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Hair Loss Common Questions


There are many myths and misconceptions about hair loss. Apart from causing unnecessary anxiety, these are harmful because they may prevent you from seeking proper treatment or cause you to seek ineffective, expensive and, sometimes, harmful ones. Let us examine some questions commonly asked by patients, and, in the process, correct some misconceptions about hair loss and its treatment.

Is hair loss caused by taking a poor diet?
Poor nutrition will certainly starve the hair follicles of essential nutrients and cause hair loss. However, this is unusual in developed countries and those with high standards of living.

In these countries, it is not that we do not take enough food but rather that we do not take a well_balanced meal. We rely too much on fast foods and snacks. Thus, while we may be taking a lot of food, these may be lacking in vitamins and essential nutrients.

Admittedly, few people ever lose hair as a result of poor eating habits, but this does not mean that such habits should be encouraged. On the contrary, if you have hair loss, you should make a determined attempt to ensure that you take sufficient nutrients. You can achieve this by taking a well balanced diet comprising of food from the four main food groups:

  • Milk and dairy products
  • Meat, poultry and fish
  • Cereals and grains
  • Vegetables and fruits

Many people make the mistake of taking specific vitamins, minerals or amino acids. This is unnecessary and may lead to side effects. It is more important that you take a well balanced diet.

Self-imposed starvation or crash diets rather than inadequate nutrition is another cause of hair loss in societies with high standards of living.

Do vitamin supplements help hair growth?
The food we take are complex molecules which have to be broken down into simpler ones before our body can utilize them. This is done by enzymes, and an important component of these enzymes are substances known as vitamins.

Vitamins are essential to life and health. It is not surprising, therefore, that they have been peddled as cures for anything from the simple cold to hair loss. Vitamin B-complex (so called because there are several B vitamins) in particular has been recommended for treating hair loss. Biotin and inositol belong to the B-complex group.

Biotin deficiency has been reported to cause hair loss in animals and there has been a case of a mentally retarded boy developing baldness after taking two raw eggs a day for five years (raw egg white contains avidin, which binds strongly to biotin and prevents its absorption). This has led people to recommend taking biotin for hair loss. However, biotin is present in food items such as Brewer's yeast, liver, kidney and egg yolk and is also produced by intestinal bacteria so that deficiency is most unlikely to occur.

Inositol deficiency has also been reported to cause hair loss in animals and has, likewise, been recommended for hair loss. However, inositol deficiency is also unusual because it, too, is found in the food that we take. Citrus fruits (with the exception of lemon), cantaloupes, beans, grains and nuts are rich in inositol.

The amount of biotin and inositol required is actually very small; taking these specially and in large quantities is unnecessary and may even be harmful.

Vitamin A, for example, is also important for the hair's health. However, excessive intake of vitamin A can actually cause hair loss. The key is moderation, and a well balanced diet ensures the right amount of vitamins without the risk of over dosage.

Do minerals such as zinc help hair loss?
Iron deficiency can cause a diffuse hair loss which can be corrected by taking iron supplements.

Deficiency of other minerals are unusual under normal circumstances. Zinc deficiency may cause hair loss in babies who inherit an inability to absorb zinc, and adults who are on intravenous feeding (feeding through the veins). Normal individuals, however, receive more than enough zinc in the food that they take. Seafood and animal meats, whole grain products, wheat bran and germ and Brewer's yeast are all rich sources of zinc.

Zinc supplements have been given to patients with alopecia areata (patchy baldness), but the benefits are unconvincing. Moreover, the doses required for treatment often cause side effects such as nausea and may interfere with the absorption of other essential minerals such as copper. Generally, mineral supplements are unnecessary. Just take a well balanced diet and rest assured that you will receive all the minerals necessary for hair growth.

Will taking amino acids induce hair growth?
Proteins are important for the growth of living cells, including those of the hair follicle. It is, therefore, important that we take sufficient amounts of proteins in our diets to help hair growth.

A well balanced diet assures you of this. There is no advantage in taking specific amino acids which are merely simpler molecules of protein. Our body makes some of them and acquire others from the proteins that we eat.

Cysteine, a sulphur containing amino acid, is important for the sulphur bonds that give hair its strength and elasticity. It may be found in some over the counter medicines, but there is no proof at all that it helps hair growth.

Taking cysteine or any other amino acid is unnecessary because sufficient amounts of these are found in the proteins that we eat. Proteins from fish, meats, eggs and milk are rich in cysteine.

Does excessive sebum (oil) cause hair loss?
Oiliness of the scalp is due to the secretion of an oily substance called sebum by the sebaceous (oil) glands in the scalp. Sebum production is increased by androgens (male hormones) which both men and women produce. Male pattern baldness is also due to androgens. It is, therefore, not uncommon for people with male pattern baldness to also have oily scalps.

This may have led to the erroneous belief that oiliness causes hair to drop. There is absolutely no truth in the suggestion that hair loss is caused by excessive oil clogging up the hair follicles and suffocating them. The hair follicles do not breathe in the same way as the lungs. They receive all the oxygen they need from the blood vessels in the scalp.

Is hair loss a sign of venereal disease (VD)?
Secondary syphilis, a venereal disease, may cause a patchy ("moth_eaten") alopecia. It was relatively common in the past but this is no longer the case. Most patients with hair loss nowadays do not suffer from it or any other form of venereal disease.

Does dandruff cause hair loss?
Dandruff causes flaking and itchiness of the scalp. It is a very common condition and, not surprisingly, people with hair loss may also suffer from it. However, dandruff does not normally cause hair loss.

Are bald people more intelligent?
There is a belief that deep thinkers go bald because of the heavy traffic of ideas going through their brains. There is no truth in this. You might even know of a few balding individuals with below-average IQs.

Are bald people are more virile?
This, again, has no scientific basis.

Does frequent shampooing cause hair loss?
Using the wrong shampoo can certainly make hair dry, brittle, lustreless or limp, but it will not cause hair loss.

The growing part of the hair-the follicle-lies embedded deep in the scalp, beyond the reach of shampoos. Shampooing does no harm even to people who are losing hair. Indeed, the right sort of shampoo keeps the hair clean, and clean hair looks thicker and healthier. It may even retard male pattern baldness by washing away androgens present in sebum.

How effective are the hair growth restorers and tonics found on department store and pharmacy shelves?
There are a few hundred, perhaps even thousands, such products which claim to help hair grow. As long as there are bald people who believe these claims, you will see these "secret" formulae in shops.

Some of these "work," but only because the hair loss was a self limiting form, or because of what doctors call the "placebo effect." The placebo effect is very well known in medicine. For example, coloured tablets are more "effective" than white ones and some colours are "better" than others.

The more impressive and elaborate the treatment program, the surroundings, the packaging, the advertisement or the more convincing the sales person, the greater the placebo effect.

The placebo effect can be very powerful, but after a while the person will begin to realize that there is no definite sign of improvement-he just feels better but does not look better. Unfortunately, he may have already spent a large sum of money.

The United States Food and Drug Administration or the FDA (the drug regulatory body which. also oversees the sale of over the counter medicines) has been watching the sale of hair growth restorers since the 1970s.

After nearly 20 years, the FDA recently came out with a ruling controlling the sale of these products. It was reported in the newspapers that manufacturers have to provide the FDA with proof of the products' safety and effectiveness before it can be sold as a hair growth restorer in the country. Whether the FDA's action will be followed by other countries remains to be seen.

At the moment, the only product approved by the FDA for the treatment of hair loss is minoxidil lotion. This product has been shown in large scale medical trials to improve male pattern baldness.

Minoxidil is actually a drug used for treating hypertension, but its side effect of increasing hair growth has been exploited for the treatment of male pattern baldness. Being a medical product, minoxidil can only be obtained with a doctor's prescription.

Does brushing or pulling the hair, standing on the head and sleeping head down on a slant board stimulate hair growth?
The underlying rationale of all these methods is to increase blood circulation to the scalp. However, it is the blood flow to the tiny blood vessels in the follicles that is vital to the health of the hair. It is hard to imagine that brushing and pulling the hair can achieve this.

At the very most, they might increase the circulation to the larger blood vessels in the scalp, However, there is already more than adequate blood in these vessels. You only need to get a cut to see how profusely it bleeds!

Common sense will tell you that pulling the hair may be detrimental. Forget about old wives' tale that 100 strokes a day with the hair brush is good for the hair. Brushing the hair helps to spread oil throughout the hair, making it more lustrous. It is fine for people with normal hair but not for those already suffering from hair loss.

Does brushing massage the scalp and stimulate blood circulation?
This is most unlikely, in my view. Brushing would have to be so vigorous to achieve this that it will probably cause more hair loss or even draw blood from the scalp!

What about scalp and neck massage?
There is no definite proof that massage helps hair growth, but this does not mean that massage is not beneficial.

Massage is certainly relaxing and it does a person tremendous good to have someone fuss over their hair. My advice, in this case, is: "If it feels good, have it." But go to a trained masseuse because an incorrectly performed scalp massage may cause hair breakage.

Various tonics and secret ingredients may be rubbed into the scalp during a massage, but I am rather sceptical about their usefulness. I feel that, if anything, it is the massage that helps rather than these things.

Can a professional hairdresser help to disguise hair loss?
Most certainly a good hairdresser can cut and style thinning hair in such a way that it can enhance what is left, or conceal balding areas.

Does wine and brandy help to stimulate hair growth?

Alcohol causes blood vessels to dilate. One old remedy for hair loss consists of rubbing wine or brandy into the scalp. It does not help. Wine and brandy are meant to be drunk, not wasted on bald scalps.

Is taking too much salt or soya sauce harmful to the hair?
It is often said that taking too much salt or soya sauce, which contains large quantities of salt, causes hair loss. This is not true. However, too much salt in the diet does cause hypertension (high blood pressure) in some people and should be avoided.

Does monosodium glutamate (MSG) cause hair loss?
MSG is a flavouring agent commonly used in Chinese cooking. It causes the Chinese Restaurant Syndrome, so named because it was first reported in people who had eaten in Chinese restaurants. This consists of headaches, dizziness, burning sensation in the extremities and chest pain, but not hair loss.

Does wearing hats cause hair loss?
Bald people often wear caps and hats to conceal baldness. This may have led people to believe that they cause hair loss. This is incorrect. Tight hats and caps may sometimes cause hair breakage from friction but not true hair loss.

Is swimming pool water bad for hair?
Chlorine, used for treating water in the swimming pool, softens the cuticle (the outer layer of hair), making hair drier and more brittle. Hair breakage may occur but not true hair loss. This can be avoided by wearing a water-tight cap during swimming or washing off the chlorine thoroughly and using a conditioner afterwards.

Does shaving the scalp stimulate hair growth?
This again has no basis at all. In a 1970 issue of the Journal of Investigative Dermatology, an article entitled Shaving and Hair Growth reported that two doctors, Y.lo Lynfield and P. MacWilliams, have actually studied the effects of shaving by getting volunteers to shave only one leg regularly, and have observed no difference in the weight of hair produced, the thickness (diameter) of hair or the rate of growth between the shaven and unshaven sides.

Does masturbation and excessive sex cause hair loss?
Such beliefs were probably started to discourage young people from engaging in masturbation and promiscuity. There is no basis at all that they cause hair .loss.

What should I do if I suspect that I am losing excessive amounts of hair?
Some types of hair loss are temporary and require no treatment while others need to be treated early to prevent permanent hair loss.

Only a doctor can diagnose your problem with certainty. If there is no treatment, he will tell you. It is better to learn the sad truth early than learn it after you have spent nearly all your savings unnecessarily. You can see your family doctor or a dermatologist (skin specialist). Hair is a part of the skin and dermatologists are the people who can give you excellent advice in this area.

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