The People's Perspective on Medicine

Show 1181: How to Keep Your Hair from Falling Out

Hair loss can be extremely distressing. There are a number of treatments that can help you keep your hair from falling out.
Dr. Chris Adigun, dermatologist, with People’s Pharmacy hosts Joe & Terry Graedon
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How to Keep Your Hair from Falling Out

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Do you love your hair the way it is? Many of us wish our hair were different–curlier, straighter, darker or lighter. But what people worry about most with their hair is when they lose it. Can you keep your hair from falling out? Why does hair loss affect some people, including women as well as men? Why do others seem relatively unaffected?

While there is some familial component to male pattern baldness (despite the name, it affects women too), the exact genetics are unclear. Other causes of hair loss include autoimmune disease such as alopecia areata or hormone imbalance such as thyroid disorders. Pregnancy is a common cause of hair loss after delivery. That’s because the hair that has been in anagen phase (growing) shifts to telogen phase in which the hair follicle rests and the hair is no longer growing. Stress can also make hair fall out.

What Can You Do About Hair Loss?

Treating the conditions that triggered hair loss can be helpful. That’s why the first test might be for thyroid function. Once that is corrected, the hair loss will generally improve. JAK (Janus kinase) inhibitors can be surprisingly effective for autoimmune hair loss. Moreover, the drugs that men use for enlarged prostate glands, finasteride and dutasteride, can also stop hair loss. They do have some sexual side effects, however, and they are inappropriate for pregnant women. Minoxidil (Rogaine) works about as well for women as for men.

A Drug for Eyelashes:

Ophthalmologists discovered some years ago that the bimatoprost eye drops they were prescribing to treat glaucoma could also make eyelashes grow thicker and fuller. The FDA subsequently approved this medication for eyelash growth under the brand name Latisse. The user applies it like eye liner and it works well for the lashes.

Drugs That Cause Hair Loss:

Certain medications may trigger hair loss, particularly in susceptible individuals. In most cases, the prescriber could find an alternative. For example, beta blockers such as metoprolol are known to cause this problem, but usually another medication could be used to control blood pressure or heart rhythm. In the case of chemotherapy, the benefit of overcoming cancer is usually considered to far outweigh the distress of losing hair. Nonetheless, there is a new tactic that may help counteract the hair loss due to chemo. It is a type of close-fitting cooling cap that constricts blood vessels so less of the medication gets to the hair follicles.

One thing to avoid: using oil with heat processing. This can actually damage and scar the follicle, preventing recovery.

Keep Your Hair from Falling Out:

Keeping your body and skin healthy with good nutrition, adequate sleep and stress control is also a good way to maintain a healthy head of hair. Crash diets or extreme calorie restriction can lead to hair loss. Essential fatty acids, including omega 3 fats found in fish oil, can be helpful. Zinc supplements may also be useful to keep hair from falling out. Reducing inflammation can be helpful to prevent hair from falling out. In general, prevention is more preferable to finding ways to rejuvenate growth. The supplements Dr. Adigun mentions as possibly helpful, although incompletely tested, are Viviscal and Nutrafol. They contain marine complexes and ashwagandha. 

This Week’s Guest:

Chris G. Adigun, MD, FAAD, is a board-certified dermatologist who practices at the Dermatology and Laser Center of Chapel Hill, NC. In the picture, she is standing in the WUNC studio with Joe (seated) and Terry Graedon, hosts of The People’s Pharmacy.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I had always had thick head hair, even through menopause. Then around age 63-64, I started using bio-identical hormone creams. I lost my thick, lush hair and now, at 73, I still have thin hair. Had to go with a short pixie hair cut. And, due to the testosterone in my hormone creams, I have more hair on my arms and other places, but not on my head! Wish I had a solution for this besides not using the hormone creams. And I’m not sure that if and when I stop these creams, my head hair would even grow back.

When I was younger I did yoga for many years including a shoulder stand (couldn’t do a head stand); after I was unable to do yoga any more due to physical problems noticed my hair got much thinner. I do think there was a benefit of added circulation to the scalp with the exercise.

Regarding chemo “cooling caps” – not a new concept. I was involved in the early research, early 1980s in Dallas.

Cooling theoretically reduces hair loss by decreasing blood flow to the scalp and thereby exposure to the drugs. The overriding concern, however, was how this could affect the major goal of attaining remission or cure.

Hair loss from chemo is temporary for the vast majority of patients. There still aren’t real answers to the basic questions. Personally – I’ll risk my hair for my life.

Years ago, I read in YOUR VERY OWN COLUMN ❤️ In the Houston Chronicle…that MSM supplements (without glucosamine) helped hair to stay full and thick. I started taking it about 2002, and I have pretty, thick healthy at age 57. I definitely saw an improvement in my hair within a few months of starting the supplement. Thank you for your always good advice!

I take a T4 for post radioactive iodine hypothyroidism. The tiniest dose change causes shedding which goes on for weeks, then my hair begins to grow again. Very frustrating. This never happened when I was taking thyroid extract, but up here in Canada, doctors seem very reluctant to precribe it any more. Anything I can take to help my situation? Thank you.

When my son was 16 I was reading an article about hair loss and the possibility of exfoliating (stimulating) the scalp keeping hair follicles active. I gave him the bad news since everyone on both sides of our family were either bald or losing hair fast by 25. He would be, too. I shared with him the article about exfoliation of the scalp, and he has been doing that daily since. He is now 31 and has a full head of thick hair. His high school picture and his hairline today look the same. Now maybe it is a accident of birth. but I think it is the daily stimulation of hair follicles.

I’m looking forward to this. I have an autoimmune problem that only affects my eyebrows. My dad and my uncle had no eyebrows as they grew older, and both of my brothers have the same condition, although one seems to be more affected than the other. I had beautiful eyebrows until I started experiencing menopause. The only thing that seems to help is steroid injections, which I get about every 2 months. Not the perfect solution, but at least I feel like I can get away without using eyebrow pencil (which is incredibly difficult to make look natural on older skin).

Interestingly, I don’t have much body hair, but the hair on my head is quite thick, with very little gray (so far) at age 67. My dad had no problem with hair loss on his head. In fact, only one brother has hair loss on his head, and he’s the one slightly less impacted on his eyebrows!

I am taking metoprolol tartrate 25mg divided between half a tablet in the morning and half in the evening.
When I shampoo, there is always a small amount of hair in the drain and now I know why.

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