Everyone wants to know how to prevent hair loss or rather be comforted that there’s a solution out there in case hair loss actually occurs. Because once hair loss occurs, it will only keep progressing and at an extensive rate. According to the American Academy of Dermatology, about 60% of men and 40% of women have visible hair loss by the time they hit 40. Usually, once hair loss is severe, a hair transplant is the best and most effective option — except it is extremely costly. 

In Singapore, a hair transplant costs about $4000 to $15000 per session. Is it worth it? Well, if the likes of the rich and famous like David Beckham and Wayne Rooney —who have admitted to having a hair transplant— are anything to go by, then for sure. However, it’s better to address the root of the issue early before progressing to the stage where a hair transplant is the only option. 

To treat and prevent hair loss early, we need to find out the underlying causes of your hair loss and eradicate risk factors as much as possible. These causes include:

Causes of hair loss

Family history

Genetics/family history is the most common cause of hair loss. We identify this as a condition called androgenic alopecia, or male-pattern baldness and female-pattern baldness. Androgenic alopecia usually occurs gradually (as early as teens or 20s) and in predictable patterns — a M-shaped receding hairline in men and general hair thinning especially around the crown in women.

Hormonal changes

Hormonal changes due to pregnancy, menopause, thyroid problems or childbirth can cause hair loss. About 40-50% of women experience hair loss during pregnancy, but this (as with other conditions that cause hormonal changes) is temporary and hair will return back to its usual growth cycle within 6 months.

Medication and supplements

Certain drugs used for conditions like cancer, depression, high blood pressure and arthritis come with hair loss as a side effect.

Autoimmune diseases

Autoimmune diseases can cause alopecia areata, a condition that often starts suddenly and may result in complete baldness. This happens when the immune system attacks the hair follicles.

Cosmetic procedures

Excessive hair styling using rollers or hot curlers can cause hair to be weak and brittle and eventually fall. While hair will grow back if these procedures are stopped, severe damage to the hair or scalp can cause permanent bald patches.

How to prevent early hair loss?

Medication

Topical vasodilators 

Originally used to treat high blood pressure, vasodilators are known for their ability to stop or slow hair loss and promote hair regrowth. When applied on the scalp, they cause blood vessels to dilate and open potassium channels, allowing more blood and nutrients to flow to the follicles. While they can cause follicles in the telogen phase to shed, this shedding allows for new, thicker hair in a new anagen phase. 

Hormone blockers 

For men: Our body naturally converts about 5% of testosterone to dihydrotestosterone (DHT), a hormone thought to contribute to hair loss in men and women. This process is possible due to an enzyme known as 5-alpha reductase. With medication, we want to block 5-alpha reductase to decrease DHT production and reduce hair loss. 

For women: Androgens contain testosterone and other hormones that accelerate hair loss in women. Anti-androgens reduce adrenal androgen production and blocks androgen receptors. 

Corticosteroids

Corticosteroids are thought to decrease inflammation around hair follicles, especially in cases of alopecia areata. Studies show a significant reduction in hair loss when using corticosteroids and an improved regrowth of about 25%.

Low Level Light Therapy

Using a low fluence red laser, low level light therapy (LLLT) sends pulses of energy into hair follicles. These pulses kickstart circulation and cellular respiration, thereby triggering dormant follicles into a regrowth phase. iGrow, a hair growth system powered by LLLT, has shown an average of 35-37% hair growth increase in 16 weeks.

Fractional Infrared Lasers

Fractional lasers induce hair growth and may not only treat alopecia but may also prevent recurrent hair loss. Trauma stimulated wound healing likely plays a role.

Regenera Activa

Healthy micro grafts of your scalp are harvested and processed through a medical device called Regenera Activa. The device extracts regenerative cells and these healthy cells are then injected into hair loss areas. Patients might first see some hair loss, but that is followed by improved thickness and density of existing hair and new hair growth.

My approach to early hair loss

Assessing the patient’s condition in full and looking out for any medical conditions that might be causing the hair loss is imperative. While treatments like medication, LLLT and lasers may not be as popular as they are slow to show effects, they should be started early to halt the progression of hair loss. I usually supplement oral medication with treatments like LLLT, fractional lasers and Regenera Activa. 

As with any medical condition, hair loss should be tackled as early as possible to avoid a hair transplant that may be costly and not always successful.

References

  1. Rossi, A., Cantisani, C., Melis, L., Iorio, A., Scali, E., & Calvieri, S. (2012). Minoxidil use in dermatology, side effects and recent patents. Recent patents on inflammation & allergy drug discovery, 6(2), 130–136. https://doi.org/10.2174/187221312800166859
  2. Diani, A. R., Mulholland, M. J., Shull, K. L., Kubicek, M. F., Johnson, G. A., Schostarez, H. J., Brunden, M. N., & Buhl, A. E. (1992). Hair growth effects of oral administration of finasteride, a steroid 5 alpha-reductase inhibitor, alone and in combination with topical minoxidil in the balding stumptail macaque. The Journal of clinical endocrinology and metabolism, 74(2), 345–350. https://doi.org/10.1210/jcem.74.2.1309834