Tips for Thicker Hair

By Gabriel Espinoza, MD

September 09, 2022

Thinning Hair

Thinning hair is a common occurrence that happens to both men and women. For some, this process starts earlier in life than one would expect, normally after middle age. The main contributors to this process are hormonal and genetic factors. Whether it is hair thinning or hair loss, we’ll review the causes, symptoms, treatment, and offer some self-care tips to continue to have luscious hair.

Signs of hair loss

Hair loss or alopecia can affect your scalp and your entire body. Alopecia can be temporary or permanent, with genes, hormones, medications, medical conditions, and aging all having a role. If you are experiencing hair loss, some of the signs that you may first notice include:

  • Gradual thinning of the hair on your scalp
  • Bald spots with slow hair growth
  • Receding hairline or a widening part
  • Less fullness of your ponytail if you have long hair

Most of the time, when we think of hair loss, we think of male pattern baldness, which can also impact women. In this condition, hair loss occurs gradually with hair thinning first before any hair loss proceeds. Sometimes hair loss can be sudden and dramatic. Some of the signs that occur include:

  • A bald patch occurs within a couple of days.
  • Clumps of hair fall out when you comb or brush your hair.
  • All or most of your hair falls out from your scalp.

Other symptoms that some experience with hair loss include burning or stinging on the scalp before sudden hair loss, sudden itching, tenderness, scaly bald patches, blisters, redness, swellings, and even pus. These can be seen in infection, chemical burns, and at times rheumatological conditions like psoriasis.

Hair thinning vs. hair loss

Hair thinning occurs gradually over time and is an example of androgenic alopecia, which appears with a receding hairline and develops the characteristic “M”-shaped hair associated with male pattern baldness. Alopecia refers to hair loss, and androgenic means relating to male hormones, testosterone, and dihydrotestosterone. The presence of the male hormone testosterone affects the hair follicles, making them shrink, leading to thin hair and increasing the time it takes to grow new hair, which leads to thinner and brittle hair.

Hair loss, on the other hand, is sudden and usually due to immediate external or internal factors. According to the American Academy of Dermatology, many conditions can lead to immediate hair loss. Some of these include:

  • Alopecia errata, where the body’s immune system attacks its hair follicles, leads to hair loss anywhere in the body
  • Chemotherapy or radiation treatment since the hair follicles have normal functioning rapidly dividing cells; unfortunately, rapidly dividing cells are normally targeted by these treatments for cancer, and hair follicle cells are sometimes affected by these treatments
  • Stressors like illness, the death of a loved one, or even childbirth
  • Excess hair cosmetic treatments like perms or relaxants that can damage your scalp by causing chemical burns, leading to the destruction of hair follicles
  • Traction alopecia or hairstyles that cause excess tension in the hair
  • Fungal infections like tinea capitis that can affect the hair growth in certain parts of the scalp until the infection is treated
  • Endocrinological and metabolic conditions like thyroid problems, or if you are deficient in vitamins and minerals like biotin, iron, or zinc
  • Pulling your hair in times of stress in conditions like trichotillomania

Associations of male and female pattern baldness

Male or female pattern baldness, known as androgenic alopecia, is a type of baldness that affects the temples and mid-frontal scalp. It can impact a person’s self-image and lead to anxiety and depression in people affected by it. Genes account for 80% of the predisposition to it, a progressive condition.

Male pattern baldness in young men was associated with increased levels of cholesterol, high blood pressure, and an increased incidence of heart attacks in men with vertex balding compared with frontal balding. Vertex balding is when men or women experience hair loss from the crown of the scalp as opposed to starting in the forehead of the temples.

Hormones play a big role in male pattern baldness, particularly testosterone. Yet, studies have failed to show the type of testosterone that contributes to male pattern baldness since measuring blood levels of androgens, testosterone, dehydroepiandrosterone (DHEA), and free testosterone has failed to demonstrate a direct association of which hormone is directly responsible for male pattern baldness. Studies have shown that the mere presence of any metabolite of testosterone for some may be sufficient to lead to male pattern baldness, and this depends on genes.

Women with androgenic alopecia tend to have normal periods and pregnancies. Testing is reserved for women who have a history of infertility. Hirsutism is a condition in women that results in the growth of dark, coarse hair in a male pattern fashion on the face, chest, and back. Other conditions that can be seen in women who suffer from female pattern baldness include polycystic ovarian syndrome (PCOS), menopause, vitamin D deficiency, and genetics, which tend to play a big role in both men and women.

Prevention and treatment

Your genetics play a huge role in hair thinning and hair loss, like male-pattern baldness and female-pattern baldness. You cannot prevent this type of hair loss, but you can try to delay the onset of this type of baldness.

First, be gentle with your hair. It plays a huge part in your identity. It's important that you ensure that you use hair products that will not irritate or damage your hair, such as hot rollers, curling irons, perms, and relaxants. Avoid tugging when brushing and combing your hair, especially when your hair is wet. Limit the amount of tension you place on your hair from styles that use rubber bands and braids.

Some medications have been approved by the Food and Drug Administration (FDA) to treat pattern baldness. These include finasteride (Propecia®), which can slow the hair loss process and even stimulate hair regrowth. This medication can take a year for patients to see a difference, and it works best when you first start to notice symptoms of male pattern baldness, mainly since hair growth can be a slow process.

For women with female pattern baldness, spironolactone (Aldactone®) is a medication that may be prescribed. This medication can help stop hair loss and increase hair thickness. If you are a woman taking this medication or of reproductive age, it is important to use some method of birth control since this medication has been shown to cause birth defects.

If your hair loss is sudden, make an appointment with your health care provider, as there may be treatments that can reverse some of these conditions. For Tinea capitis, a fungal infection of the scalp, you may be prescribed an oral antifungal called griseofulvin (Gris-PEG®) for 4–8 weeks. Other medications can also be itraconazole and fluconazole in addition to antifungal shampoos. If your baldness is due to a thyroid condition, your physician can prescribe medication to help regulate your thyroid hormone.

If your hair loss is due to stress or anxiety and you are diagnosed with trichotillomania, there is treatment available that will help reverse the signs or symptoms of this condition. Behavioral treatment will be key, and a proper evaluation will be important to rule out other psychological conditions like obsessive-compulsive disorder. Antidepressant medications like fluoxetine (Prozac®), sertraline (Zoloft®), paroxetine (Paxil®), valproate (Depakote®), and bupropion (Wellbutrin®)are some of the medications that can help.

Some may need a boost of self-esteem since baldness in western countries can affect your identity and self-esteem. While it will not slow hair loss or help you regrow hair, wearing a wig or concealer can offer immediate results. Some wigs can be custom-made, and there are endless choices if you need a quick solution.

Make sure that you have professional help when choosing a wig or concealer. If you are prescribed a medication for hair loss, make sure to use your prescription savings card to get the best price. Your local pharmacist can also help you find available discounts if you are prescribed a medication for hair loss.

How to get thicker hair

You are what you eat. Eating a healthy diet filled with greens, protein, and healthy fats will provide all the vitamins and minerals you need to continue having healthy, luscious hair. Suppose an evaluation by your healthcare provider shows a deficiency in biotin, iron, zinc, or vitamin D. In that case, your healthcare provider can recommend supplementing with the respective over-the-counter supplement that you are deficient in.

You should only supplement with the nutrient you are deficient in since taking more than the recommended amount for some, like iron, can cause stomach irritation. Use gentle hair products that will clean and condition your hair while adding volume to it.

Consult with a dermatologist who can offer various tips on hair care if you are suffering from hair loss. Lastly, take care of yourself and find healthy ways of managing stress and anxiety, such as exercising, attending social gatherings, being part of help groups, therapy, and, if recommended by a health care provider, taking medications.

References:

  1. https://www.aad.org/public/diseases/hair-loss/insider/begin
  2. https://medlineplus.gov/genetics/condition/androgenetic-alopecia/#:~:text=Androgenetic%20alopecia%20is%20a%20common,a%20characteristic%20%22M%22%20shape
  3. https://www.aad.org/public/diseases/hair-loss/causes/18-causes
  4. https://www.ncbi.nlm.nih.gov/books/NBK278957/
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4812885/
  6. https://www.jidsponline.org/article/S0022-202X(15)52936-9/fulltext
  7. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
  8. https://www.ncbi.nlm.nih.gov/books/NBK536909/
  9. https://adaa.org/learn-from-us/from-the-experts/blog-posts/professional/trichotillomania-facts-and-treatment
  10. https://www.aad.org/public/diseases/hair-loss/treatment/tips
  11. https://www.aad.org/public/everyday-care/hair-scalp-care/hair
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