Hair Thinning / Hair Loss – Facts, Stats and What To Do

Hair Thinning / Hair Loss

Let’s get straight to it – The truth about Hair Thinning

Why does your hair start to thin? The simple answer is because your hair follicles stop producing hair. The causes are a little more difficult, and there are many reasons as to why you may be experiencing hair thinning or hair loss. Depending on when you started to notice your hair thinning, there may not be much you can do about it, with the exception of getting a hair transplant, or Hair Follicles Transplanted. But let’s not get ahead of ourselves. Let’s talk about some Facts and Stats.

 Facts and Stats

The average amount of hair that “normal” people lose is 80 to 100 hairs each day. If you wash you hair every other day, double that amount. The amount of times that you wash you hair during any given week doesn’t change the number of hairs that you lose, we doubled it because it is two days worth of hair falling out.  Sounds like a lot of hair loss in one day? Not when you consider that the average person has approximately 110,000 hair folicles and that hair is the second fastest growing cells in the human body, (second only to skin cells).

Are there really any “normal” people on this planet anyway? We’ll tackle that question in a later article. For now, we’ll stick to hair loss. Here are some more intersting stats:

1. The technical term for hair loss is Alopecia
2. Hair loss or thinning is more prevelent in men
3. Male Pattern Baldness is called Androgenetic Alopecia
4. Androgenetic Alopecia is a genetic predisposition
5. By age 50, 50% of men experience balding
6. 12 % of women experience female pattern baldness at 30 – 40 years old
7. Female pattern baldness rises with age in caucasin women
8. The most common reason for hair loss is from a chemical (DHT) from Testosterone
9. DHT (Dihydrotestosterone) attacks the hair follicle
10. Native Americans and Eskimos are mostly immune to baldness

Recent Hair Loss or Thinning

If you have noticed recent hair loss or thinning, you’ll need to find out the root cause of why it is happening. (no pun intended). Have you started a new medication? Are you experiencing new or an increased amount of stress in your life? Have you changed any of your hair care products? Have you recently given birth or have a change in your hormonal levels? Do you have an autoimmune condition? How is your nutrition? Schedule a visit with your primary care physician to rule out any biological/hormonal issues, as well as any possible autoimmune issues.

With recent hair loss or thinning, and ruling out any physical changes, you can most likely regrow your hair with a simple salon product. Nioxin is what I professionally recommend, and there are 6 different types for different types of hair, (thin, thick, colored, etc) and hair loss, (mild to advanced loss). Prior to using Nioxin, or whatever hair thickening agent you decide to use, make sure you get a good clarifying shampoo, and cleanse your scalp and hair thoroughly. If you use Nioxin, you will start to notice thickening within two – three weeks of using the product as directed.

Medications That Can Cause Hair Loss

Hair loss due to prescription drugs is a common side effect. When this is the case, it is often referred to as drug-induced alopecia. Alopecia is the medical term for baldness. Alopecia from medication often presents in a diffuse hair loss pattern (all over the scalp) and has a nonscarring nature (the scalp or the hair follicles are not damaged). In some cases, loss of body hair, including eyebrows and eyelashes, is also a symptom of alopecia from medication. In most cases, hair loss caused by medications is reversible once the drug is stopped. If there’s already a predisposition to hair loss because of any of these reasons, it is possible that medication has just triggered alopecia, in which case it might not be as easily reversed by only stopping such medication.

Why and how do medications cause hair loss? Drug-induced hair fall is often due to an alteration of the normal hair growth cycle caused by the pharmaceutical. Some drugs directly damage the hair follicles (scalp structures where hair grows from) and some drugs disrupt the growth phases, making them longer or shorter. Usually, each follicle goes through 3 main phases when growing hair:

The Anagen phase is the active hair growth phase. It may last between 2 and 7 years. This is when your hair grows longer. The Catagen phase is a short transitional phase that lasts about 2 weeks. This is when the hair stops growing longer but it is still attached to the follicle. The Telogen phase is the resting and shedding stage that lasts about 2 to 4 months. This is when the hair starts detaching from the follicle until eventually the hair shaft and bulb (root) detach and fall. This gives room for a new hair strand to grow from the same follicle and the cycle starts once more. Based on this explanation, medications cause two types of hair loss:

ANAGEN EFFLUVIUM – Hair loss takes place during the anagen (growing) phase. This means that instead of hairs growing thicker and longer for a few years, they detach and fall as they grow. In other words, growing hairs do not stop growing or go to a resting phase. They just fall from one moment to another when they are supposed to be growing instead. This type of drug-induced hair loss is commonly experienced during chemotherapy treatments, and sometimes after poisoning or toxicity from drugs such as arsenic or thallium. Anagen effluvium is considered long-term hair loss but it is still reversible. The first symptoms of anagen effluvium are usually experienced within 2 to 6 weeks of taking the drug for the first time. In many cases, hair loss is excessive and in clumps.

TELOGEN EFFLUVIUM – Hair loss takes place during the telogen (resting) phase. What really happens is that the medication alters the hair cycle, pushing hair follicles that are still on the anagen phase to jump abruptly to the telogen phase. Then, they stay in that resting phase for about 2 to 4 months. That is why, in Telogen Effluvium hair starts to fall about 2 to 4 months after starting the medication. The severity of hair loss caused by medications depends on the dosage, length of treatment, and often, the patient’s sensitivity to the drug.

Hair loss due to medication: Will it grow back? If you have experienced hair loss due to medication, you will most likely grow it back after a few months. But there are exceptions. Both anagen and telogen effluvium are temporary and reversible conditions. Hair growth will often reappear about 3 months after you discontinue the medication, although it will take about 12 to 24 months for your hair to return to its original texture and volume. Only in some cases will hair loss continue after stopping the prescribed drug. For example, if the medication was just a trigger for a genetic hair loss  condition or if telogen effluvium became chronic. In these situations, you might continue experiencing shedding and won’t see any significant hair regrowth. .

Which medications cause hair to fall out?  Many types and groups of medications lead to hair falling out as a side effect. Within the medication groups, some cause hair loss and others do not. For example, not all antidepressants cause hair loss, but some of them do. We present you with the list of medications most often associated with hair loss.

ACNE MEDICATIONS: Oral medications used to treat severe acne usually contain isotretinoin, a retinoid (vitamin A derivative) that is linked to hair loss. The mechanisms of action of isotretinoin are not well understood yet, however, recent studies indicate the drug suppresses sebum production and also the production of sex and thyroid hormones, which could directly affect the hair cycle. Some of the acne medications that cause hair loss include:

• Absorica
• Accutane
• Amnesteem
• Claravis
• Myorisan
• Sotret
• Zenatane

ANTIBIOTICS: Can antibiotics cause hair loss? Yes. Antibiotics that cause hair loss are more common than you think. In fact, this is a somewhat frequent side effect, particularly in long-term treatments. The main reason why antibiotics can make your hair fall is that, besides neutralizing bad bacteria, they also affect good bacteria. As they do this, they can get in the way of absorption and metabolic processes, making it harder for the body to use important nutrients, such as iron and B vitamins, both essential for hair growth. In this sense, almost all antibiotics have the potential to cause hair loss. Whether your hair falls or not depends on how sensitive to the drug and predisposed to hair loss you are.

ANTIDEPRESSANTS: Many people are not aware that antidepressants can cause hair loss when they first start their treatment. Some people might experience shedding a few months after first taking an antidepressant medication. The two most commonly reported antidepressants to cause hair fall are fluoxetine hydrochloride, better known for its brand name Prozac, and bupropion, whose brand name is Wellbutrin. Both Prozac and Wellbutrin are usually prescribed to treat patients with depression or other health conditions such as OCD and nicotine addiction. Their mechanisms of action are different, though. While Prozac works on serotonin levels, Wellbutrin regulates norepinephrine and dopamine. However, they both seem to have the same effect on the hair cycle: they prematurely push hair follicles from the anagen to the telogen phase. Prozac and Wellbutrin hair loss is reversible if you stop taking the drug.

This is a list of antidepressants that cause hair loss, besides Prozac and Wellbutrin:

• Zoloft (sertraline hydrochloride)
• Tofranil (imipramine)
• Janimine (imipramine)
• Anafranil (clomipramine)
• Elavil (amitriptyline)

Paroxetine, known by its brand name Paxil, seems to lead to hair loss in some patients but studies have reported it offers the lowest hair fall risks among all the antidepressants. Hair loss from antidepressants is usually seen 2 to 4 months after starting the drug. It is temporary and reversible from the moment the person stops taking the medication. Some people have experienced hair regrowth after a year taking the medication nonstop. Never stop an antidepressant without the supervision of a doctor, or you might experience adverse effects.

ANTICOAGULANT DRUGS: Hair loss is often associated with the use of blood thinners heparin and coumarin (including warfarin), even though the exact mechanisms by which this happens are still unknown. Hair loss from anticoagulants usually starts 8 weeks after taking the medication for the first time. It is temporary and reversible once the drug is suspended. Warfarin brand name is Coumadin and brand names for heparin include:

• Ariven
• Arteven
• Bemiparin
• Calciparine
• Clexane
• Fluxum
• Hemochron
• Hep-Lock
• Hep-Lock U/P
• HepFlush-10
• Heparin Sodium
• Hepathrom
• Leparan
• Pabyrin
• Pularin
• Vetren

ANTICONVULSANTS: Hair loss has been reported as a side effect of medications that treat seizures and bipolar disorder. Some of the most commonly reported antiepileptic and antiseizure medications that lead to some degree of hair loss include:

• Valproic acid / divalproex (Depakene, Depakote, Valproate Sodium, Depacon, Stavzor)
• Carbamazepine (Tegretol, Carbatrol, Epitol, Tegretol XR)
• Lamotrigine (Lamictal, Lamictal XR, Lamictal CD, Subvenite)
• Levetiracetam (Keppra, Keppra XR, Spritam, Roweepra XR)

ARTHRITIS MEDICATIONS : Hair loss is a common symptom among people with autoimmune rheumatoid arthritis as well as a side effect of some medications prescribed for this and other types of arthritis. In many cases, hair fall can be controlled by adjusting the dosage; in other cases, the only way to stop it is discontinuing the drug, which for many arthritis patients is not possible or recommended. Hair loss from arthritis medication is usually experienced after 6 to 8 weeks of starting the treatment. Usually, arthritis is treated with one or more of these types of medications: disease-modifying antirheumatic drug (DMARD), biologics and nonsteroidal anti-inflammatory drugs (NSAIDs). All of these might lead to hair loss in about 1 to 10 percent of people, according to the Arthritis Foundation. To learn about the NSAIDs most commonly associated with hair loss symptoms, please scroll down to the NSAIDs section. Regarding DMARDs and biologic that may cause hair loss, not all of them cause hair loss. This is a list of the ones that might:

• Methotrexate (Trexall, Rasuvo, RediTrex, Xatmep) – Often used as a chemotherapy agent too.
• Leflunomide (Arava)
• Etanercept (Enbrel, Eticovo, Erelzi)
• Adalimumab (Humira, Amjevita)

According to the Arthritis Foundation, people taking these medications and experiencing hair loss might benefit from supplementing folic acid under the supervision of their doctor. Chemotherapy and steroid injections can lead to sudden or progressive hair loss.

CANCER DRUGS :Cancer or chemotherapy drugs are designed to kill cancer cells. However, they also kill some healthy cells in the body, and hence, they can affect hair follicles and hair matrix cells, leading to hair loss. If you are on chemotherapy, you are likely to lose your hair gradually or extremely quick, on your head only or on your whole body. Not everyone on chemotherapy loses all their hair, but most experience at least some hair thinning and accelerated shedding. How much hair you lose and how quickly depends on the drug, as well as the frequency and duration of the treatment.

Which chemo drugs cause hair loss? Most reports include the following:

(Generic name – Brand names – Cancer treated)

• • Altretamine – Hexalen – Ovarian
  • Carboplatin – Paraplatin, Carboplatin Novaplus – Cervical, Ovarian, Testicular, Others
  • Cyclophosphamide – Cytoxan, Cytoxan Lyophilized, Neosar – Leukemia, Brain, Breast, Hodgkin’s Lymphoma, Others
  • Dactinomycin – Cosmegen – Sarcomas, Ovarian, Testicular, Wilms’ tumor.aunorubicin – Cerubidine – Leukemia,
  • Docetaxel – Taxotere, Docefrez – Breast, Gastric, Prostate, Others
  • Doxorubicin – Adriamycin, Adriamycin PFS, Adriamycin RDF – Leukemia, Bladder, Breast, Lymphomas, Sarcomas, Ovarian, Thyroid, Others
  • Epirubicin – Ellence, Pharmorubicin PFS, Pharmorubicin RDF – Breast
  • Etoposide – Toposar, VePesid, Etopophos – Hodgkin’s Lymphoma, Ovarian, Lung, Testicular
  • Fluorouracil – Adrucil – Anal, Breast, Cervical, Colorectal, Pancreatic, Stomac
  • Gemcitabine – Gemzar, Infugem – Breast, Lung, Ovarian, Pancreatic
  • Idarubicin – Idamycin PFS, Idamycin – Leukemia, Solid tumors
  • Ifosfamide – Ifex – Cervical, Testicular
  • Irinotecan – Camptosar – Colorectal
  • Methotrexate – Trexall, Rasuvo, RediTrex, Xatmep – Leukemias, Bladder, Brain, Breast, Cervical, Colorectal, Esophageal, Others
  • Paclitaxel – Taxol, Onxol – Breast, Sarcomas, Ovarian, Others
  • Tamoxifen – Nolvadex D, Nolvadex, Tamone, Emblon – Breast
  • Topotecan – Hycamtin – Cervical, Lung, Ovarian
  • Vincristine – Oncovin, Vincasar PFS – Leukemia, Lymphomas, Multiple myeloma, Others
  • Vinorelbine – Navelbine – Lung

Note: Doxorubicin (Adriamycin) is the main drug in CAF chemo treatments, which cause complete baldness during the first few weeks of therapy. Methotrexate (Trexall) is the main drug in CMF chemo treatments, which cause some thinning of the hair but not complete hair loss.
Radiation therapy is also associated with hair loss but only on the body part that is being directly treated.
Hair loss linked to chemotherapy is, in most cases, reversible.
Once you stop the treatment, it might take several weeks for you to see hair growth, and you might notice a different quality to your hair, but in time you will see normal hair growth and texture. Sometimes, hair regrowth after chemotherapy is of unusual texture. For example, you might see new curly hair even if you had straight hair before chemo.

CHOLESTEROL-LOWERING DRUGS : Statins are effective cholesterol-lowering agents that are frequently prescribed as long-term medication treatments. Alopecia is a rare but possible side effect of these drugs. Even though no study has linked the two yet, many people who are on these prescription drugs for high cholesterol report hair loss during the treatment, and hair regrowth when they stop the medication. Atorvastatin, known for its brand name Lipitor, and simvastatin, known for its brand name Zocor, have been reported as causes of temporary hair loss. Some people also experience hair loss when taking Atromid-S and Lopid.

• • Metoprolol (Metoprolol Tartrate, Toprol-XL, Lopressor)
  • Captopril (Capoten)
  • Enalapril (Vasotec)
  • Lisinopril (Zestril, Prinvil, Qbrelis)
  • Atenolol (Tenormin)
  • Nadolol (Corgard)
  • Propranolol (Hemangeol, Inderal, InnoPran)
  • Timolol (Blocadren)

Only about 1 to 5 percent of patients report hair loss with blood pressure medication, and it is usually a temporary side effect and fully reversible. Furosemide is a blood pressure medication that does not cause hair loss as is Hydrochlorothiazide. Discuss with your doctor the pros and cons of these drugs and the ones you are taking.
Do not interrupt or change the dose of your current medication without first consulting with a health professional.
HORMONES INCLUDING THE PILL: In women, estrogen or progesterone hormone replacement therapy (HRT), also known as menopausal hormone therapy or treatment for menopause, is associated with the onset of telogen effluvium.
Hair loss on birth control pills is also a frequently reported side effect. Some women experience hair loss while they are taking the pill, while others see shedding only after stopping oral contraceptives or when they switch from one type of pill to another. Hormone injections, hormone skin patches, progestin implants, and vaginal rings can also lead to hair loss.
Why does the pill, other contraceptives, and HRT cause hair loss? They trigger the telogen phase in your hair follicles, particularly if you are sensitive to the given hormone or if you are already predisposed to hormone-related hair loss (like if it runs in your dad’s or mom’s family). It’s the same mechanism seen in alopecia during and right after pregnancy.
So, birth control pills and hair loss: Is it permanent? For most women hair loss related to birth control pills is not permanent. However, if you are already predisposed to Androgenic Alopecia (hormone-related hair loss), you might continue to see your hair fall even after stopping the pill or any other hormone-based birth control and will continue losing hair progressively thereafter. To help prevent or at least slow down this situation, the American Hair Loss Association recommends opting for low-androgen index oral contraceptives. The following contraceptive pills might lead to some degree of hair loss and/or trigger hormone-related alopecia such as Female Pattern Baldness.
They are listed from the lowest-androgen to the highest-androgen index:

• Desogen
• Ortho-Cept
• Ortho-Cyclen
• Ortho Tri-Cyclen
• Micronor
• Nor-Q D
• Ovcon-35
• Brevicon/Modicon
• Ortho Norvum 7/7/7
• Ortho Novum 10/11
• Tri-Norinyl
• Norinyl and Ortho 1/35
• Demulen 1/35
• Triphasil/Tri-Levien
• Nordette
• Lo/Ovral
• Ovrette
• Ovral
• Loestrin 1/20
• Loestrin 1.5/30

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) : Both over-the-counter and prescription nonsteroidal anti-inflammatory medications used to treat inflammation, pain, and fever can cause hair loss in some people. This drug-induced alopecia depends on predisposition, length and frequency of medication use, and dosage. NSAIDs that can cause hair loss include:

• • Ibuprofen (Advil, Motrin, IBU)
  • Naproxen (Aleve, Naprosyn, Anaprox)
  • Celecoxib (Celebrex, Elyxyb)
  • Diclofenac (Voltaren, Cambia, Zorvolex, Zipsor)
  • Etodolac (Lodine)
  • Fenoprofen (Nalfon, Profeno, Fernortho
  • Indomethacin (Indocin, Tivorbex)
  • Ketoprofen (Oruvail, Nexcede, Orudis, Actron)
  • Oxaprozin (Daypro)
  • Nabumetone (RelafenSulindac (Clinoril)

Hair shedding usually begins within 2 months of using NSAIDs for the first time. The longer and more frequently these medications are used, the more likely you are to experience hair loss.
PARKINSON’S DISEASE DRUGS :A few cases of hair loss induced by dopamine-agonists used to treat Parkinson’s disease have been reported in the last two or so decades.
The most commonly reported are:

• Dopar
• Larodapo

STEROIDS : Steroids work by affecting the levels of certain hormones in the body and are used for a multitude of reasons that go from relieving chronic inflammation to assisting transgender people to go from female to male. In many cases, bodybuilders use anabolic steroids to increase performance and build muscle, although this is risky and not recommended. Steroids increase the levels of dihydrotestosterone (DHT), the testosterone-derived hormone most commonly associated with baldness in men and women. In fact, treatments for Male Pattern Baldness as well as for Female Baldness are usually about reducing the amount of DHT in the hair follicles on the scalp. Not everyone experiences hair loss with the use of steroids though and it mainly depends on two things: genetic predisposition to baldness and degree of sensitivity to DHT. Men who misuse steroids for appearance or athletic reasons are also most likely to see increased and sudden hair loss, which in most cases of steroid-induced baldness is not reversible. Every anabolic and androgenic steroid drug will cause hair loss, particularly in long-term use situations.

The most likely steroids to cause hair loss include:

• • Anadrol
  • Dianabol
  • Masteron
  • Prednisone
  • Primobolan
  • Proviron
  • Trenbolone
  • Winstrol

In sum, you can never be certain how steroids will affect your body. Genetic predisposition is a factor but not the only one. If you want to avoid hair loss at all costs, avoid using any type of steroid drug. Hair loss caused by medications is usually reversible and can stop once the drug is discontinued.

• • Phentermine for weight loss
  • Acitretin (Soriatane) for psoriasis treatment
  • Amiodarone for heart arrhythmia
  • Cimetidine for GERD and acid reflux
  • Colchicine for gout
  • Ketoconazole for fungal infections
  • Amphetamines
  • Famotidine (Pepcid) for upset stomach
  • Lithium
  • Gabapentin for seizure disorders and nerve damage
  • Bromocriptine for menstrual problems, Parkinson’s and tumor
  • Escitalopram (Lexapro) for depression and anxiety treatment
  • Metformin for diabetes
  • Levothyroxine for thyroid (mostly in cases of overdose)
  • Medications that contain thallium, boric acid, bismuth, and arsenic
  • Medications that contain vitamin A

SUPPLEMENTS THAT CAUSE HAIRLOSS: Yes. Supplements can cause hair loss in some people, and it is usually related to the dosage. It is very important to follow the recommended dietary allowances for each supplement and discussing with your doctor the addition of a supplement to your routine. Even though vitamins, minerals, and some herbs are very beneficial to your health, there are plenty of natural sources for them and it is difficult to calculate how much you are really ingesting of a particular nutrient. For example, if you are supplementing with zinc, you need to be careful about the orange juice and other zinc-enriched products you might be consuming too.
The most common supplements to trigger telogen effluvium include:

• • • • Vitamin A – RDA 700-900ug
      • Selenium – RDA 55 mg
      • Zinc – RDA 10 mg
      • Vitamin E – RDA 3-4 mg

What can you do if you have hair loss from medications? Discuss with your doctor if your dosage can be adjusted or if you can switch to another medication that also helps your condition without the hair loss side effect. Never do this without the strict supervision of your doctor. In most cases, hair loss from medication will stop a few weeks after you discontinue the drug. However, new hair growth can take a while (12 to 24 months) and might not return to its original texture or volume.
If you have been taking the medication for a long time, you might also develop chronic telogen effluvium. That means you might continue losing hair even after stopping the medication. Chronic telogen effluvium can last up to 7 years. Discuss your hair loss with your doctor. Discontinuing the drug is not always the only solution. Sometimes, adjusting the dosage or adding a supplement can help a great deal.

Please Note: The list of medications that can cause hair loss is extensive and it is not meant to scare you. Again, do not discontinue any medication without having an informed discussion with your doctor. In many cases, there are alternative medications, or as mentioned above, supplements that may help. Also, not everyone experiences hair loss from the above listed drugs. This is simply a list of medications that were involved in trials, and they must list ALL of the side effects reported by those that were included in the trial. If only one member of a trial experienced hair loss as a side effect, then it is listed on the medication as a possible side effect.