Certain Hairstyles and Headwear Can Cause Hair Loss
True: A type of hair loss called traction alopecia can develop if we wear our hair in ways that place prolonged or repetitive tension on hair strands. Tight ponytails, buns, cornrows, weaves, extensions and braids can damage hair follicles, even permanently in some cases. You might have heard that wearing hats “suffocates hair” so it can’t breathe. This is a myth, but frequently wearing tight headwear such as sports helmets and elastic headbands that stress hair follicles can cause hair to fall out. Usually, hair loss due to traction alopecia is reversible unless the hair follicles are damaged.
Heat styling tools and products can cause hair to break — breakage mimics hair loss, but hair doesn’t fall out of the follicles. If you frequently use hot blow dryers, curling or straightening irons and other harsh styling products and tools, your hair can become thinner. Chemical styling treatments such as relaxers can also cause hair to break. Some chemical products even lead to permanent hair loss, again, if the follicles sustain damage.
#9) Shampooing Too Often Can Cause Hair Loss
False: Unfortunately, many people have jumped on the “No-Poo'' bandwagon, believing that not shampooing their hair is somehow healthier. As long as you’re using a mild shampoo, how often you shampoo your hair doesn’t impact hair loss. In fact, not washing our hair often enough can lead to sebum (oil) and bacteria buildup, dandruff and hair loss. Our scalp is essentially skin, and scalps need regular cleansing, just as our skin does, to remove dirt, oil, allergens and dust. And just as with skin types, some of us have oiler skin and scalps that require more frequent washing.
Surprisingly, people with fine hair usually must wash more frequently than those with thick or coarse hair. Why? Because they have more hair follicles than those with coarse hair. Each follicle contains a sebaceous (oil) gland that releases oil to keep the scalp and hair moisturized. Since fine-haired folks have more follicles producing oil, their scalps become greasy faster.
Many shampoos and styling products have harsh chemicals that can dry hair out, causing it to break — which can appear like hair loss. Over-rubbing your hair with a towel or not combing it gently when it’s wet can also cause breakage. Using a conditioner every time you shampoo can reduce breakage because hair is less brittle and easier to comb. Check out ScalpMED®’s line of hair thickening shampoos and treatments!
One reason people feel that shampooing their hair causes it to fall out is simply because washing it loosens trapped hair that the follicle has already shed naturally. The less often they wash their hair, the more hair they see coming out, so they mistakenly blame it on shampooing. Brushing your hair before you wash it removes the shed hair, so less of it ends up in your drain. It also makes it easier to comb after you wash it.
#10) Your Diet Affects Hair Loss
True: Nutritional deficiencies from crash dieting and restrictive diets that limit protein can lead to hair loss, primarily due to iron deficiencies. Our bodies store some iron in our hair follicles in the form of a protein called ferritin. Low ferritin levels are more common in women than men, due to blood loss from menstruation. Sudden weight loss, celiac disease and gluten-intolerances can also cause low ferritin levels. We can have low ferritin levels even if our blood tests show our iron levels are within a normal range. A regular blood test may only test for iron, not ferritin. If you follow a restrictive diet that eliminates food groups, especially protein, and you’re losing your hair, ask your doctor to test your ferritin levels.
Hair follicles need ferritin to sustain a healthy growth phase. When ferritin levels are too low, hair follicles don’t remain in the growth (anagen) phase long enough to grow hair to its usual length — and it falls out prematurely. People with low ferritin levels often see short hairs that look as if they’ve been broken, but they’re just stunted. The good news is that hair loss due to nutritional deficiencies is almost always reversible when the deficiencies are addressed.
#11) Stress Can Lead to Hair Loss
True: A sudden emotionally traumatic event such as a divorce, job loss or death of a loved one can cause telogen effluvium (TE) hair loss. As we noted earlier, TE occurs when an unusually high number of hair follicles in the active phase either shift into the resting (telogen) phase or remain in it for longer than average. Hair follicles shed their strands during the telogen phase. These hair strands are easy to identify because telogen hairs typically have a small bulb of keratin (a type of protein) at the root end. The hair shedding usually begins about one to two months after the emotional shock and can last for up to eight months. Hair will start growing back once the shedding ends. You can accelerate hair growth with Minoxidil products such as this bestselling line from ScalpMED®.
Some researchers believe that chronic stress can lead to a type of TE that causes gradual hair loss because follicles remain in the resting phase for an extended period. A typical growth cycle shows a hair follicle in the active phase for two to six years, the transitional phase for a few weeks and the resting (shedding) phase for about two to three months. In this type of TE, your shed hair doesn’t grow back, so after a prolonged period, you have fewer hairs on your head.
#12) Frequent Haircuts Prevent Hair Loss and Promote Growth
False: Hair follicles have no idea how long hair strands are or how often they are being cut. As we noted earlier, hair only grows when follicles are in the anagen (active) phase, which can last anywhere from two to six years. The longer your hair follicles’ anagen phase lasts, the longer your hair strands will grow. If your hair never grows as long as others, your anagen phase could simply be shorter. However, it’s a good idea to get regular trims to cut away split ends since split ends can lead to breakage. Breakage can mimic hair loss since you have fewer long hairs on your head.
#13) Smoking Causes Hair Loss
True: Research has found that “a significant relationship between smoking and baldness.” Asians tend to be less likely to develop AGA (male and female pattern baldness) than whites and other races. A group of Taiwanese researchers studied 740 Asian men aged 40 or older. After controlling for family history and age, researchers determined that smokers had a statistically significant higher rate of AGA. Other research has indicated similar findings.
We already know smoking causes our skin to prematurely age, so it should come as no surprise that our hair follicles may also prematurely age if we smoke. Smoking has been connected to hair becoming prematurely gray too. Many factors may be involved with smoking and hair loss, from restricting blood flow to the follicles, toxins causing follicular DNA damage and interference with the growth phase to micro-inflammation. Smoking can also cause hair to be dry and brittle, so it breaks easily, making hair appear thinner.
#14) Scalp Massages Help Hair Strands Grow Thicker
Potentially True: Scalp massages, like body massages, can feel great, but the research is limited. A few small studies found a correlation with thicker hair after participants followed a scalp massage regiment for a specified period. Massage techniques involved pressing, pinching and stretching the scalp, which in turn stretched hair follicle cells. It’s believed that the stretched cells produced a thicker strand of hair. Massage also may have dilated the blood vessels feeding hair follicles, which increased nutrient flow. More research is needed, but scalp massage done properly may help with hair growth, but probably not with preventing hair loss.
#15) Hair Thickening Products Only Coat Hair, but Don’t Promote Growth
Partially True: Most hair thickening shampoos and products merely coat and plump the hair shaft, usually with some type of hydrolyzed protein. The plumper strands can make our hair appear fuller, but the effect is only temporary. As soon as you wash your hair with a different product, the coating is lost. Using these types of hair thickening products every time you wash your hair can also lead to product buildup, which makes hair look limp and dull.
However, some thickening products contain ingredients that do more than coat hair - they reduce hair loss and promote growth. Products that contain essential amino acids and biotin can help nourish hair follicles. Saw palmetto extract has been shown to inhibit damaging DHT from adhering to hair follicles, preventing shrinkage and dormancy. ScalpMED® makes a whole line of products that contain these essential amino acids, biotin, saw palmetto and other proven ingredients to not only make hair appear thicker — but promote hair growth and reduce loss!