Alopecia Treatment

Human hair is a fundamentally part of the image we portray to the rest of our society. Hair acts as a representation of many things to many people, for example, our uniqueness for the man with the ‘Mohican’ style; or the red, white and blue dyed hair; for a woman with flowing tresses her femininity; for the Sikh man with his hair grown long, his religious beliefs; for the African man or woman with braided hair or the Afro style it may represent his or her heritage. As a result of this, the loss of one’s hair can have an absolutely devastating effect on the way we view ourselves, and in many instances, the way others view us.

In conditions such as Alopecia areata, where large patches of head hair and in some instances total body hair can be lost all at once there can be an enormous amount of psychological stress experienced for the person, and his/her family, and associated psychosocial problems accompanying this. The resulting low self-esteem affects the quality of life for the individual concerned. The unpredictable nature of such conditions (i.e., there is likelihood of re-occurrences once it has happened for the first time), and experiencing potentially unpleasant therapies, makes living with this type of condition very anxiety provoking and unpleasant. Alopecia treatment research surrounding this particular condition will be reviewed in more clarity in the later part of this information article.

Male pattern baldness, on the other hand, unlike the condition mentioned previously, tends to occur over a longer period of time and hair loss develops much more progressively, but nevertheless, it can still induce intense feelings of anxiety for some individuals depending on how they portray their own image to the rest of society and how they wish others to see them. Many people, of course are not too concerned by losing their hair in this way, but for others it can cause great emotional distress, low self esteem and depression. Hair loss of course can result from neither of the aforementioned conditions/situations but can be a result of other illnesses, or conditions, which when treated can result in hair regrowth. Below is a list of reasons why hair loss may occur:

Chart to show Diseases/Conditions causing Hair Loss:
Chart to show conditions leading to pattern baldness
(Ref.:  Information from mens health about.com, 06/11/12)

Male Pattern Baldness:

The most common type of hair loss in men, by far, is pattern baldness. Referring to the NHS’s most recent figures on this, state that it affects approximately 6.5 million men in the UK alone. The global figures for this type of baldness would be phenomenal, emphasising the importance of this issue for so many men worldwide. For a small percentage of men this process may begin from a very early age, i.e., starting in their late teens, and the loss of self esteem as a result of this for some people can be felt acutely. It is small comfort for these few people to know that by the age of sixty years, most men, to varying degrees are experiencing hair loss.

What is Male Pattern Baldness?:

It is a good starting point at this stage to do a little myth busting surrounding this subject matter. It has been said that going bald is a sign of virility because of it’s association with the male hormone testosterone, and that somehow this condition is related to having more male hormone than other men, it is regretful, therefore, for the author to have to be the messenger for bad news, but this is strictly not true. The actual cause of this condition which may affect women as well as men is that the hair follicles are oversensitive to Dihydrotestosterone (DHT) which is produced by the male hormone testosterone, and results in the shrinking of hair follicles which will eventually stop functioning. Essentially, it is an inherited condition, therefore, anyone with parents or grandparents with the condition may have passed on the genes for this specific over-sensitivity to DHT.. Each strand of hair sits in a tiny hole or cavity called a follicle. In people with an oversensitivity to DHT the follicle will shrink over time, as seen in the diagram below, resulting in shorter and finer hair, until eventually the hair is so short and fine the person appears to become bald. Finally the follicle will not grow new hair at all and stops functioning, therefore any treatments for this condition tend to concentrate on maintaining existing hair and it’s growth, and so the earlier preventative therapy commences the better.

Diagram to Show How the Hair Follicle Shrinks over time:
Hair follicles showing how alopecia occurs
(Ref:  nlm.nih.gov/medlineplus, 19/11/12)

Male pattern baldness will classically occur in a pattern, hence it’s name. This begins with loss at the hairline to form an M shape. The hair in the middle then becomes finer and shorter eventually forming a horseshoe shape. At the same time as the M shape a small bald patch can form on the crown, and eventually form part of the U like shape, where the remaining hair is around the sides of the head. Below are diagrams which demonstrate this type of hair loss:

Diagrams to show the Pattern of hair loss in Male Pattern Baldness:
The different stages of male pattern baldness
(Ref:  nlm.nih/medlineplus, 21/11/12)

If hair loss occurs differently to the above diagrams which occurs over a period of time, often years, then it may be that it is due to other causes as discussed just above. For example, if hair is lost in patches, or a lot of hair is lost all at once, if the hair is breaking and brittle, or if hair loss occurs along with redness, scaling or pain, there is a good possibility that it is due to disease or other reasons, not genetic disposition to male pattern baldness. This will be discussed in more detail a little later. It is important to say at this stage that male pattern baldness is not classified as a disease, and so will not affect general health, but because of the distress and psychological issues associated with hair loss, referrals through the NHS can be made to see a dermatologist, or to see a Psychologist with regards to the anxiety, and there are numerous treatments available to try to re-grow or retain hair, but these will be discussed a little later.

Below the diagram shows the main form of treatment, anti-androgens, prescribed for the treatment of male pattern baldness and hair restoration, in what form they come and their action to prevent hair loss, and encourage growth.

Diagram to Show Anti-Androgens available for the treatment of Hair Loss:
Chart showing anti androgens with respect to hair loss
(Ref:  hda-online.org.uk, 02/02/2013)

Genetic Research:

A report in ‘Nature Genetics’ magazine, 2008, analysed the DNA of 5,000 volunteers with and without male pattern baldness, and reported that there are two separate areas located on the genome linked to the condition.  As a result of having the two genetic links to the condition, it may increase the risk of early baldness amongst men by seven-fold.  It was ascertained from this study that one in seven men have both of the genetic variants. A follow up study was done to this involving 500 men with early onset baldness, and 500 men without this condition to identify the two regions which were responsible for increasing the risk of early onset male pattern baldness.

The first is the androgen receptor gene, which has previously been linked to this condition.  The other is chromosome 20 previously unconnected.  More research is required to find out how these areas on the genome influence early onset baldness. These areas are also found in women, but there is a weaker association.  Not only is research regarding this going on in the UK, it is also underway with Dutch researchers, and Icelandic scientists. A further study published in ‘Nature Genetics’, describes how the androgen gene identified with baldness is on the X chromosome, which is inherited from the mother.

The chromosome 20, however, is inherited from both the father and the mother and is leading some way to explaining why baldness is passed on from father to son. It is suggested from these studies that approximately fourteen percent of men carry both variants.  Knowing this information is a good way to diagnose early if someone is likely to lose their hair, and an indicator for pharmaceutical companies to start developing more effective treatment interventions to re-grow lost hair, or prevent hair loss in the first place with the use of gene therapy.

There is a genetic component to the condition Alopecia Areata, and may be seen amongst several family members in approximately 1 in 5 cases.

Alopecia Areata and a Cochrane Review on interventions relating to this condition:

Green, 2000, describes Alopecia areata as a disorder whereby the hair loss occurs in patches, often oval or circular in shape, with the scalp being very smooth to the touch. Typically it can be multi-focal, and not just occurring on the scalp, but on any other hair bearing parts of the skin and body. The condition can progress on to involve the entire scalp (Alopecia totalis), or both the scalp and the entire body(Alopecia universalis). Estimated numbers of people developing Alopecia areata who then go on to develop either Alopecia totalis, or Alopecia universalis range from 7% up to 30%, of all people with the condition. It accounts for approximately 2% of new cases attending dermatology outpatients clinics in the UK and the USA. Lifetime risk of acquiring this condition, bearing in mind the possible hereditary pattern of this condition is 1.7%. (Safavi, 1995).

The condition can start at any age, although the majority of cases develop before twenty years of age, which is a distressing aspect of the condition, as hair loss is not normally associated with the very young. Both sexes are affected in similar measures, with no known racial predominance of the condition. Alopecia areata has been classified to be an autoimmune type disease affecting genetically susceptible individuals. (Colombe, 1999). The prognostic factors for the condition are, if someone has a family history; if there has been childhood onset; episodes of aggressive hair loss, for example, alopecia totalis, or alopecia universalis; history of atopic disease such as asthma and eczema, or hay fever; or any other autoimmune conditions. People are more susceptible to this condition if they have thyroid disease (particularly hyperthyroidism); diabetes; or vitiligo(a skin disease marked by an absence of pigmentation in the skin resulting in white patches occurring). People with Down’s syndrome are also more predisposed to the condition, and it affects approximately one in twenty people with Down’s syndrome. If any of the pre-mentioned conditions are then combined with other precipitating life events such as physical or psychological stress; trauma; or a serious life crisis, its likely that susceptibility to these conditions may actually increase.

The problem with assessing any hair loss treatment used for this condition is that spontaneous re-growth of hair occurs as a matter of course of this disease, but then in some cases there will be another period of hair loss in the future. Treatments vary, but it is important to say that there is no universal proven therapy to induce hair re-growth and sustain a period of remission. Pattern of hair loss and severity of the condition also varies considerably from person to person making it difficult to make controlled observations. Factors affecting the type of therapy given to individuals is dependant upon severity of hair loss and age of the person, but can also be affected by availability of treatments, personal preference and anecdotal evidence that the individual with hair loss may have heard about.

Treatments considered in the Cochrane Review:

Over the page is a table describing the types of treatments which have been reviewed by the Cochrane skin group specialised register for how to stop hair loss in studies dating between 1982 and 2006. To see full details of this study however the Cochrane online library has a fully printable version of the study. For the purposes of this article an outline only of this study will be mentioned, including a table of results for presentation and a review relating to hair loss treatment Birmingham.

The objective target of this study was the assessment of the effects of interventions used in the successful control of alopecia areata, alopecia universalis and alopecia totalis.

Table describing treatments reviewed by the Cochrane Skin Group:
Research from the Cochrane database
(Ref.:  Information from wiley online library, 29/05/12)

All trials looked at were randomised controlled trials looking at both topical and systemic treatments. The types of participants included in the study were any individuals diagnosed with one of the three conditions by a medical practitioner. Some studies were single therapy studies whereas others were combination therapies, eg., oral medication and light therapy. Outcome measures used for the effectiveness of each of the treatments was: Primary outcome measure of 50% hair re-growth (score of 3) pertaining to a clinically significant improvement.

Secondary outcome measures used were also thought to be very important from the basis that some of these treatments produce side-effects, so the following aspects were examined: Serious adverse events (serious enough to withdraw from treatment); minor participant reporting other adverse issues not requiring withdrawal; long-term sustainability of hair re-growth (classified as greater than 6 months); pattern of hair re-growth; quality of hair re-grown.
Databases investigated to find appropriate research articles to review:

MEDLINE – (from 2003 – Feb 2006) strategy used to search is outlined in the full study

  • EMBASE – (from 2005 – Feb 2006) as above for strategy used.
  • PsycINFO (up to Feb 2006)
  • AMED (Allied and Complementary Medicine) – (from 1985 – Feb 2006)
  • LILACS (Latin American and Caribbean Health Science Information database) – (from 1982 – Feb 2006)

Numbers of male and female participants for each study was noted in the table of results, if not stated in a study then it is stated in the results table. Two of the authors from the Cochrane skin group were responsible for all the data extraction from the studies, which was then checked and entered by one of the reviewers.
The points examined within each study included:

Chart to show points examined in data analysis by the Cochrane review team:
Points examined using data analysis for hair loss
(Ref:  Information from:  wiley online library. )

Results for each particular study, stating which treatment method was used for the alopecia can be seen in the tables below:

Results table for studies reviewed by the Cochrane skin group:
Chart to show the side effects of hair growth therapy
(Ref.:  Information from: wiley onlinelibrary. )

Results table continued for studies reviewed by the Cochrane skin group:
Analysis of hair growth treatment and baldness cure
(Ref.:  Information from: wiley online library. )

Discussion of results:

The majority of studies were so small that it was difficult to conclude if treatments were significantly effective, but it can be said that many of the interventions could prove to have a clinically useful benefit if they were evaluated in a more adequately powered study. This indicates that larger, and better thought out research is required in the future to get a more accurate picture of which treatments work the best for hair re-growth therapy.

Current treatments are based on suppressing the immune system, and do not aim at any permanent changes to the immune system or genetic make-up of peoples, meaning that when treatments stop there is a possibility of disease relapse. With this in mind any long term treatment or cure is unlikely. It may be useful, however, if future research looked more at the possible long term effects of any available treatments as this has not been done to date.

It was thought by the reviewers of the studies looked at that one true measure of a successful treatment would be if the person concerned reported satisfaction with their hair re-growth for a sustained period of time. None of the participants in any of the studies looked at to date achieved this participant orientated outcome, partly because in some studies this was not considered, which points to this being considered a priority in any new research carried out.

With the early stages of alopecia areata, or for anyone with less than twenty five percent hair loss there is a high degree of resolution which means that by using a wide range of participants with varying degrees and length of time suffering with alopecia areata results of studies can be somewhat distorted by the natural course of the condition. New data also suggests that people with the opposite, that is a severe or long term course of disease have a less than ten percent chance to fully recover, and even when there has been a non-response to treatment of one kind, and this is then changed to another form of treatment, response is still considered very poor, as described by Tosti, 1991 and described McDonald Hull, 2003. This points to the need for research in the future that will take this in to consideration, as there was only one study amongst the ones reviewed that only had participants with patchy alopecia areata and in this particular study ‘patchy’ was not clearly enough defined for the study to have real credibility.

The results of this review were in agreement with Epstein, 2001, who stated that there is such a lack of consistent response to any of the therapies that are available, it has lead the Federal Drugs Administration in the USA to not have, as yet, an approved list for the disease. (Olsen, 2004).
With this evidence in mind, it was actually concluded in this review that for some people, at least, with extensive alopecia areata, the wearing of a wig might be a reasonable option.

Side effects of some of the treatments, namely, systemic corticosteroids are potentially serious and so this should be considered when someone is choosing a therapy. Some treatments such as topical steroids and Minoxidil widely prescribed by dermatologists appear to be safe with fewer side effects but with too few good research studies their efficacy is not yet proven. This is not to say they cannot be beneficial to some people however.

Finally, of the studies reviewed, there were a considerable number of participants that withdrew, or were lost to follow-up, and it was concluded from this that any future studies should point out that there is a need for commitment, a certain amount of inconvenience involved, i.e. number of times application of treatment is required on a regular basis, and over an extended period of time, so that participants are completely aware of their part in the study.

Women and baldness:

As described earlier in the text, as well as male-pattern baldness, we see female baldness in patterns, although the genetic link seems to be weaker, and so this condition appears to be less common in women. Also described earlier the disease alopecia areata affects both male and females alike. Apart from these conditions, however, there are some reasons for temporary hair loss in women who are more susceptible than men to some diseases. Some females with this condition may consider a hair transplant for women but this is not always a good idea with Telogen effluvium because of its temporary nature.

Telogen effluvium refers to temporary hair loss caused by the body reacting to certain conditions. The human head has on average 100,000 hairs, each hair developing in a follicle as described earlier, and growing for three years before falling out, when a new one will then grow. 50-100 hairs fall out every day, but for hair loss to be objectively noticeable over half the hair must be lost. In Telogen effluvium hair is shedded but there is usually still good scalp coverage, but in the active phase of this condition, the pull test may be positive, i.e. hair is more easily pulled from the scalp, where later tapered short hair is seen.

Below is a diagram describing changes to the body which may lead to Telogen effluvium, many of which women are more prone to:

Diagram to show body changes leading to the condition Telogen effluvium:
Research results for women suffering from alopecia
(Ref.:  Information only from nhs.uk/conditions/Hair-loss, 22/11/12)

It is important to point out that women are as susceptible to any of the diseases and conditions mentioned on the list drawn up earlier for reasons for hair loss as well as male/female pattern baldness and the condition alopecia areata, for example they are just as prone to hair loss when receiving some cancer therapies for instance. Although one of the treatments for hair loss examined in the Cochrane Review is anti-depressants with the aim of reducing psychological anxiety and thus attempting to restore hair re-growth by reducing stress induced factors, the irony is that certain anti-Depressants but not all have also been linked to hair loss.

LaserComb and Laser Phototherapy for the Treatment of Hair Loss:

Background:

Light therapy for hair re-growth was first discovered in 1967 by a Hungarian scientist, Endre Mester, who had decided to test laser radiation on mice to discover if it induced cancer. The experiment involved shaving the hair off the backs of the mice, and dividing them in to two groups. The one group received low powered ruby laser treatment (694 nm); the control group on the other hand were not exposed to the low level ruby laser treatment.

Surprisingly, what Mester found from this initial experiment is that it not only proved harmless in terms of not causing cancerous growths, he found that the hair on the backs of the treated group of mice grew back more quickly than the untreated control group.

As a therapy, light therapy is actually one of the oldest forms of human therapy. Light therapy actually dates back to the Egyptians, up to 1904, before Mester’s experiment, when another famous scientist, Nils Finsen won the Nobel prize for his work with Ultraviolet (UV) therapy. Lasers and the use of LEDs as a light source for therapy came later as the next step, and it is now applied as a therapy not only for hair re-growth as with Mester’s experiment, but for a wide variety of treatments for skin conditions; musculoskeletal pains; in dentistry for inflammation, and healing ulcerations; in rheumatology and other auto-immune conditions; as well as being used widely in veterinary medicine.

Low Level Laser Therapy (LLLT), is also referred to as ‘cold laser’; ‘soft laser’; ‘biostimulation’; or ‘photobiomodulation’, which may be a little confusing to the lay person, but all the terms are referring to the same therapy. The term, ‘Low Level’ is very important in terms of optimal dose for application on humans, because too low a dose, or indeed too high a dose of light source will diminish the therapeutic outcome, and indeed, particularly with too high a dose, it could have a negative outcome for the client.

This optimum level of light is referred to as the ‘optical window’ for human tissue for red and near-infrared wavelengths, in order to maximise effective tissue penetration of the light. LLLT in animals and people, therefore, almost exclusively involves red and near-infrared light between 600-950 nm, as therapeutic use. (Hamblin, M., 2012).
Over the page is a diagram which attempts to describe the action of red or near-infrared light on the human cells as described in an article by Professor Michael Hamblin of Harvard Medical School, USA..

With reference to the diagram over the page, one of the important theories is that the Redox potential of the cell refers to the oxidation state of the enzyme cytochrome coxidase. The cellular response to red or near infrared light therapy is better when the oxidation state of the enzyme is shifted to a reduced state, ie., not fully oxidised, (and the intracellular PH is lowered).

Since 2002 there has been FDA approval of diode laser treatment (830 nm) for medical conditions such as carpal tunnel syndrome, and following on from this, approval of several light sources similar to infrared heating lamps for a range of musculoskeletal disorders. There has been a move towards longer wavelengths in more recent times, i.e., 800 to 900 nm, and higher output powers (to 100 milli Watts) for therapeutic devices. The exception to this, however, appears to be in therapeutic red light treatment for hair re-growth which tends to be at around 600 – 670 nm.

Diagram to demonstrate the action of red light therapy and near-infrared light therapy within the cells of the human body:
How to stop alopecia with laser hair treatment
(Ref.:Information from Hamblin, M., 2012)

Another important theory is that laser light is preferable to non-coherent light because of the action of laser speckle. Laser speckle provides a rapidly alternating pattern of Energy with varying density and a spatial dimension of approximately one micron. (Hamblin, M., 2012).

Laser therapy research in hair re-growth:

The Mester experiment was done over a period of eleven weeks, and before each light treatment the skin was depilated, and increased growth of hair was seen in the light treated area, as compared to the control groups. There was a pattern of growth noted however, and that was rapid hair growth was seen ( within 4-6 days of treatment growing as lush as other unshaven body parts) up to the ninth light therapy treatment, then after this treatment the irradiated areas stopped growing hair, but instead a peripheral ring of hair growth was noted around the irradiated area.

There has not been a great deal of research on human hair growth, which suggests this should be carried out in the future to ascertain the efficacy of LLLT on hair re-growth. From the research that has been carried out on laser hair treatment to date, there appears to be positive results.

Japanese scientists carried out some research on the ‘Super Lizer’, which is a linear polarised light source providing 1.8W of 600-1600nm of light, in the treatment of alopecia areata. Findings suggested that there was good hair re-growth after patients were treated every 1-2 weeks just for just three minute sessions in 47% of people, compared to non-treated lesions.

Both Spanish researchers and researchers from Finland have been looking at different light sources in both androgenic alopecia (male pattern baldness condition), also alopecia areata, looking at, for example, blood flow to the scalp. A large study has also been undertaken looking at the effects of LLLT on hair growth on the female scalp, by the US Institute of Health, in combination with Erchonia Corporation.
Results of this study are yet to be published, but completion for data collection for this study was set at February 2012.

The study undertook involved seventy women, aged between 18 and 60 years old suffering from female pattern androgenic alopecia, classifications according to the Ludwig and Savin Hair loss Scale; onset within the past five years; progressive thinning over the past 12 months; and skin type as classified by the Fitzpatrick Skin Type Scale.

The research was carried out over a period of 13 weeks, and was a double-blind trial, with placebo controlled randomised evaluation of the effects of the ‘Erchonia ML Scanner(LLLT device).

The primary outcome measure used in this research was, percentage of change in non-vellus terminal hair count across a 3cm diameter scalp area, which had been exposed to light therapy, or not in the case of control groups.

There were several secondary outcome measures looked at, including several scales, as mentioned earlier, and global assessments on new hair growth.

There were several exclusion criteria used in this study to try to narrow down the margin of externally influenced and internal factors which can distort the outcome of this experiment and these are listed below:

List to show exclusion criteria for LLT study looking at female hair loss:
List of exclusions from female hair growth study
(Ref.:  Information only from: clinical trials.gov, 22/11/12)

Theory related to how LLLT may stimulate hair growth:

Peters et al, 2005; and Schwartz et al, 2002, suggest that LLLT influences hair re-growth through the stimulation and increased release of human nerve growth factor (NGF), making it bioavailable. This in turn allows follicular stem cell migration and reconstitution of the lower part of the hair follicle, which is the prerequisite for the hair shaft formation, and may have been shrunken or damaged due to DHT sensitivity.

Secondly, the LLLT, appears to lead to increased levels of the enzyme heparanase, with more recent research associating this enzyme with the healing and immune response repair. This in turn appears to enhance active hair growth, and enable faster hair recovery, discovered from research carried out in to patients who have lost their hair due to the effects of chemotherapy.

Finally, the stimulation and release of activin, which is closely related to protein complexes plays a role in cell proliferation; the immune response, and cell repair as well as hair growth, and although there is not a great deal of evidence at this moment in time that suggests LLLT plays a role in this, it leads the way for further research in the future, and in terms of a therapy. It can be said that from what has been done to date things look positive for this type of therapy. For a consultation and detailed analysis on how low level laser therapy will rejuvenate dormant follicles our hair loss clinic London has clinicians specialising in this type of restoration procedure.

The Lasercomb phototherapy device:

Research carried out by Leavitt, M., et al, 2009, and published on Pub Med looks at some research carried out, describes how to thicken hair, using a hand held laser comb device, known as the Hair Max. This device is a class 3R low level laser device containing a single laser module emulating nine beams at a wavelength of 655nm.

This device works by parting the hair, and each of the teeth on the comb is aligned to a laser beam, the energy is then delivered more effectively to the scalp and not obstructed by any existing hair in the area.

This study took place over a period of twenty six weeks, and was a double-blind randomised trial involving 110 male patients, with androgenic alopecia. The control group used a sham device which was identical to the laser comb, but the laser light had been replaced by a non-active incandescent light source.

Results from this study appear positive, with a significantly greater increase in mean terminal hair density with those using the laser comb, than with those using the sham device. This also tied in with patients own subjective view of hair re-growth over the 26 week period, as compared with the baseline (before commencement of the study).
It was derived from this study that the laser comb device is a highly effective, excellently tolerated and safe device to use. A full copy of this study can be obtained on the Pub Med website for anyone interested to see the whole study, but for the purposes of this article a brief outline only has been mentioned.

A brief look at Alternative Treatments for Hair Loss:

There is not many instances of research surrounding alternative treatments for hair loss with results from an anecdotal point of view appear to be very varied, but with hair transplantation being extremely expensive as an option, and even some of the GP prescribed treatments, such as, Minoxidil, not having consistent results in all the cases, meaning alternatives to these treatments may offer a solution for some people.
Below are a number of herbal treatments which have been reported to prevent, block, hair loss, and in some instances enhanced hair re-growth:

Aloe Vera: This herb has been used for hundreds of years to keep good conditioned hair. One of the options is rubbing the pure Aloe Vera gel in to the scalp every night. Other suggestions is mixing it with other ingredients, such as coconut milk and wheat germ oil as a shampoo. Another suggestion is taking an oral measure of the pure Aloe Gel on a daily basis, approximately 15 mls., as it contains all types of nutrients that have a beneficial effect on hair growth.

Nettle Root Extract: This is more commonly found in health food stores as a capsule. It is said to contain many important minerals, lipids and vitamins, namely vitamin A and C, which together help to boost the activity of hair follicles and stimulate hair re-growth. Used in combination with another herbal preparation, Saw Palmetto Extract, it is said to be more effective.

Saw Palmetto Extract: This herb is believed to inhibit the conversion of testosterone to the DHT which some people are over-sensitive to, and is closely linked with male and to a lesser extent female hair loss. It must be avoided however with females taking the contraceptive pills, or if a female is nursing or pregnant, as there may be contraindications.

Procerin: Has a similar effect to Saw Palmetto Extract. It is available in tablet and lotion form, and is made up of various herbs, making it available without prescription. It again inhibits the conversion of testosterone in to DHT. From the point of view of anecdotal reports it appears to be very effective for many people but not successful for others, with it’s effects being extremely variable according to the individual. It is reportedly most effective on those people in the 18-35 year old category with remaining hair that is actively growing.

Indian Head Massage: The primary association between this therapy and the stimulation of hair growth is that it increases the flow of blood to the scalp region. There by strengthening hair follicles, supplies appropriate nutrients and removes waste build up. The action of this, then improves the functioning of the hair cells, which are able to grow and renew more efficiently. An additional theory is that the massage itself relieves stress, which has sometimes been associated with hair loss. It is common practice in India, for example, to have a routine head massage after each hair cut to promote a healthy scalp and hair growth. As a therapy it appears to be a mixture of acupressure, shiatsu, and massage focussing on the scalp, neck, shoulders and face.

Acupuncture: Again, as with Indian head massage, the key to the effectiveness of acupuncture is stimulating the flow of blood back to the scalp. The small sterile needles are actually inserted in to particular parts of the scalp to improve flow of blood hopefully enhancing hair growth. To date research has shown that this can be effective in improving hair growth, but not to totally reverse or stop hair loss. It is sometimes used in conjunction with Chinese herbal remedies, and as a therapy is not known to cause any adverse side effects to individuals, so from this point of view it is sometimes worth trying if all else is failing.

Lifestyle Changes: Aspects such as change of diet and improving nutritional status by introducing more fresh food in to the diet, such as foods high in vitamins (B-C-D-E), for example, oranges; fresh fish and fish oils; fortified cereals, aid hair health and growth. It is suggested that drinking Green Tea, for example, as opposed to English breakfast tea (Black tea) is healthier because it contains catechins, which are a key inhibitor of DHT, which is associated with hair loss, as described earlier in this article.

To conclude this article it can be said that hair loss is something that affects a large portion of the population, particularly males, suffering with male pattern type baldness. For some, this can be distressing, particularly if it has early onset when the person is in their early twenties and their physical appearance may be a prime focus to them. It is not the only cause of hair loss, however, and there are several other reasons/causes for this loss either temporary, and sometimes, re-occurring as may be the case with diseases such as alopecia areata, as we have already discussed.

There are several ways of dealing with hair loss, such as hairpieces for women; a wig or wearing a hair replacement system. There are more permanent solutions such as FUE surgical procedures but its important to consider the relatively high hair transplant cost. There are also many drugs and preparations discussed in this article used to re-grow hair, or prevent further hair loss. For informative research on FUE surgical procedures refer to hair transplant Birmingham which provides an in depth look at the latest technologies available throughout the UK.

Alopecia treatment looked at in this article, some of which appear effective, also seem to have varying results according to the individual, so it seems that choice is down to the action of the individual, i.e. looking at existing research and weighing up the pros and cons of each treatment, considering anecdotal testimonials, and possibly word of mouth from other individuals experiencing hair loss; price comparisons, for example hair replacement cost; and willingness of the individual to persevere with chosen treatments, as well as arming themselves with the appropriate knowledge of the particular reasons for their own hair loss. For example, if the individual knows that hair loss is temporary, or due to treatment they are having like, chemotherapy, it may affect the way in which that individual will deal with their hair loss, i.e. they may decide just to go for the wearing of a wig to achieve a celebrity hair look, or a hat/scarf until the hair begins to grow back naturally.

Finally, it is important to say that whatever direction the person chooses to deal with their hair loss, it should be one that they feel happy and comfortable to follow, and one that gives them back the confidence and self esteem they may have lost as a result of the hair loss. Not all hair treatments will be effective on all individuals, and it is important that people are aware of this from the onset so as not to instil further disappointment, or loss of confidence.

tricologist suzanne clark at invisihair
above: Suzanne Z Clark, RGN/Dip/BSc

A Review of Current Hair Loss Research