How to Deal With Excessive Hair Loss

Many men and women fear hair loss and the development of baldness. Head of the Department of Dermatology at Health+, MUDr. Lucia Mansfeldová, reveals what causes excessive hair loss, how this problem can be addressed and how to prevent these difficulties.

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A certain degree of hair loss is natural. How can people tell if they are losing more hair than normal?
It is generally said that we normally lose about 60 to 100 hairs a day. We usually notice this in the drain in the shower after washing our hair. However, when we find hair all over our home and on our clothes, comb out more hair each time we brush, or notice thinning hair in certain areas of our head, we should seek professional help as soon as possible.

What are the most common causes of excessive hair loss?
The most common causes include genetic predisposition and hormonal changes. The predominance of male sex hormones, mainly testosterone, leads to increased hair loss. Therefore, men are more likely to suffer from alopecia, i.e. baldness. The male type of alopecia, so-called androgenic alopecia, manifests as a gradual recession of the hairline above the forehead, where corners form on the sides, and later on the top of the head. Women also experience increased hair loss due to hormonal changes. This occurs with the loss of estrogen, for example, after childbirth or during menopause. Women also have a certain level of male sex hormones in their body, and an increase can occur, for example, with endocrinological or cancer diseases. Other common causes include thyroid disorders or iron deficiency anemia. Changes in diet, dieting and rapid weight loss can also lead to excessive hair loss due to deficiencies of vitamins A, B and D, minerals (zinc and iron) and trace elements. Last but not least, psychological problems, excessive stress, depression and exhaustion often accompany increased hair loss. Excessive hair loss is also common after serious febrile infectious diseases, after certain medications (especially cytostatics) or after sudden withdrawal of hormonal contraceptives.

Can you advise effective ways to prevent hair loss?
The best prevention is a balanced diet with sufficient intake of iron, B vitamins and other important substances such as amino acids called methionine and cysteine. It is important to avoid unnecessary hairdressing, poor quality aggressive hair dyes and inappropriate hairstyles that put excessive stress on the hair. Stimulating shampoos and tonics with caffeine or panthenol have a very good effect. However, it is true that there are a huge number of “miracle products” on the market, so it is useful to consult a dermatologist when choosing one.

If a person recognizes that their hair is falling out excessively, how should they proceed?
It is certainly advisable to see a specialist as soon as possible, ideally a dermatologist, or your GP who may recommend blood tests or other investigations. It is very important to address the cause of excessive hair loss as soon as possible and to start appropriate therapy. This is the only way to prevent major hair loss, which is then difficult to grow back in the long term.

How is the examination in cases of excessive hair loss carried out and what are the methods of treatment?
The most important thing is a careful and detailed medical history, which can direct us to the cause. We ask clients about dietary changes, diet, new medications, hair cosmetics, stressful situations and infectious or febrile illnesses, sometimes going back as far as two to three months before the onset of the problem. Blood tests are also performed – blood count, basic biochemistry, hormone profile (especially thyroid and sex hormones), iron and vitamin B12 levels, inflammatory markers, etc. During the clinical examination, the scalp is examined in detail for inflammatory changes, lesions or eczema. A hair traction test (hair pull test) is also performed to assess the anchorage strength of the hair. If necessary, other special examinations are added, such as swabs of the throat and nose to exclude inflammatory deposits, endocrinological or gynecological examinations. Once the underlying cause is identified and eliminated, the hair usually grows back spontaneously within six months. Topical preparations with a hormonal component or a corticosteroid, special stimulating shampoos with, for example, caffeine, vitamin supplements, minerals and amino acids, especially methionine, are recommended as part of the therapy. In case of insufficient improvement, special treatments such as cryostimulation (freezing of the scalp with liquid nitrogen), vitamin mesotherapy or very effective application of the client's own blood plasma can also be performed.

Does the clinic offer anything in this area that is not commonly available in conventional dermatology practices?
At Health+, the great advantage is the extensive interdisciplinary cooperation, where the client can be comprehensively examined by several specialists in a very short time interval, the cause of the hair loss can be determined in time and the appropriate therapy can be initiated. Among the special treatment methods, we are particularly good at high-quality mesotherapy, i.e. the application of cocktails with vitamin preparations, minerals and trace elements with microneedles directly into the scalp and the application of blood plasma. Plasma therapy is a relatively new method, where the client's blood is drawn and after centrifugation, the blood plasma rich in platelets and a huge amount of growth factors is separated, which after application by the microneedle method directly stimulates the hair follicles. The clinic uses the most advanced Swiss RegenPlasma technology, which manages to activate up to 90% of the growth factors, which is approximately three times more than other methods. The advantage is that it is the client's own biological material, so there is no allergic reaction or infection.

Can the clinic also provide hair transplants for clients?
Absolutely, we can also arrange hair transplants at special workplaces. Most often we cooperate with Aura Clinic, because their experts have extensive experience with transplantation methods for alopecia treatment.  

People can also suffer from other hair and scalp diseases. Can you briefly describe which of these are the most common and what causes them?
The most common disease is genetic seborrhoeic dermatitis, where reddish, scaly patches, sometimes scabs and sores, form on the scalp. There may also be psoriasis or infectious fungal and bacterial diseases. Often we also encounter a contact allergic reaction of the scalp to unsuitable hair cosmetics or hair dye. Last but not least, a herpetic viral infection, so-called shingles, can occur in the hair and later spread to the forehead or around the eyes. It is very serious when, in addition to hair loss, scarring occurs. Here, unfortunately, there is usually no effective therapy.

What are the modern treatment options for the most common hair and scalp diseases?
In modern therapy, the direct application of active substances to the scalp by means of the aforementioned mesotherapy (microneedling) is mainly used. Plasmotherapy and robotic hair transplantation seem to be particularly effective.

How should people take proper care of their hair and scalp to prevent similar problems? Can you give any tips for effective prevention?
As with excessive hair loss, effective prevention is a good quality and balanced diet with plenty of vitamins A, B and D, iron, zinc and amino acids, adequate stress management, avoiding poor quality hair cosmetics and inappropriate hairdressing treatments, occasionally using special stimulating hair shampoos and tonics and being lucky enough to have a good genetic predisposition.

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