Balding: Causes, Symptoms And Treatments

How often have you noticed clumps of hair on your comb? If your hair has been thinning beyond normal level (above 100 hair strands), or if parts of your scalp are visible, it could be a sign of balding.

Before you panic, let’s tell you that balding is very much preventable and treatable today. You just need to know the signs of balding and understand all the different treatment options that are available. Let’s dig deep.

Highlights:

• What Exactly Is Baldness?
• Does Hair Thinning Mean Balding?
• At What Age Does Balding Start?
• What Are The Causes Of Baldness?
• Balding Treatment Options
• Tips To Prevent Hair Loss
• How Long Does It Take To Go Bald Once Your Hair Starts Thinning?
• How Is Baldness Diagnosed?
• Can Hair Be Regrown On A Bald Head?
• Does Shaving The Head Make The Hair Grow Back?

What Exactly Is Baldness?

Baldness is a condition with excessive hair loss or areas on your scalp where the hair has fallen off completely. Absence of hair all over the scalp is known as complete baldness.

Every person loses an average of 50-100 hair strands on a daily basis [1], which is normal. Only when you lose more hair, and the rate of hair fall is greater than that of new strands growing, it is termed as balding. Male or female pattern hair loss, and androgenetic alopecia are also referred to as balding.

Does Hair Thinning Mean Balding?

Hair thinning may not always mean balding. Sometimes, the hair shaft grows out thinner than before. Hair thinning can happen for both men and women, but the pattern in which the hair thins out differs in the two genders.

In the case of men, it starts with a receding hairline. WIth women, it is usually seen on top of the head just behind the hairline.

In both cases, other causes determine whether hair thinning will lead to balding. Factors like diet, lack of sleep, health issues, lifestyle issues and medical conditions may change the hair to grow out finer and thinner than before.

At What Age Does Balding Start?

Men usually start losing hair in their 20s. It varies from case to case though. There is no fixed age when balding starts or how long it takes to go bald.

At least 25% of men [2] who have hair loss due to genetics, start to go bald before they turn 21 years of age. Women usually experience hair thinning after menopause. Statistics show that more than 50% of women also go bald [3].

What Are The Causes Of Baldness?

Balding can be due to several causes. The most common cause of balding is androgenetic alopecia, which is also known as male pattern baldness for men and female pattern baldness for women. According to the American Hair Loss Council, it is the cause for 95% of balding [4].

Androgenetic alopecia is a biological condition that is connected with the ageing process, inherited due to genetics and the male hormone known as androgen. If it is inherited, it implies that your genes affect important enzymes such as 5-alpha reductase, which is responsible for converting testosterone to dihydrotestosterone [DHT].

Increased levels of DHT makes the hair follicles more sensitive and they start shrinking, which can lead to baldness. Here are certain lifestyle choices that may increase DHT production and can increase the hair loss depending on your sensitivity levels:

1. If you smoke

2. Take creatinine supplements or anabolic steroids

3. Do resistance and weight training exercises

4. Are undergoing testosterone hormone replacement therapy

5. Are stressed

There are other conditions too that may cause severe hair loss. But they don’t follow the pattern typically associated with balding. Some of these conditions cause permanent hair loss while others are reversible:

• Alopecia areata [5] is described as an autoimmune disease. Here the body attacks its own hair follicles and can damage the roots. Hair loss occurs in a manner where it may or may not grow back. It can affect both genders and even children of all ages.
• The condition where you lose all the hair on your scalp is known as alopecia totalis.
• Traction alopecia is caused by stress and tension caused to the hair due to certain hairstyles. Corn rows, hair extensions, very tight braids or ponytails can cause traction alopecia or hair falling out due to frequent and repeated tension or being pulled back too tightly. If controlled earlier, it is reversible; and irreversible if not discontinued.
• Anagen effluvium [6] is a condition usually connected with chemotherapy or radiation therapy and certain drugs. Here, the toxins associated with these therapies damage the hair follicle while it is still at the anagen phase. The balding is sudden, but is reversible.
• Telogen effluvium [7] is hair loss that is caused due to trauma or severe stress. Surgery, illnesses like viral fever, sudden weight loss and physical trauma like an accident can cause this condition. It is reversible and hair can grow back within six months.
• A condition where fungus causes scaly patches on the scalp and can lead to permanent baldness if not treated immediately is known as Tinea capitis or ringworm of the scalp.
• Side effects of other medical conditions can also cause excessive hair loss. Balding is associated with nutritional deficiencies, hypothyroidism, hyperthyroidism, anaemia and iron deficiencies as well as a low protein diet.

Balding Treatment Options

There are several treatment options for balding, some of which are cosmetic and some are based on technology. Medicines to slow or reduce hair loss and to promote regrowth of hair are also available. Some of the treatment options are given below:

1. Hair Transplant

This mode of treatment involves a surgery, where the surgeon will remove existing hair, mostly from the back of your head and reinsert it into the bald patches on your scalp.

2. Scalp Expansion [8]

This surgical procedure uses a balloon tissue expander to stretch out sections of the scalp and even the forehead. The expander is inserted under the scalp in a surgical procedure and filled with saline for four to ten weeks. The stretched tissue is used to cover bald areas of the scalp as it usually contains hair.

3. Flap Surgery

This is a surgical treatment option for baldness. A flap of skin is removed from one part of the scalp that has hair and added to a bald area to give that area hair instantly. If there are any gaps left between flaps, they are usually touched up with hair transplants or scalp reduction surgery.

4. Scalp Reduction

A surgical procedure where the surgeon removes skin from your scalp which has hair on it to areas which doesn’t is known as scalp reduction surgery. An option available to both men and women, it is commonly used to cover bald patches on top of your head.

5. Laser Therapy

Laser therapy is used to treat male and female pattern baldness. This technique uses low energy light pulses, which stimulate hair follicles.

6. Protein-Rich Plasma (PRP) Injections

This treatment takes platelets from your blood in concentrated form and injects into areas of your scalp where there is hair loss. This protein-rich plasma (PRP) treatment may help promote hair growth and is often used to treat androgenetic alopecia.

7. Medications

There are several medical formulations which are known to promote hair regrowth and slow down the balding process. One of the best known ones is Minoxidil or Rogaine. It is a topical OTC prescription formulation that can be used by men and women to increase hair regrowth.

Spironolactone is also known as Aldactone and it is prescribed mostly to treat balding in women. This formulation prevents DHT from affecting the hair follicle by reducing the production of androgen in the body.

Finasteride is a prescription medication that is mostly prescribed for male pattern baldness. It also slows down the hair loss and promotes regrowth of hair.

8. Right Nutrition

According to studies [9], women who are experiencing severe hair fall and bald spots, should increase their consumption of antioxidants and omega 3 and 6 fatty acids as they may help promote hair regrowth.

9. Home Remedies

You can try some of the home remedies listed below to prevent hair loss or slow down the balding process. Some of these treatments may also promote regrowth and thicker hair.

A. Aloe Vera

A traditional remedy for hair loss is aloe vera [10] which is known to soothe the scalp and also work as a hair conditioner. It can also help to reduce dandruff and clear out any blockages in hair follicles due to excess oil secretion.

B. Hair Oils

You can choose from a variety of oils that can be massaged into your scalp to promote regrowth and prevent hair loss. Rosemary, coconut, geranium and lemon oils have different qualities that can help hair to become healthier.

Coconut oil [11] has fatty acids that can penetrate the hair shaft and prevent the loss of protein from our hair giving it shine. If your hair is oily, apply and leave it on overnight. If it is dry, you can apply coconut oil after shampoo as a leave on treatment option.

Rosemary oil [12] helps reduce hair loss and promotes hair regrowth. It can be used to treat androgenetic alopecia. You can mix a few drops of rosemary oil with a carrier oil and massage it into your scalp; or it can be mixed with your shampoo and conditioner.

Geranium oil [13] helps hydrate your hair and make it stronger. It also improves hair growth and blood circulation to the scalp. Essential oils can’t be used directly on the hair. You can mix a few drops with a carrier oil and massage or mix it with your shampoo and conditioner.

Lemon juice or lemon oil [14] can improve the health of your scalp and promote hair growth. Lemon oil may be mixed with a carrier oil and applied. If using lemon juice, apply it to your scalp and hair and leave it on for 15 minutes; then wash off.

C. Massage

This age old remedy of massaging the scalp can do wonders for your hair. You can even gently massage your scalp without any oils to stimulate blood circulation. Massaging [15] can reduce stress, promote hair growth and thickness in the dermal papilla cells.

D. Onion Juice

Onion juice, according to studies [16], promotes hair growth and effectively treats alopecia areata. It Improves blood circulation to the cuticles and promotes keratin production. Puree a few onions, squeeze the juice. Apply it to your hair and scalp, leave on for 15 minutes and wash off.

E. Fish Oil And Ginseng

Including fish oil that contains omega 3 and omega 6 fatty acids can help to improve the quality of your hair by providing it with nutrients from within. It can help make the hair thicker, prevent hair loss and boost immunity.

Ginseng [17] contains ginsenosides, which help to stimulate hair follicles and promote hair growth. It can be taken as a supplement, but only with a doctor’s guidance.

10. Hormone Therapy

In some cases, HRT or hormone replacement therapy, where oestrogen and progesterone are introduced into the body, may also help in slowing down hair loss and prevent baldness.

Tips To Prevent Hair Loss

• Don’t tie your hair too tightly. Cornrows, tight braids and ponytails can stress your hair follicles resulting in hair fall.
• Avoid gizmos that heat your hair. Curling irons, hair straighteners and hair dryers can cause damage to the roots of your hair.
• Give your scalp a massage, preferably with coconut oil. Regularly massaging your scalp improves blood circulation and may even help to promote hair growth. Massage gently and do not stress the follicles of your hair.
• Maintain a healthy balanced diet so that you don’t lack the nutrients that give you healthy hair.
• Stop smoking as studies have shown a link between hair loss and smoking [18].
• If you are undergoing chemotherapy, wearing a cooling cap may help prevent or reduce hair loss after the therapy.
• If you feel that your hair is falling as a side effect of some medication, consult your doctor.

How Long Does It Take To Go Bald Once Your Hair Starts Thinning?

It can take anything between 5-25 years for a person to go completely bald. Hair thinning might start earlier, but the balding doesn’t follow a set pattern and differs from case to case. One person may lose all his hair in a few years, while another may lose it after two decades.

How Is Baldness Diagnosed?

There are several ways in which a dermatologist will diagnose your hair loss patterns and confirm whether you are going bald or the hair fall is due to some other cause.

The type of hair loss is assessed visually by examining the pattern in which the hair is falling. Sometimes a measuring tool is used to magnify the scalp at least a 100 times and then examined.

If there is an ailment or health condition that is causing the hair fall, a scalp biopsy, a blood test to check for iron deficiency/thyroid and even a test for fungal infections may be conducted.

Your lifestyle habits such as your hairstyles, diet, exercise routines, family history of baldness and pre-existing health conditions may also be questioned.

A dermatologist may conduct a pull and tug test to check the hair loss. In the pull test, the doctor will hold small sections of your hair from all over your scalp and give a gentle pull. If more than 6 or 7 strands fall out, it is considered as active hair loss.

In the tug test, he or she will hold a section of your hair with both hands -- one placed near the root and one hand placed near the tip of your hair. A tug will indicate whether the hair is brittle or fragile, if the strands break in the middle.

A card test may also be conducted to check how healthy the hair shaft is and to evaluate the growth of new hair. The dermatologist will part your hair and place a felt card that is rectangular, against your scalp.

It will show the new hair strands -- even the very tiny ones or the broken ones and they can be counted. If your hair is very thin, it indicates you may have telogen effluvium, and short strands that have broken tips may be a sign of an abnormality in the hair shaft.

To diagnose for yourself if you are going bald, you can check whether your hairline on your forehead is forming a pattern like the letter M. You may find the hair on your temple receding backwards.

You can hold a mirror to your crown to check if you have any bald spots there or whether the hair is thinning out.

Can Hair Be Regrown On A Bald Head?

If the baldness is due to alopecia, it is known to be practically incurable. However, some research indicates that the skin on the head of someone who is bald may have hair cells just like those with hair on the head. But, these cells no longer have the ability to grow hair.

Does Shaving The Head Make The Hair Grow Back?

No, shaving your hair does not lead to faster or thicker hair growth. It does not help with growing hair on a bald scalp either. This is a myth because when new hair grows after shaving, the rough base of the hair is visible. The thinner part of the shaft is only visible when it grows.

If you shave off the hair on your head, it will help to remove all the damage that has been caused by colouring the hair. Since hair grows from within the scalp, the condition of your body and the follicles will determine the health of the hair that grows back.

Any new hair that grows back after shaving your head bald will be exactly like the hair you shaved off. Shaving the head bald will also not speed up the growth of the hair.

Wrapping Up

Balding is a very common phenomenon that affects both men and women. Unless it is genetic, there are surgical and non-surgical ways to correct it. Preventive measures and lifestyle changes can also help slow down the balding process. However, remember that if you sport your bald look with confidence, you will always look great!

Begin By Knowing Your Skin