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Crowning glory: treating hair loss

By Sasa Jankovic

Millions of men and women in the UK suffer from hair loss. A recent survey on behalf of Regaine found that almost half (49 per cent) of pharmacists are asked for advice on hair loss at least once a month.

According to Marilyn Sherlock, chairman of the Institute of Trichologists, there are at least 50 different reasons for hair loss or “alopecia”. She says: “These are mainly due to a person’s genetic inheritance or hormonal changes. Age is not a factor and, as yet, hair loss caused by stress is unproven — although physical stress such as an injury to the head or scalp could cause hair loss in the affected areas.”

But when does normal shedding of the hair become a cause for concern? Warren Vaheeswaran, director of the Landmark Lifestyle London hair replacement clinic, says: “It is normal to lose between 50 and 100 hairs per day from the scalp, and of the 100,000 hairs on your head, you need to lose about half before it’s noticeable.”

Hair loss of one form or another is estimated to affect nearly 30 per cent of men before they reach the age of 30 years, and 50 per cent of men over the age of 50. It also affects many women and in each case has different causes.

Androgenetic alopecia

Androgenetic alopecia, or male pattern baldness, is the most common form of hair loss in men and leads to hair loss on the top and sides of the head. The causes are still not completely understood although it is widely thought to involve hormonal (androgen) and genetic causes.

Female pattern hair loss

“Female pattern hair loss is generally genetic and leads to hair loss on the top and sides of the head, due to lowering of oestrogen levels,” says Ms Sherlock. “It is also seen in younger women with polycystic ovary syndrome and if this is treated the hair loss can be reversed.” Women can also be affected by androgenetic alopecia.

Traction alopecia is another form of hair loss experienced, most commonly, by women, as Toby Cobbledick, brand manager of the Nanogen range of products for thinning hair, explains. He says: “This occurs due to physical strain on the follicle from being pulled by tight ponytails, braids and hair extensions. The thinning can be reversible if the problem is identified early, but traction alopecia can cause permanent loss.”

Alopecia areata

Alopecia areata is patchy areas of baldness that can join up, and is caused by an autoimmune disorder for which there is no known cure. It commonly rectifies itself in time.

Teenage hair loss

Teenagers and young adults can often experience excessive hair shedding, according to consultant trichologist Iain Sallis, who believes the triggers can include a febrile illness, emotional trauma such as exams, or even lifestyle changes — for example, swapping to a strict vegetarian diet.

He says: “The onset is usually between six weeks and four months after one of the triggers and, although this type of hair shedding is very stressful and severe, the problem does usually rectify itself after approxi-mately six months, and the loss is rarely permanent.”

What can prevent these conditions?

Ms Sherlock says: “There is not really any way to prevent hair loss, but if your customer begins to notice it the best thing to do is refer him or her to a trichologist, who will be able to give the most appropriate advice.”

David Kingsley is a trichologist who has studied the hair and scalp for over 30 years. He agrees that the first thing to do is find out why the hair loss is happening, saying: “Tell your customer to seek a specialist and make sure they are tested for all the most common causes of hair loss, such as thyroid problems, anaemia or iron deficiency. Even if genetic hair loss is the most obvious reason, other factors that could be contributing to hair loss or making it worse, should be explored.

“Once the causes of hair loss have been ascertained, try to correct what can be corrected. I invariably suggest a multi-treatment approach to hair loss, as the more things you do, the faster and more likely you are to see results.”

OTC treatments

The multi-treatment approach is also recommended by Bessam Farjo, medical director of the Institute of Trichologists and co-founder of The Farjo Medical Centre, who says: “Although hair transplant surgery is the only method guaranteed to restore hair in bald or thin areas, it is important to try to slow down and, hopefully, stop potential future hair loss. This can be achieved using one, or a combination, of medicines. With any medicine, continuous use is needed to maintain the benefits. Results should be apparent after six to eight months of use but may take longer.”

Ms Sherlock recommends minoxidil — commonly sold under the brand name of Regaine by McNeil Healthcare (UK) Ltd — adding: “This is the only OTC treatment that helps men and women who are losing their hair retain the hair they’ve already got — and I say this because I’ve seen the evidence that it works.”

However, Dr Kingsley suggests some other OTC treatments that might help. “The herb saw palmetto is often suggested as a treatment for genetic hair loss,” he says, “although there is disagreement about its effectiveness as some studies indicate that it may help reduce genetic hair loss while others suggest it doesn’t. Then there’s Nourkrin, which contains natural ingredients and has been clinically proven to help thinning hair. Topical niacin (vitamin B3)-based products such as nicotinic acid may also be beneficial, with a study concluding a statistical improvement in the hair growth of women using a topical niacin solution when compared with a control group.”

There are also shampoos and other products that can make hair appear thicker, which can be of some use, as Mr Cobbledick explains: “A new option in the market is a hair growth factor serum. It uses selected cytokines (growth factors) identical to the human ones which regulate hair growth and survival. Adding these topically marginally increases the natural levels, increasing hair growth and survival. Its mode of action also creates the potential to speed up pre-existing recovery from any form of alopecia — although this has not been tested at this time.”

Other advice

Aside from OTC products, there is plenty of general health advice that you can give customers dealing with hair loss, as Ms Sherlock points out: “Hair should be washed daily with a product appropriate to the person’s hair type, and keeping fit also helps because a person’s general level of health shows in their hair. Advise them to eat a well balanced diet because without that hair doesn’t grow well.”

“Telling your customer that they’re not alone is the best advice you can give them,” according to Mr Cobbledick. “In spite of statistics showing a surprisingly high incidence of hair loss, it is still a taboo subject and most people don’t realise how common it is or how much support is available. Charities such as Alopecia UK and forums such as exist specially for people with thinning hair.”

John Davies, the founder of the blog, agrees, saying: “There is no cure for baldness, and simply halting any further loss should be seen as a success. I always say the best way to cope with hair loss is to accept and ideally, embrace it, but persevere with a dedicated regimen and good results can be gained.”


“The treatment which can produce the best regrowth of hair (excluding hair transplants) is finasteride, available on private prescription in the UK under its trade name Propecia,” says trichologist and cosmetic chemist Tony Maleedy.
The action of finasteride can be impressive, with the first effect being a reduction in hair loss of up to 90 per cent, usually within a month or two of starting the treatment. Within six months approximately 50 per cent of men will have new hair growing, usually on the periphery of the thinning regions.

Within 12 months the regrowth can be considerable over the entire region. Many people find that the combined effect of taking finasteride and using a treatment applied to the scalp has the best effect.

More information

  • Regaine health professional website:
  • NHS Choices: Pages/Introduction.aspx
  • Institute of Trichologists:
  • Farjo Medical Centre
  • Alopecia UK

Citation: Community Matters URI: 11103559

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