All About Hair and Hair Loss
In This Chapter
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Getting to know your hair and why you have it
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Acknowledging causes and the personal impact of hair loss
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Considering temporary and permanent solutions
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Looking forward to future developments in the field
you may wonder how we can write an entire book on the topic of hair loss. You may think hair loss is an incurable condition,
so what is there to say about it? But hair loss doesn’t have to be inevitable, even if your whole family is balding or thinning. You can take steps to slow hair loss and replace the hair you’ve lost.
In this chapter, we introduce some facts about hair loss, including who may experience it and, best of all, what your options are when you start to feel air on the top of your head.
Who Cares About Hair? Everyone!
Even people who don’t pay much attention to their hair care when it starts to thin or fall out. You may feel somewhat betrayed: You’ve been kind to your hair, bought expensive shampoos, and kept up with regular maintenance, and this is how it rewards you — by falling out?
We take our youth and our hair for granted as long as we have them. Then, certain things happen as we age — we sag, gain weight, lose muscle tone — and we may not like them, but we know we could fix them by exercise, diet, and lifestyle changes — not that we will, necessarily, but we feel we could if we wanted to. In other words, we still feel like we have control.
And then there’s hair. At least every month, in the case of most men, we face our hair in the mirror at the hair salon, where for some reason the situation always looks more dire than it does at home.
“Is there as much hair there today as last month?” you ask your- self. “That hair in the sink, in my shower drain, on my brush. Am I going bald?” As your hair starts to disappear, you feel helpless because you’re at the mercy of your hair; you can’t control its fall- out any more than you can control the weather. To a young man of twenty-one a receding hairline can seem like the end of the world.
Is it really hopeless? Of course not! If you’re just starting to lose your hair, there are many things you can do to slow its loss; if you’re bald already, there are still options to replace your hair or cover up your bald pate. This book will help you, no matter what stage your hair loss is in.
Hair 101: What exactly is hair?
Most people have no idea what really lurks beneath their hair, unless they’ve been shaving it off already.
For something that you play with, obsess over, color, cut, and twist into odd shapes, hair is surprisingly dead. Yes, the hair you think looks so vibrant and alive is actually not alive at all. I’m not saying that you should ignore or mistreat your hair. For something that’s dead, hair is quite capable of responding to good treatment or bad.
Hair is technically part of your skin, although like fingernails and toenails, it grows and separates from your skin. The average head contains around 100,000 hair follicles, and your entire body is home to around 5 million hair follicles. Most of the complex activity that keeps your hair growing goes on below the surface.
The active growth phase of a hair follicle, called the anagen phase, averages around three years. At any given time, about 90 percent of your hair is in the anagen phase, and the other 10 percent is taking a rest in the telogen phase, which is the resting phase, and disappears from your head.
Hair grows about 1⁄2 inch a month (although it certainly seems like more when you need a haircut!) and grows to a length of 11⁄2 to 3 feet before growth stops and the hair falls out. (In Chapter 2, we tell you all you ever wanted to know about hair, right down to its roots.)
Hair 102: Why do we have hair?
Hair is more than just a pretty cover up. It serves many biological functions and actually covers most of your body (often growing in places you’d rather it didn’t).
The functions of hair (both on your head and elsewhere on your body) are that
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It protects your head.
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It keeps you warm in the winter and cool in the summer.
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It protects you against sunburn.
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It has nerve endings that serve to make a scalp massage feel good, yet tell you when a mosquito has landed on your arm to bite you.
Hair and ethnicity: How race impacts hair
What your hair looks like is directly related to the genes you received from your parents. There are some hair generalities related to different racial groups, although your individual hair traits will vary. Many people’s gene pool today is pretty diverse! (See Chapter 2 for much more about hair and ethnicity.)
However, the following generalities apply:
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Although it appears that many Caucasians have thinner hair than other ethnicities, Caucasians actually have the highest number of hairs on their heads, an average of two hundred hairs per square centimeter.
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Asians have the thickest and coarsest hair, which makes it appear as though they have more hairs on their head. They average a hundred and fifty hairs per square centimeter.
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African Americans have the thinnest and the finest hair, but because it mats together more than Caucasian or Asian hair, it appears thicker. African hair averages a hundred and thirty hairs per square centimeter.
You’re Not Alone: Dealing with Causes of Hair Loss and the Personal Impact
When you’re going bald, you may feel like you’re the only one. It seems like every commercial on television features hair wafting gently in the breeze as tanned youngsters run across the beach;
you may not have the tan or the body, but those are at least theoretically obtainable, whereas lost hair seems to be just that — lost youth forever.
You’re not alone, though; hair loss affects over 50 million people in the United States alone, and lest you think only men have hair loss issues, over 20 million of sufferers are women. So it’s a safe bet that thousands of people are thinking the same thing you are: “I can’t believe I’m going bald.”
The many possible causes of hair loss
Everyone loses around 100 hairs from their head every day, but serious hair loss isn’t a “one cause fits all” type of problem; many factors contribute to hair loss, and we give you the full rundown in Chapters 4 and 5. The most common causes of hair loss are listed here.
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Genetics: Yes, you knew it all along: It’s Mom’s (or Dad’s) fault that you have no hair. The overwhelming majority (up to 98 percent) of men with balding fall into the genetic category. Female genetic balding occurs much less frequently, but up to 50 percent of women have hair loss related to their inherited genes. (See Chapter 4 for more on genetics and hair loss.) The good news is that only seven percent of men develop the most advanced balding pattern (left with just a 3 inch wreath of hair around the side and back of the head). If you’ve inherited this pattern, it’s usually evident by the time you’re 30. Genetic hair loss in men generally falls into one of several distinct hair loss patterns identified under the Norwood classification system (see Chapter 4). In balding men, the hair around the sides of the head almost always retains a normal, thick appearance. In women, genetic hair loss is different; for one thing, it tends to occur as overall hair thinning (including the sides of the head) rather than loss of hair on certain areas of the head.
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Diseases: A number of diseases as well as hormonal influences, including thyroid disease and anemia, cause hair loss. Autoimmune disease also can cause patchy hair loss. We cover these causes in Chapter 5.
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Mechanical causes: Mechanical hair loss is caused by external forces such as tight braiding, rubber banding, turbans, or other hair torture devices that put stress and strain on your hair.
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Stress: In some cases, stress can contribute to hair loss in those who are genetically predisposed to it or can result in a sudden loss of hair in a condition called telogen effluvium (read all about it in Chapter 5).
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Medications: Many medicines, most notably anabolic steroids, birth control pills, antidepressants, and tranquilizers, can cause hair loss. (See Chapter 5 for a complete list).
Society’s emphasis on hair
“So what if you’re going bald — it’s only hair!” Statements like that can make your blood boil when you first start losing your hair. Most people are cavalier about hair loss when they’re not the ones losing it and are unsympathetic to the plight of the victims of hair loss, but when their hair starts falling out, they’ll be looking for miracle cures, too — you can be sure of it.
Hair loss isn’t life threatening, but it can be an extreme threat to self-esteem. Studies show that hair loss can lead to feelings of shame, depression, frustration, helplessness, and anger. It also can result in feelings of sexual inadequacy and loss of self confidence.
Today, hair is something of a status symbol; you can find thou- sands of products devoted to hair care, which only emphasize the problem for those experiencing hair loss. Many men now have their hair styled rather than just getting it cut at a local barber shop. Television gives the impression that a full head of luxurious hair is the norm, implying that those who are losing it are some- how abnormal.
Hair is also used as a method of self expression, a way to say who you are. A “bad hair day” can ruin your week; a “no hair life” can derail your career, your love life, and your self-esteem, but so can anything, if you let it.
Before you can fix a problem, you have to realize you have a problem. Denial is your enemy; you can’t fix what you can’t admit. This book will teach you what you need to know about keeping your hair before you lose it or getting it back if you waited too long. The good news is that there are solutions to hair loss, no matter where you are in the hair loss process.
Why men worry about losing their hair
Twenty-five percent of men will show signs of balding by age 30 and 50 percent by the time they’re 50. While women can rearrange their hair to help disguise hair loss or resort to extensions or wigs, men sometimes don’t have enough hair — or wear it long enough — to utilize these options.
Studies have shown that self confidence levels both inside and out- side of the workplace can be affected by hair loss, and that correct- ing hair loss can have huge psychological and career benefits.
The devastation of hair loss in women
Women lose hair, but not in the same ways as men do. However, severe hair loss can be even more devastating to women than it is to men. Hair loss may be a serious blow to a woman’s self-esteem, in large part because of cultural norms, society’s concept of femininity, and the expectation that a woman should have glossy, luxurious, well-kept hair. We know that because the magazines women read tell them just that.
As much as half of the female population suffers from hair loss at some time in their lives. Women’s hair loss tends to differ from men’s hair loss both in cause and in the way the hair is affected. Women’s hair loss is generally widespread, with thinning all over the scalp rather than loss in certain areas; rarely do you see women whose hair loss leaves them bald on top with a healthy fringe around the edges like the typical look of male pattern baldness. In Chapter 4, we look at the unique challenges of hair loss in women.
For women, thinning hair may be caused by a number of medical conditions which, when treated, may restore their hair. This book covers these issues in Chapter 6.
Keeping Your Hair Healthy
In the process of caring for our hair, we do many damaging things to it, from combing it the wrong way to coloring it with harsh chemicals or subjecting it to strong sunlight.
If you’re starting to lose your hair, it’s important to take the best possible care of the hair you still have. Throughout this book, we discuss the best ways to care for your hair, but here a few of the worst things you can do to your hair. (See Chapter 3 for a full dis- cussion of proper hair care).
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Never back comb your hair: It damages the hair shaft.
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Don’t rub your hair dry with a towel.
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Don’t over dry your hair with a blow dryer; stop before your hair is completely dry.
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Select the right shampoo and conditioner for your hair type (Chapter 3 tells you how).
Surveying Hair Replacement Options
Whether you’re a man or a woman, losing your hair doesn’t mean you have to present a bald head to the world; in most cases, your options range from the simple, like plopping a department store wig on your head, to the more complicated (and expensive), like pricey hair systems or hair transplant surgery.
Minimizing or hiding hair loss
In a society used to chemical fixes and instant gratification, your first response to falling hair may be to search the drugstore shelves for a tonic that will replace lost hair — or at least preserve what you still have. You want to believe that these tonics will do the job and restore your head to its former glory. There are med- ications that can help save your hair, but you may not want to resort to medication, at least not just yet.
Chapter 3 gives you a wealth of information on taking care of your hair because, although good hair care by itself can’t help you fight genetic hair loss, it will keep your hair looking good while you still have it. In cases where hair loss results from disease or mechanical damage, good hair care can help you keep your hair as well as keep it looking good.
In Chapter 8, we introduce some of the products that can work with the hair you have left to give the illusion of fuller hair. It’s not quite as simple as spraying silly string on the top of your head or using a can of paint to color your bald spot, but today’s spray-on or powdery products can definitely improve your hair’s appearance for some time without looking weird.
Wearing a wig
When we say “wig,” we don’t mean the powdered version commonly worn in the 1700s — although if that’s your style, who’s to stop you? In this book, we use the terms “wig” or “hair replacement system” (hair systems for short) when we are referring
to a hairpiece as a hair replacement option for men or women (usually wigs for women and toupees for men, but the terminology is flexible).
Wigs have improved tremendously over the last few decades, and a good one is virtually undetectable. (Your hair stylist will know, but he or she may be the only one.)
A wig can be a quick fix for temporary hair loss, such as the hair loss from chemotherapy treatments, or it can be your lifetime solution to lost hair. Many women have several wigs and can change from “Gee, you need a haircut” to a freshly trimmed look overnight. Men may have many hair systems to wear in various settings or situations.
You can buy an inexpensive wig for less than $100, but if you want it to be foolproof, you probably have to spend more than that. A good wig (or wigs) can easily run into the thousands, and it’s possible for the maintenance fees to rival those of your car or condo. Turn to Part III for all the details on buying and caring for hair replacement systems of all sorts.
Pharmaceutical, laser, and topical treatments
If hair loss looks like it’s going to be a permanent part of your life, you may be ready to turn to prescription medications or treatments to minimize your losses. The good news is that treatments are available to help slow hair loss caused by inherited male pattern baldness. (See Chapter 9 for a rundown of prescription medications, Chapter 10 for a list of herbs that some people swear by, as well as dietary recommendations for maintaining a healthy scalp.)
For many women, hair loss may also respond to medication, or, if a specific disease process is causing the loss, by addressing the health issue.
Anyone can have healthier hair by modifying their diets, but giving you hair through medication is a bit more selective. Medications have limitations and may only work on certain types of hair loss.
They can be used in addition to surgical procedures, such as hair transplant, to help slow continuing hair loss (yes, you still lose hair after a transplant — not the transplanted hair, but hair in balding areas) or to help you keep your hair as long as possible.
Zapping your head with lasers to help your hair grow may sound like science fiction, but some laser treatments can do just that. Chapter 11 has information on which laser treatments may help and which ones will part you from your money without adding a hair to your head.
Considering hair restoration surgery
Hair transplants were an option out of reach for many men until fairly recently. With new advances in technology and better access to well-trained surgeons who work with modern techniques, the option of transplant is more accessible — and more men are taking advantage of it.
Around 100,000 American men have hair transplants every year, and the results are truly remarkable. What’s most impressive is that these men look so natural that not even their hairdresser will know for sure!
The difficulties of transplants in the past — the pluggy look — have been largely overcome with better technologies and well- trained surgeons. The main objection to a hair transplant is the cost, which is why it’s vitally important that you pick a hair trans- plant surgeon who will give you the most for your money in terms of positive, long-lasting results.
Although the cost of a hair transplant can sound exorbitant at first glance, it may not be as far out of your reach as you think. The fact is that a hair transplant costs less than five years’ worth of buying and maintaining one decent quality wig!
We devote Chapter 13 to advising you on how to choose a hair transplant surgeon (price should never be your main consideration!), take you through the transplant process, and go home with you and your new hair in Chapter 14 to look at how life will be after your transplant.
Looking at the Future of Hair Loss Prevention
The future of hair loss prevention is bright. Surgical procedures are improving all the time (the transplant surgeon of tomorrow may be a robot!), and new medications are being developed to slow or at times reverse hair loss. Gene manipulation and hair cloning may not be too far down the road to give you an unlimited amount of hair to work with.
In the meantime, hair replacement systems are better looking than ever, and more research has been done on hair care products and treatments and ways to enhance the hair you have. Chapter 12 takes a look at what’s on the hair horizon and the techniques that could make hair loss a thing of the past.