Recent interview with Hong Kong based Magazine
We are a husband and wife team of trichologists. Our Hair & Scalp Clinic is located in Greater Manchester, UK. We deal with all types of male and female hair loss, scalp problems such as dandruff, psoriasis, excema, and any malady of the scalp and hair.
We carry out a thorough consultation which has a holistic approach. We look at the medical, environmental, dietary and genetic history of every patient. In this way we aim to find the cause of the problem rather than just aimlessly treating a symptom.
As an aid to diagnosis we use a tricho-derm camera. This magnifies the scalp up to 200 times enabling us to look closely at skin patterns and hair loss markers. We can actually view inside the hair follicle opening and identify poor growth hair shaft growth cycle.
Frank is a member of the Institute of Trichologists who are UK based, and Joanne is a Member of the International Association of Trichologists who are Australia based with practitioners operating in many countries. Our web address is www.trichology.co.uk
How many (internal or external) causes are there for hair loss?
Too many to be able to document. Apart from androgenetic hair loss which affects both male and female(Male and Female Pattern Hair Loss) one can consider that hair is the barometer of the body's health. If the body is healthy then so will the hair. If the body is not healthy, hair loss may be triggered.
General health and hormone levels around the menstrual cycle can increase hair loss. A poor diet, hormone imbalance or anaemia can also cause problems
Many causes of temporary hair loss include, Dietary deficiency, Low iron reserves, Crash dieting, Abnormal hormone levels, Childbirth, Acute blood loss, Some prescription drugs, Underactive or overactive thyroid, Extreme physical stress, emotional stress, severe illness, fever, localised inflammation, to name a few. All these and more besides can cause hair loss.
External causes of hair loss are usually caused by physical or chemical trauma. Self harming (pulling one's own hair out).Traction Alopecia from braiding or hot combing. Poor quality colouring/bleaching/perming. In these cases the hair is usually broken rather than falling out from the follicle.
There is so much information on hair loss and hair thinning on the Internet. Do you think that is a benefit or hindrance to your clients? Why, when should someone seek help?
Generally internet information is a hindrance. There is a lot of useful information on the 'net' but there is more misinformation which misleads people. There are no advertising restrictions and false claims are made. Also, a little knowledge can be dangerous. People do not really understand there hair/scalp condition. They use guess work and basic elimination techniques for self diagnosis and eventually purchase lotions, potions or tablets that are both expensive and ineffectual. There is also the problem of the large percentage of fake medicines that have been reported on the internet.
Look for a Trichologist (hair expert) who is a Member of the Institute of Trichologists or a Member of the International Association of Trichologists for good advice
Be aware, normal hair shedding is between 80 & 100 hairs per day. In many cases people worry that this rate of loss is abnormal. Basically, If your hair loss pattern increases to a degree that worries you, then you should seek help. A good marker to follow is that if you notice increased hair loss on shampooing or hairs on your pillow in a morning it could signal increased hair shedding which needs attention.
Would travel and/or relocation trigger sudden hair loss? If it is temporary, when would the hair cycle fix itself?
Constant air travel, staying in hotels, constantly on the move, poor quality food. The quality of re-cycled air reported in aircraft could affect regular travellers. All these affect health status and could cause an increase in hair shedding.
Re-location is very stressful which can also lead to poor eating habits could cause a temporary hair loss.
It can take up to six months for this type of loss to right itself but this would depend on getting into the habit of resting, sleeping and eating properly.
I've read that SLS and SLES shampoo are to blame for hair loss and thinning.
Sodium Lauryl Sulphate (SLS and Sodium Laureth Ether Sulphate (SLES) are used in 95% of shampoos. They are good foaming agents that degrease the hair and remove dirt.
Most people can use these products without experiencing any problems but if you have a sensitive scalp, suffer from scaly scalp or suffer from hair loss, then these ingredients can be too searching. It has been reported that these products can corrode the hair follicle and impair its' ability to grow hair
Your scalp has a protective film called the natural moistening factor of the skin(NMF). This film protects the scalp from germs and bacteria. Washing your hair with a shampoo containing either of the above products can remove the protective layer and it can take between 4 and 12 hours to re-establish the NMF. During this time the scalp can be prone to infection.
There are products that do not contain these products so if you have a sensitive scalp or hair/scalp problem then it is important that you study the shampoo labels very carefully.
A receding hairline is probably a man's worst nightmare. Can the rate of hair loss be slowed down.
Unfortunately, there is no 100% cure for Male Pattern Hair Loss(MPHL) but with care the rate of loss can be slowed down considerably. Hair hygiene is very important. MPHL can coincide with oily, scaly scalp. Our experience has shown that many men who suffer from MPHL notice extreme hair shedding when they shampoo, so they stop shampooing as regularly. This actually makes the problem worse. A healthy scalp promote a healthy growth so it is important to shampoo daily, using a mild shampoo with an anti-dandruff agent incorporated. This in itself will slow down hair shedding. Secondly a diet with plenty protein and iron rich foods to promote hair growth.
There are lotions containing minoxidil that can help slow down hair loss and an oral medication containing finasteride that blocks the hair loss factor. There is a herbal tablet called Saw Palmetto which has been used for many years to slow hair loss. Also lotions that contain Azaleic Acid, Caffeine, Menthol, Vitamin B 12, are anecdotally successful in slowing MPHL.
Do men suffer from hair loss more than women?
The answer is no but more men are seen to suffer hair loss than women. This is because of the different appearance and pattern of loss. Men lose their hair from the temples and crown then gradually lose all the hair from the top area. This process is very visual.
Female Pattern Hair Loss (FPHL) is manifested by a gradual diffuse thinning of the hair on the top of the head. The hairline is not usually affected. So a woman with FPHL can go for many years before the thinning hair becomes visible.
Women in their 40's and 50's aren't just dealing with hair thinning but white hair too. Dyeing, perming, hair straightening. Do these treatments play in hair thinning in women?
Cosmetic treatments as mentioned above do not affect the ability of the hair follicle to produce hair so it is safe to carry out any of these treatments. If the treatments are not carried out properly though, then the hair shaft can become coarse, dry, lose its' elasticity and breakage of the hair shaft is the result. A lot of home hairdressing causes these problems. Because hairdressing colours contain an allergic substance it is imperative that a colour test is carried out 48 hours prior to every colour application. Many hairdressers and home users ignore this basic rule. Reaction to colour can be very serious, swollen eyes and neck, Inflammation of face and other parts of the body.
Choose a good hairdresser by recommendation. Look at other women's hair. If you like the cut or colour or how healthy her hair looks then ask her for her hairdresser's name and telephone number. She will be delighted with the complement.
Would you please explain Seborrheic Alopecia?
There is a lot of confusion over this terminology. Seborrheic Alopecia is another term for Male Pattern Hair Loss. The hair loss is permanent. It manifests differently than normal MPHL insofar that it has excessive sebum that occurs on the scalp. This can cause an increase in dandruff and itchiness of the scalp. It usually occurs in the younger male. The treatment is to shampoo daily using a mild anti-dandruff shampoo and use medications for MPHL (as noted in answer to question 6)
What is the best solution for hair loss caused by Tinea Capitis?
Tinea Capitis is also known as ringworm of the hair. It is a superficial fungal infection. The clinical presentation is typically a single or multiple patches of hair loss accompanied by inflammation, scaling, pustules and itching.
A treatment is a drug called Griseofulvin. This is taken orally. There are other drugs that can also be prescribed by a doctor. Once the funus has been destroyed the hair will grow again.
What kind of hair loss is the most serious and hardest to deal with?
Without a doubt this has to be the Alopecias, Alopecia Areata, Alopecia Totalis and Alopecia Universalis. Alopecia Areata manifests as bald patches that affect the scalp and other hair bearing areas of the skin. It is very unpredictable and there is no medical treatment available. Sometimes the patches on the scalp become larger and coalesce until the whole skull is bald, including eyebrows and eye lashes (A. Totalis). This can further affect the whole body until all bodily hair is lost (A.Universalis.)
It is an immune system problem that targets the hair. There are all sorts of treatments offered on the 'net' but none are medically or scientifically backed. The only treatment is to have a full health check with blood tests to eliminate any underlying health problem and try to achieve a body health status of 100%. Sufferers of Alopecia Areata do have a 97% chance of eventual recovery but this can take a few years. The other 3% unfortunately can develop into Alopecia Totalis or/ Alopecia Universalis. The prognosis for these two conditions is poor
How can we choose the right shampoo without being extravagant and spending money on different products?
There are so many different shampoos with so many different additives that it is said that the odds are a million to one on you being able to choose a shampoo that is correct for you. Let's try to shorten the odds in your favour. There are different shampoos for oily hair, dry hair, chemically coloured, bleached or permed hair. Forget all these and choose a mild shampoo for dry hair. A shampoo for dry hair is good for all hair types.
If your hair is chemically treated use a conditioner after the shampoo. You do not need an two in one product.
Remember a shampoo is to cleanse hair, it is only in contact two or three minutes so all it needs to do is gently remove dirt.
If you need to add volume or protect the hair from the hair dryer or straighteners, then use specialised products after washing and conditioning.
Daily life affects hair to a great degree. The weather can be hot, cold, humid, dry, windy. Many people end up washing their hair daily but this can strip the hair of its natural oils, which cause brittle hair, dry scalp?
I think we have answered this question in previous answers. Daily shampooing of the hair is never a problem. The problem is the type of shampoo used. A harsh shampoo will strip out the natural oils and devastate the hair shaft.
A mild shampoo (no SLS SLES) will gently remove the dirt and grease without stripping the natural moistening factor (NMF) Hair products can be used after shampooing if necessary .
How about general conditions?
Think of your hair as a silk garment. Both silk and hair are protein fibres. You would not wash a silk garment with a cheap detergent in a washing machine with a high agitation cycle and then dry it in a dryer at a very high temperature. Think of what a silk garment would look like after such treatment.
Treat you hair as you would a silk garment. Use the correct products and gentle treatment and you will enjoy optimum hair condition.
Never use a hair brush with plastic bristles. Under a microscope a plastic bristle looks like a saw with tiny teeth. Brushing your hair can damage the surface and cause breakage and split ends. Only us a good quality wide toothed comb.
Never use a tight elastic band to keep the hair back in a pony tail. This causes breakage of the hair shaft. Use a loose elastic or a special comb that grabs the hair and holds it in position.
Shampoo in warm not hot water. After shampooing, wrap your hair in a towel and blot dry. Do not use a rubbing action. This causes breakage.
If you use a hair dryer, keep it on medium heat and keep it moving. Do not concentrate heat on a fixed area. This burns the hair shaft.
Eat a good balanced diet with protein from chicken, fish meat, fresh fruit and vegetables.
One last thought. Why have straw when you can have silk
What are some options to combat hair loss or at least slow down the process? Is there anything that is more permanent?
If you look after your body, it in turn will look after your hair. Look at your lifestyle, is there anything you could change as an improvement? Do you eat too much 'fast food' because you are too busy to prepare healthy food? You can turn things round with a little effort.
Androgenetic hair loss (Female or Male Pattern Hair Loss) is a different. You cannot alter genetics. If you have the hair loss gene then you will lose your hair but using the medications mentioned earlier and keeping your scalp healthy will slow the loss to a minimum.
There are cosmetic products that dye the hair and scalp to make the loss look less. If your loss is very severe you may benefit from a hair transplant or maybe wearing a hair unit.
There are answers but please, always go to a registered trichologist for help. There are many hair clinics but not all use qualified staff.