The Absolute Hair Loss Guide





Going by the statistics, roughly 50% of women are affected by hair loss. About 40% of men have noticeable hair loss by the time they turn 35, about 65% of them by the age of 60 and about 80% by the time they turn 80. And losing hair can have a deep impact on them.

Sample this – 60% of hair loss sufferers would rather have more hair than money or friends and almost half (47%) of the hair loss sufferers would spend their life savings to regrow their hair!

Therefore, it is not uncommon to find people suffering from hair loss leaving no stones unturned to find ‘baldness cure’. They try every trick in the book and wait for miracles to happen. But by the time they realize the actual reasons behind their hair fall or hair loss and seek professional help, it is already too late.

We thought of lessening the ordeal for people who suffer from hair loss or hair fall. Because there is an overwhelming amount of literature available online about hair fall, hair loss, hair regrowth and everything in between, we thought of coming up with a comprehensive guide that answers most, if not all of the queries related to the same.

Take a look.

There is a difference between hair fall and hair loss.

When the hair falls out, new hair takes its place. But in the case of hair loss, hair may not grow back and replace the fallen hair. Sometimes, even when the hair does grow back, they are not enough, leading to a thinning hairline, followed by baldness.

On an average, a human adult has about 100,000 – 150,000 strands of hair. Therefore, losing about 50-100 strands per day is a common phenomenon and should not be considered as hair fall or hair loss.

  • In men, the hair recedes from the forehead in a line resembling the alphabet M.
  • In women, the hair on the forehead remains unaffected, but the parting of their hair broadens.
  • Hair starts thinning gradually from the top of the head or all over the scalp.
  • Circular bald spots or patches appear all over the scalp, which may be the size of a coin.
  • Itchy or pain on the scalp before hair fall.
  • Loss of hair all over the body.

Both men and women can experience hair fall or hair loss at different stages of their lives owing to various reasons. Even kids can experience hair fall/ hair loss.

There is no ‘age’ for hair fall/hair loss. Kids, adults and the elderly can experience hair fall/hair loss at some or the other stages of their lives.

Only a doctor can aptly diagnose and evaluate hair loss and tell you the underlying cause(s). To diagnose hair fall/hair loss, you need to visit your trichologist. He/she will examine you thoroughly, go through your medical records and ask you some questions. If needed, he/she will ask you to go through some tests such as – blood test, pull test, light microscopy and a scalp biopsy to check the extent of hair fall and hair loss. These tests also help them determine the stage of the hair fall or hair loss and shed light on the reasons.

It is not uncommon to come across several misconceptions or myths related to hair fall and hair loss. Some of them are:

  • It’s the mother who carries the genes of hair loss.
  • It’s only men who suffer from genetic hair loss.
  • Women tend to lose their hair only post pregnancy and menopause.
  • Any shedding of hair on a daily basis, indicates hair loss.
  • Hair thinning is always a result of old age.
  • If you’ve a head full of hair post 40, you are less likely to lose it.
  • Hair loss can be easily detected by taking a look at your head.
  • Rogaine or Minodoxil is the only treatment that works.
  • Hair replacement surgery or hair transplant are the best treatments for hair regrowth.
  • Men with high testosterone levels go bald quickly.
  • Wearing headgear makes you go bald.
  • A change in temperature causes hair loss.
  • Cutting your hair and shaving your head promotes healthy hair growth.
  • Hair loss can’t always be treated.
  • Plucking one hair (especially grey hair) makes two grow back in its place.
  • Standing on your head promotes hair regrowth.
  • Dead follicles can be regrown.
  • Exposure to the sun or tanning beds leads to hair loss.
  • Hair growth oil can work miracles.

Hair grows on the human skin except for the palms and soles. Made up of a Keratin (a protein that your nails are also made up of), hair is created in hair follicles that lie on the outer layer of the skin. These follicles are responsible for production of new hair cells. As new cells are produced, the old cells are pushed out through the surface of the skin. This is how hair grows.

So, your hair is basically a string of dead keratin cells.

Each of the hair follicles have a life cycle of its own. This life cycle can be influenced by age, disease and a number of other factors and is divided into phases.

Phase 1: The Anagen Phase/Growing Phase

Duration of 2-6 years. Active hair growth occurs in this phase. This phase determines the hair length.

Phase 2: The Catagen Phase/Regression Phase

Duration of 10 days or in some cases, 2-3 weeks. Transitional hair growth occurs during this phase with the shrinking of hair follicles.

Phase 3: The Telogen Phase/Resting Phase

Duration of 2-3 months. This is a resting phase at the end of which, hair sheds and is replaced by new hair. The growing cycle starts again once the resting phase is over.

Phase 4: The Exogen Phase/Shedding Phase

In this period, the resting hair detaches from the follicle and sheds.

Note: It should be noted that the rate of hair growth slows down as we age.

Hair loss or Alopecia and the severity, duration and effect varies, depending on various factors.

  • Involutional Alopecia – This is a natural condition, where the hair starts thinning gradually with age. In this condition, the hair follicles enter the resting phase in large numbers. The remaining hair reduces and this results in visible hair loss.
  • Androgenic Alopecia – Also known as Male Pattern Baldness, Androgenic or Androgenetic Alopecia a genetic condition and can also affect women (Female Pattern Baldness). Men who are affected by Androgenic Alopecia, can suffer hair loss right from their teens or in their early twenties. A receding hairline and thinning hair from crown and frontal scalp are tell-tale signs of the condition. As opposed to men, women who are affected by this condition, don’t have visible thinning of hair until they reach their forties or later. The hair thinning in women occurs generally over the entire scalp, but the major extent of hair loss is at the crown.
  • Alopecia Areata – Alopecia Areata results in hair loss in patches. This condition is prevalent in children and young adults, often leading to complete baldness (Alopecia Totalis). The condition can’t be cured but treated. With an effective treatment, the hair is most likely to regrow within a span of a few years.
  • Alopecia Universalis – Hair loss is not just limited to the scalp. In a condition called Alopecia Universalis, it affects the entire body i.e. it causes body hair to fall out such as the eyebrows, eyelashes, hair on the arms and legs and pubic hair. It is an advanced form of Alopecia Areata.
  • Alopecia Totalis – Alopecia Totalis or complete baldness. The causes of it is still unknown, but it is speculated to stem from autoimmune diseases.
  • Telogen Effluvium – A temporary thinning of the hair on the scalp, Telogen Effluvium is a result of the changes in the hair-growth cycle. In this condition, hair shedding and subsequent thinning occurs as a large number of hair enter the resting phase.
  • Anagen Effluvium – Chemotherapy or radiotherapy, which is used to treat cancer, also has a toll on the hair in the form of Anagen Effluvium,. It disrupts the matrix cells of the hair follicles. As a result of this, the patient loses hair in patches and gradually, loses all the hair on the scalp. However, most of the cases, hair regrows within 6 months or more after the treatment is ceased. Similarly, some other medicines can also lead to hair loss.
  • Alopecia Mucinosa – Alopecia Mucinosa is also called Follicular Mucinosis. It refers to an inflammatory condition of hair follicle and sebaceous glands, which may result in scarring/non-scarring hair loss. This condition can affect any part of the body, but more often than not, it affects the neck, face and the scalp. Different types of Alopecia Mucinosa can affect children and teenagers, people over 40, and people having a skin disease. It is often perceived as an autoimmune disease. Early treatment can curb it to an extent and reverse it. This means that there are chances of the hair growing back. In severe cases though, the hair will not grow back, even when the disease is gone.
  • Cicatricial or Scarring Alopecia – A permanent loss of hair, Cicatricial Alopecia can be triggered by – inflammatory skin conditions such as acne, folliculitis and cellulitis along with other disorders like lupus and lichen planus. These skin conditions destroy the ability of hair to regenerate or regrow, leading to baldness. Sometimes, tight hairstyles over a period of time (Traction Alopecia) and use of hot hairstyling tools can also result in permanent hair loss.
  • Alopecia Barbae – Alopecia Barbae refers to loss of facial hair and affects men more often than women. They lose hair in the beard-area of their face.
  • Traction Alopecia – Too much pulling or tension on the hair shafts also leads to hair loss over a period of time. This is more common in women than men, especially those who experiment with tight hairstyles such as tight braids, cornrows, buns and ponytails along with excessive use of hair accessories and extensions that pull the hair shafts.
  • Psychological disorders – Trichophagia is compulsive of one’s own hair. It is often associated with Trichotillomania or pulling out one’s own hair, leading to hair loss.

It is common for everyone to lose up to 100 strands in a day. Severe hair fall occurs when the number of strands are more and can lead to hair loss (where the hair doesn’t grow back), if untreated. Here are some of the most common causes of hair fall/hair loss:

  • Hereditary: Androgenic Alopecia is hereditary hair loss and is one of the most common causes of hair loss. There are many myths that say hair loss gene is inherited from the mother’s side. This is false. The gene can be inherited from either of the parents’.
  • Telogen Effluvium: Telogen Effluvium is a condition that leads to excessive shedding of hair. It is often triggered by a major disease or surgery, extreme stress, drastic weight loss and even pregnancy. As a result of shock from various causes, the hair enters its resting phase. However, the hair often grows back, once it is out of the resting phase.
  • Unhealthy scalp: An unhealthy scalp can result in the infection and inflammation of hair follicles and has a negative effect on the hair growth. Seborrheic Dermatitis, Psoriasis, Ringworm are some of the common conditions that inhibit the growth of hair and all these conditions are often triggered by an unhealthy scalp.
  • Diseases: There are certain diseases, which are closely associated with hair fall and hair loss. Some of them are:
    • Thyroid malfunction: The malfunction of the thyroid glands leads to thyroid diseases, which are a leading cause of hair fall and hair loss. Without the right amount of thyroid hormones, the growth of hair slows down drastically. In some instances, the hair may also become prone to brittleness and breakage.
    • Autoimmune diseases: A number of autoimmune diseases such as Lupus, makes the body’s immune system attack healthy tissues. This leads to hair loss, which can range from mild to severe. When its severe, the hair falls out in patches, leaving rashes on the scalp. When it is mild, hair falls out in relatively fewer numbers during shampooing or brushing/combing.
    • Anemia – Iron-deficiency anemia can also lead to hair loss.
    • PCOS/PCOD – Polycystic Ovarian Syndrome/Disease is also a cause of hair loss. However, while this may lead to hair loss on the scalp, women can experience facial hair growth and hair growth on other parts of their body.
  • Excessive styling: Excessive styling of the hair using extreme heat, products laced with harmful chemicals or pulling the hair shaft too tightly can also lead to potential hair loss over a period of time.
  • Physical or emotional shock: Physical or emotional shock such as extreme trauma after an accident, post-pregnancy can also lead to hair fall. This type of hair fall can often be temporary in nature.
  • Age: Many people experience thinning of hair, followed by hair loss, as they age.
  • Medical treatments: There are certain medicines, which can cause hair loss.
  • Injuries: Physical injuries such as those resulting from an accident and scarring, burns on the scalp etc. can also lead to the loss of hair. These are often permanent in nature and require surgical procedures for treatment. However, it differs from patient to patient.

There is no specific time as such to see your trichologist. The moment you detect some symptom of hair fall or hair loss, especially if it happens all of a sudden, book an appointment with your trichologist without any delay.

As soon as your trichologist detects and diagnoses hair fall or hair loss, you need to start the treatment. After all, a stitch in time saves nine!

Both hair fall and hair loss can be treated to an extent. In some cases, hair fall treatments and hair loss treatments are accompanied by healthy hair regrowth. Some of the effective hair fall treatments or hair loss treatments include but are not limited to:

  • Over the counter lotions: Hair For Sure is a clinically-proven lotion that works effectively for hair loss. Available as an over-the-counter-product, you don’t need a doctor’s prescription for the lotion. Use the product on a regular basis, as instructed on the packaging and you’ll be able to see visible results over a period of time.
  • Hormone therapy – Hormone therapy or Hormone replacement therapy (HRT) is a common treatment opted by women, who suffer from hair loss. This should ideally be the last resort due to a number of negative side-effects that follow the treatment.
  • Laser Phototherapy/ Light therapy – A low level of light treatment or Laser Phototherapy can be a useful treatment for Androgenetic Alopecia. And like every medical procedure, this treatment also has its own share of pros and cons and needs to be opted only when prescribed by a medical practitioner.
  • Steroid injections: Corticosteroids injections and ointments are often used for treating Alopecia Areata. In some cases, pills are also prescribed. The ointments available are less effective though. There are several sessions for this expensive treatment.
  • Immunotherapy – Immunotherapy is often prescribed for total hair loss. However, it can have certain side effects like rashes and swollen lymph nodes among others.
  • Alternative therapies – A lot of people suffering from chronic hair loss turn to alternative therapies such as homeopathy, aromatherapy, acupuncture, ayurveda and so on and so forth. However, these treatments often take up a lot of time to show results and may not be as effective.
  • Surgery and replacement/hair transplant – Hair transplants or hair replacement are treatments that are rapidly gaining popularity. Although they too have certain side-effects, most people don’t opt for them because both hair replacement and hair transplant cost is way too high for them to afford. (Read more about surgical treatment for hair loss here)
  • Change in the lifestyle – Maintaining a clean scalp and having a balanced diet can make a huge difference in your lifestyle and is an effective way to prevent hair loss.

Home remedies or natural remedies are the tried and tested way of preventing hair fall to an extent. But their effectiveness for hair loss is debatable. For the time being, you can use them for preventing hair fall, but getting a trichologist’s opinion and using a clinically-proven product is always the better option.

Hair transplants regrow hair on bald patches of the head. The procedure is surgical and needs to be conducted by an expert. These treatments are quite expensive, have a number of temporary side-effects and require the patient to take additional supplements for ensuring maximum effectiveness. Usually the patients for these treatments include men with Androgenetic Alopecia or Male Pattern Baldness, women and people who have lost hair due to an accident.

But then, it is never a good option for those who have hair loss all over the scalp, those who don’t have sufficient number of “donor” hair sites, from which hair can be removed for the transplant, those with “Keloid scars” following an injury or surgery or those who lost their hair as a result of chemotherapy.

The side-effects of hair transplant include but are not limited to:

  • Bleeding
  • Itching
  • Infection
  • Bruising around eyes
  • Crust formation on scalp from areas where hair was implanted or removed
  • Folliculitis or inflammation/infection of hair follicles
  • Shock loss or temporary loss of transplanted hair
  • Loss of sensation or numbness on the treated areas
  • Tufts of unnatural looking hair

You can prevent hair fall/hair loss by avoiding certain medications (after consulting your doctor of course), getting adequate nutrition and maintaining a healthy lifestyle. Also, you need to stay clear of hairstyles and hair styling treatments that can lead to hair loss.

However, inherited hair loss or Androgenetic Alopecia can’t be prevented.

You can work on treating hair loss (see here) or follow some tips (given here). This should be of help.

  • Using shampoos/conditioners way too often: No matter what the advertisements say, using shampoos or conditioners on a daily basis can prove to be detrimental to your hair. They are laced with chemicals and can damage the structure of your hair follicles if overused.
  • Using too much of styling products: Hairstylists may wax eloquent about styling products and how they prove to be the elixir for your hair. For instance, gels, mousse, pomades, hair sprays, leave-in conditioners are some of the products that may make your hair look fantastic and get rid of a potentially bad hair day, but in the long run, these strip your hair off its natural oils. Also, let’s not forget the fact that product buildup can also potentially damage the hair follicles and slow down hair growth. If you have to use the products at all, use them sparingly.
  • Using cheap products: When products are expensive, know that they are expensive for a reason. By buying cheap products as an alternative, you are going to cause potential damage to your hair. This is owing to the fact that cheaper products may not be tested for effectiveness and contain additional chemicals, scents and preservatives, which can take a toll on the hair follicles as well as the hair shaft. This often accelerates hair fall and subsequently, hair loss.
  • Over-brushing hair: There is a common notion that says brushing your hair 100 times every day helps distribute natural oils from your scalp to the end of the hair and makes it appear shiny. Even teasing the hair too much for creating different hairstyles can cause irreparable damage to your hair.
  • Brushing wet hair: Wet hair is more prone to breakage. Therefore, make it a point to never brush your hair when it is wet. Instead, gently comb it with a wide-toothed comb or run your fingers through them to detangle. Don’t use a fine-toothed comb or brush it while the hair is still wet. You must also avoid vigorously rubbing your hair dry with a towel.
  • Using extreme heat: Blow-drying, straight-ironing, perming and curling your hair requires the use of styling tools that generate extreme heat. This damages the hair follicles.
  • Using chemical treatments: Chemically treating your hair with hair dyes, hair colors and other products is also one of the leading reasons of hair fall, hair thinning and hair loss.
  • Tight hairstyles: It goes without saying that tight hairstyles such as ponytails, braids, pigtails etc. pull the hair shafts vigorously and damage the follicles. The same holds true for using hair accessories such as elastic hair ties, barrettes and hair pins, which pull your hair at the shaft.
  • Unclean scalp: An unhealthy scalp is the playground of a number of infections and diseases. This may not result in hair fall or hair loss directly, but can lead to the buildup itchy patches on the scalp, which causes infection and inflammation of follicles. This infection and inflammation of the follicles stall hair growth.
  • Eating unhealthy: There is no definite proof that eating unhealthy promotes hair fall or hair loss. However, eating healthy may do the opposite i.e. promote healthy hair growth!

There are a lot of queries from people suffering from hair fall and hair loss, which are usually on the lines of –

  • How can I regrow my hair?
  • How can I retain my hair length or increase it?
  • How to stop hair fall/hair loss?
  • How to eat healthy for preventing hair loss?
  • What steps do I need to follow for hair fall control?

All these queries and more are answered via the following tips:

  • Hot oil massage: Massaging your scalp with hot oils is an age-old therapy that almost everyone has tried at some or the other point of our lives. While it doesn’t directly promote hair regrowth or is supposed to be the only remedy for hair fall control, massaging does improve blood circulation on the hair and stimulate the hair follicles. Also, it reduces anxiety and stress, which is often said to be one of the main reasons of hair thinning. After gently massaging your scalp with an oil, wash it off with a mild shampoo.
  • Opt for a topical hair loss or hair fall solution: Hair For Sure is a revolutionary product, which is clinically-proven to treat hair loss. The hair loss prevention lotion available as an over the counter medication, has a non-greasy texture and can be easily used on a daily basis. This is any day better than popping endless pills or going through expensive surgery to treat hair loss!
  • Treat wet hair with care: When your hair is wet, it is more susceptible to breakage. The best way to dry your hair is to let it dry naturally. And instead of rubbing your hair with a towel, opt for patting it dry. The best option is to use a t-shirt instead of a towel, because it tends to soak up moisture in a much better way. Alternatively, you can use a micro-fiber towel to dry your hair.

    Don’t brush wet hair and try air-drying it instead of using a blow-dryer. Also, never use blow-dryer on hair that is dripping with water! Instead, you can use a blow-dryer with cool air setting to dry your hair.

  • Say no to hot water head wash: Too much heat of any kind is bad for the hair and this includes hot water too. It damages the hair follicles and strips scalp of its natural oils. Therefore, avoid washing your hair with hot water and instead, rinse it with lukewarm water. In the end, wash the hair with cold water, which will close the pores and lock in the hair shine. This will make a huge difference to your hair and keep it healthy for a long time.
  • Avoid washing hair too frequently: As much as it is important to keep your scalp clean, make it a point to avoid washing it way too frequently. For instance, if you choose to shampoo your hair on a daily basis and use a conditioner along with it, the chemicals from these products will adversely affect your hair.
  • Choosing the right shampoo: Biotin is known to be good for hair growth. Try choosing a shampoo that contains Biotin. Alternatively, you can opt for a natural shampoo that contains less number of chemicals.
  • Be choosy about other products as well: Apart from your shampoo, you need to be choosy about other products, which include conditioners, hair spray, mousse etc. It is advisable going for quality products, even if they come with an expensive price tag. Never, settle for cheap fakes or alternate products with an unbelievably low price tag or you’ll end up doing more damage to your hair than you can imagine.
  • Ditch those styling tools: Styling tools such as blow-dryers, curlers, straightening irons etc. are bad for the hair. The extreme heat generated by these tools weaken the hair, make it brittle and this leads to hair fall in the long run. You can use them sparingly though (use a heat-protectant spray before this), and by keeping them on a low-heat setting.
  • Say no to chemical treatments: Just like heat, chemical treatments are also bane for your hair. Coloring, chemical straightening, bleaching, dying, lightening your hair are some of the treatments that are detrimental for your hair shaft. If at all you need to opt for hair treatments that involve a lot of chemicals, follow it up with homemade deep-conditioning treatment to restore the damage to an extent. This however, doesn’t guarantee protection against hair fall or hair loss.
  • Change the part of your hair: Women tend to lose hair at the part of their hair. To avoid this from happening, change the way you part your hair. This is one of the simplest hair fall solution that you can opt for.
  • Avoid tight hairstyles: Another red flag for your hair is tight hairstyles, which includes ponytails, cornrows, braids etc. They pull at your hair shaft and may lead to a receding hairline or thinning of hair. Let your hair loose literally, and you ‘ll be able to feel the difference.
  • Be gentle while handling your hair: Steer clear of anything that is rough on your hair including physical stress. When you comb or brush your hair, don’t tug at it with more force than is required and take your time while untangling it. Similarly, when you try out different hairstyles, make sure you don’t pull at the hair shafts way too roughly as this will only promote hair fall.

A healthy diet is a must for a healthy hair. Here are some “superfoods” that you need to include in your diet for a healthy hair growth or at least, for maintaining lustrous hair.

  • Carbohydrates: An essential source of energy, Carbohydrates play an important role in the growth of body tissues and hair. Include more carbs in your diet, which can be in the form of vegetables, grains, brown rice and fruits.
  • Proteins: Proteins should be there in ample amounts in your diet. Meat, poultry, milk, eggs, curd, cottage-cheese, nuts, legumes, oil seeds, soy and tofu are some of the rich sources of Proteins, which you can include in your diet to promote healthy hair growth.
  • Fatty acids: Fatty acids are useful in improving hair texture. Sources of essential fatty acids include – vegetable oils, oil seeds, pumpkin seeds and whole grains.
  • Vitamin A: Increasing the intake of vitamin A helps you maintain a healthy scalp. Opt for food rich in Beta-Carotene, which includes pumpkins, carrots, sweet potatoes, broccoli, apricots etc.
  • Vitamin B: Fresh fruits, citrus fruits, tomatoes, wheat, brown rice, legumes, oats, walnuts, sunflower seeds are some sources of Vitamin B, which improve hair texture, accelerate hair regrowth and prevent premature greying of hair.
  • Vitamin C: To enhance hair color and blood circulation on the scalp, increase the intake of Vitamin C. Citrus fruits, green leafy vegetables, bell peppers and cauliflower are the best sources of this vitamin.
  • Vitamin E: Known for improving oxygen circulation, Vitamin E enhances healthy hair growth. Rice bran, nuts, dark green vegetables, nuts, legumes and whole grains are some of the common sources of Vitamin E.
  • Vitamin K: Dairy food, cabbage, green leafy vegetables, oats, soy, yogurt and wheat are rich in Vitamin K and supports healthy hair growth.
    Antioxidants can also help you promote healthy hair apart from offering a number of other benefits. The best sources of antioxidants are – green tea, prunes, berries, avocados, eggs, nuts etc.
  • Water: Make sure that you drink a lot of water and other healthy fluids. Ideally, you need to have 8-10 glasses of water to flush out toxins and pollutants from your body and maintain lustrous hair.
  • Minerals like Iron, Potassium, Magnesium, Zinc etc. are also important and assist in hair regrowth. Dark green vegetables, whole grains, bananas, dairy products, nuts, fresh fruits, legumes, spinach, pumpkin and sunflower seeds and mushrooms are rich in minerals. Including them in your diet can significantly improve the health of your hair and help in hair loss prevention.
  • Apart from including these superfoods in your diet, avoid junk food, start exercising, avoid stress and cut down on alcohol, sugar and smoking.

Hair fall and hair loss treatments take their time and these treatments may differ from person to person. However, leading a stress-free and healthy lifestyle will ensure that you get the best results, irrespective of the route you take. Just make sure that you opt for the best treatment available and you will definitely have a fuller mane.