Noticing more hair in your shower drain?

Avoiding your hair brush because it reminds you of how much hair you're losing daily?

You're not alone. In fact, I'm right there with you!

Hair loss is SUPER common. People spend hundreds upon hundreds of dollars (and even thousands) on hair products--from shampoos and serums to medications and professional treatments.

What does normal hair loss look like?

Before we get into why you're losing hair, let's first go through what normal hair loss looks like.

We actually (very normally) lose 50-200 hairs per day! You lose less on a non-shampoo day, and more on a shampoo day (or even a hair oiling day if you do that).

So, it's not an abnormal thing that happens. It's JUST. A. THING.

Your hair follicles are in different phases of growth and scalp stimulation (of sorts) can cause the hair that was already going to fall out come out sooner. This is because there's a hair growing behind the hair that's going to fall out.

Why is my hair falling out more than usual?

Now, if you're noticing excessive hair fall, i.e., more than the normal amount you lose.

This can be pretty scary, especially if it persists.

Here are some reasons why this may be happening:

• Stress response: this is called a telogen effluvium and it's a BIG reason. Stress in this case can look like different things: physical stress like an injury, immunological stress like an infection, physiological stress like rapid weight loss, hormonal shifts like stopping oral contraceptive pill, postpartum, menopause, etc., and/or mental-emotional stress. In telogen effluvium, the hair loss typically shows up 2-3 months after the stressful event. So, if you're losing hair now, think back to a few months ago: what was happening back then?
• Pattern Hair loss: this is androgenetic hair loss, meaning it's related to testosterone and DHEA and you may even have a strong genetic predisposition here. This is male pattern baldness or female pattern hair loss (top of the head, hairline) It's actually the most common type of hair loss and tends to get worse with age. It's also a super common symptom seen in PCOS (polycystic ovary syndrome).
• Nutrient Deficiencies: the most common deficiencies that we can test for are iron and vitamin D. These deficiencies also can lead to fatigue, mood changes, and the blahs. Other than those two, irregular eating and undereating can also lead to hair loss because when you eat poorly, you get less nutrients!
• Other reasons: autoimmune hair loss often shows up as alopecia areata which are bald patches due to your immune system overreacting to your hair follicles, medications and supplements like Accutane and cancer drugs as well as too much vitamin A, hair-pulling (aka trichotillomania), and scalp conditions and infections.

Medications your doctor might recommend or prescribe

You may or may not like using medications BUT they do work. In fact, we have wayyy more science on some of the following medicated treatments than natural solutions at this point in time.

Here are the ones commonly used:

• Topical Minoxidil: This comes in a 2.5% or 5% solution, with the foam being the most user-friendly. It takes 4-8 months to see hair growth, aaaand you may actually see more hair loss initially (which is part of the process--trust it!). To keep your gains, you gotta use it forever (else your hair will return to its baseline, whatever that is for you). Tip: application is easier with a spoolie or toothbrush to target the spots you want.
• Oral minoxidil: This is more effective than the topical version, but has side-effects like body hair growth elsewhere.
• Finasteride: This is actually the gold standard for pattern hair loss and it works by decreasing hormone conversion that causes that kind of hair loss. In males, it can lead to erectile dysfunction, and in females we use it with contraception because it can cause fetal abnormalities (if you conceive while taking the medication).
• Spironolactone: This is often used in female pattern hair loss, especially if/when also accompanied by hirsutism (facial hair growth and body hair growth that is thick and coarse) and/or acne seen in conditions like PCOS. This is an anti-androgen and is often used with contraception as it can lead to fetus abnormalities (if you conceive while taking it).

Natural, Integrative, and Other Options for Hair Loss and Hair Regrowth

Soooo, the research isn't great for these options (which also leads to a lot of money wasted on products that don't really help you out). That said, there ARE solutions available.

• Topical caffeine: 0.2% is the dose studied and is often found in serums and such
• Topical Pumpkin seed oil: This is easy to find and easy to use, especially if you already oil your hair. It may not be feasible to use every single day (which is how it was studied) but it's a solid option
• Saw palmetto: This one could be helpful orally and/or topically to improve hair density in pattern hair loss driven by hormones
• Low-Level Laser Therapy: Red light therapy can actually be helpful!
• PRP (Platelet-rich Plasma): This is your spun down and processed blood injected into your scalp and should be done with a professional well-trained in it for hair! It's also expensive.
• Zinc pyrithione: A 1% concentration shampoo left on for 2 minutes before washing off can help a little bit. The most common brand here is Head & Shoulders (there's alternatives out there)
• Other considerations: a multivitamin with some focused nutrients and/or supplemenation can be helpful if your diet leaves something to be desired and/or if you're going through a stressful time. Definitely supplement with iron and/or vitamin D if you're low in those, and make sure to eat adequate protein for your hair too.

Could medications, supplementation, and natural topical solutions be combined?

In science, we study most things solo and used perfectly--in real life, however, things aren't necessarily perfect (I feel that in my bones lol).

So, even though we haven't really studied different solutions together, layering a few things in can be helpful; as in, a few options scattered throughout the week is better than doing nothing. I can corroborate that through clinical experience!

I see A LOT of hair loss complaints in my practice through virtual care across Ontario, at The WellWoman Clinic in Sharon/Newmarket and at The Innisfil Wellness Centre near Barrie.

What Does Successful Hair Loss Treatment Look Like?

You'll notice a decrease in hair fall first (unless you choose minoxidil which may cause a bit more shedding before it decreases the hair fall--again, very normal).

Then, you'll (hopefully!) start to notice regrowth: those pesky little hairs that are unruly and give you that static-chic kind of look lol! It's all part of the process you signed up for.

Here's where I also think we need to talk about reality versus expectation.

You likely want your hair to return 100% to its former glory, but that's going to set you up for failure. In medicine, we're looking for a 40-60% improvement IF consistent effort being put in.

(Sorry, wishful thinking doesn't work here ... it would be nice!)

Remember, hair loss is SUPER common and SUPER frustrating. See your naturopathic doctor or medical doctor to start understanding where your hair loss is coming from.

If you're looking for support in Ontario, reach out sooner rather than later if you want to keep the hair on your head! You can book in here.