Hong Kong-based general practitioner Dr Lisa Chan gives the lowdown on hair loss treatments

Hair loss is one of those issues that can be similarly distressing to both men and women, and can result from seasonal weather changes, nutrition and even virus recovery. 

The good news is that it’s usually only temporary. Stress, nutritional deficiency, sudden changes in weight, hormonal disturbance, and a lack of vitamin D from staying indoors for a prolonged period of time can trigger short-term hair loss. Relaxation, healthy eating, and outdoor exercise may help reverse those effects.

The increase in hair loss in recent months may have been exacerbated by previously cooler weather. In dry winter months, people’s hairlines can be affected by low humidity and a lack of hydration and exposure to sunlight. Taking a vitamin D supplement or popping out for a 15-minute dose of moderate sunshine are simple and good remedies.

Of course, even temporary hair loss can have a devastating effect on one’s self-esteem. Hair is a core part of many people’s identity and appearance and the loss of it can lead to depression and social anxiety.

The important thing to remember is that hair loss is entirely natural and unavoidable. Every day, we lose 50 to 100 strands of hair, according to the American Academy of Dermatologists. What counts is the rate of replacement. When the rate of replacement is insufficient to keep up with loss, thinning and bald spots may appear—also known as alopecia.

The most common type of hair loss involves a gradual thinning of hair at the top of the head and their hairline. In men, this is often first seen over the hairline, while women tend to notice a broadening of the part line (a trend that is most prevalent in post-menopausal women). Men are more likely to go bald than women.

Other forms of hair loss are alopecia areata where hair is lost in specific patches, telogen effluvium where hair is lost because of a shock to the body’s system such as illness or trauma, traction alopecia where hair loss is caused by styling such as tight ponytails, and scalp infections or scarring alopecia where inflammation causes permanent damage to the follicles.

Given society’s high expectations of appearance, hair loss can be very upsetting and directly impact the quality of life. Some people may choose to camouflage it with a hairstyle that adds more volume or use hats, wigs or headscarves. Others may opt for medical treatment, which can help slow down hair loss or even reverse it.

Treatment options depend on the actual cause of the hair loss. Examination of the scalp and hair base can help rule out infections such as ringworm, and blood tests can be done to determine whether immune or hormonal imbalances such as lupus, diabetes or thyroid dysfunction are behind the hair loss.

In such cases, treatment of the underlying condition can usually reverse the loss. Loosened hair due to shock is usually temporary and may not require immediate treatment.

In cases of hereditary hair loss due to ageing, medications such as minoxidil, spironolactone, finasteride, iron, biotin, omega-3 and folic acid supplements may be prescribed. It takes time to reverse the impact of hair loss and treatment may be needed daily for up to a year before results are visible.

If the treatment succeeds, it may need to be continued indefinitely to prevent further hair loss. Some medications have side effects and are not suitable for women who are pregnant or breastfeeding, so always consult your doctor before deciding on any course of treatment.

Low-level laser treatment and platelet-rich plasma therapies are also options, and hair transplantation may be considered in severe cases.

Lifestyle changes like having adequate rest and nutrition, avoiding hairstyles that cause excessive traction on the hair, reducing ultraviolet light exposure and quitting smoking can also help to maintain a healthy, shiny head of hair.

This is part of a monthly column by Dr Lisa Chan, a Hong Kong-based general practitioner who has an avid interest in medical beauty. Dr Chan, MBChB (CUHK), MScPD (Cardiff), PgDipPD (Cardiff), PGDipClinDerm (Lond), DipMed (CUHK), DCH (Sydney), also holds a master's degree in practical dermatology with distinction at Cardiff University.

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