Lifecoach: What to do about hair loss
Our experts answer your questions . This week: how to prevent hair loss
12:11PM GMT 31 Jan 2011
Q My son, who is 32, has hair loss at the temples and now loss on his crown. He is self-conscious about this and I wonder if there is anything he could do to help prevent further loss. Jane Butler, email
DR DAN RUTHERFORD WRITES:
A Loss of hair on the crown and at the front hairline is the typical pattern of male hair loss, but a lot can be done about it now.
The hair-growing follicles in these scalp areas are particularly sensitive to testosterone, which slowly reduces their hair-producing activity until they finally switch off at some point in most men. This sensitivity is programmed into the follicle rather than the scalp area, which is why moving follicles from the sides and back of the scalp, which do not have this sensitivity, can be an effective long-term solution.
There are, however, many options other than transplantation. Finasteride is an anti-testosterone drug used mainly to reduce the size of enlarged prostate glands in older men, but at a lower dose (Propecia) it is licensed to slow the rate of hair loss in males. It has a good rate of effectiveness and causes few side-effects, even when used over several years. It comes in tablet form, but is not available via the NHS, so needs to be obtained by private prescription (which can be written by an NHS GP, if he or she is willing).
Minoxidil is a drug originally discovered in the search for high-blood-pressure treatments but found to have a side effect of stimulating hair growth. It comes in a solution (Regaine) and is also non-prescribable on the NHS, but can be bought without prescription from a pharmacy (the five per cent strength is more effective than the two per cent, which is being phased out).
Both Propecia and Regaine can be combined if desired, although there is little formal research on the extra benefit achievable. Both need to be continued long-term as they work only as long as they are used.
Other treatments that use hair-weaving or other cosmetic techniques are now highly developed and can also give excellent results. Seewww.patient.co.uk/showdoc/23069043/; www.regaine.co.uk; andwww.empowerhair.com.
SARA STANNER WRITES:
A There are many causes of hair loss such as stress and anxiety, hormonal problems, fungal infections, some illnesses and medications, and dietary deficiencies. But most cases of balding result from genetic disposition or heredity influences. This affects up to 50 per cent of men by the age of 50, and dietary changes have not been shown to reverse such effects.
However, deficiencies in protein, and the many vitamins and minerals that are needed to promote the growth and health of cells and tissues throughout the body, including the hair and scalp, have been linked to hair shedding, damaged hair, slow regrowth and hair loss. So a healthy diet is needed to keep hair healthy and might be important in slowing down the rate of hair loss in men.
Hair loss is a common side effect of conditions associated with poor nutrition, such as anorexia. Those experiencing rapid weight loss from very low-calorie diets or following fad diets that lead to dietary imbalances have also reported increased hair shedding. In such cases, normal hair growth returns with adequate nutritional intake.
Hair loss and dandruff are also associated with zinc deficiency, but severe deficiencies are uncommon in those consuming a normal diet. Supplements often promoted to protect against hair loss include L-lysine, biotin and essential fatty acids, but solid scientific studies for many of these claims are lacking.
SECOND OPINION Dr James Le Fanu
Diagnosing headaches is a headache in itself
There were, at last count, 150 different types of headache. This might seem excessive, but the head is by far the most complex structure of the body. The necessity to distinguish one type from another is that so often the chances of successful treatment depend on correct diagnosis. Thus a reader describes how recurrent headaches over 20 years were attributed to migraine, sinusitis, neuritis and so on.
“The big breakthrough came when I was having dinner with friends,” he writes – the host being a professor of surgery, while the other guests included a consultant physician.
After a glass of red wine he developed a “full-blown attack” with associated symptoms including nasal congestion and reddening of the eye.
This prompted the physician to suggest the diagnosis of periodic migrainous neuralgia or “cluster” headaches which are resistant to traditional painkillers but are often relieved (for reasons unknown) by oxygen treatment.
The difficulty (and there always is a difficulty) arises because the symptoms of these many different headache syndromes can also overlap – as illustrated by a recent review of 40 cases of the debilitating hemicrania continua which, as its name suggests, is an unremitting (continua) severe headache confined to the same half size of the head (hemicrania).
That should be specific enough for an accurate diagnosis, but a detailed analysis of the symptoms revealed a much wider spectrum – with the headache fluctuating in intensity, switching from one side to the other and with features more commonly associated with migraine and related conditions.
The unifying factor however – and the reason it is so important to make the diagnosis – is that all responded dramatically to just one type of drug, the anti-inflammatory Indomethacin.
For those troubled by chronic headaches who respond poorly to treatment, it would seem sensible to consider this possible alternative diagnosis.
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