Facts and fables about hair

Getting bald is part of getting older

fable. At the hair clinic of the Erasmus Medical Center in Rotterdam, Tristan van Dongen treats people with very different hair problems. It is sensible for them to seek help, according to Van Dongen: “We often think that hair loss is part of getting older, but that is a misunderstanding. Your hair can also fall out due to a condition or because you treat it incorrectly. In many cases, something can still be done.”

Women in particular seek help with hair loss

Fact. When we think of hair problems, we often think of balding men. Yet Van Dongen mainly sees women in his consulting room who are seeking help for thinning hair. “In many cases there is androgenetic alopecia, popularly called male pattern baldness, a name that does not quite cover the load. The hair becomes thinner due to a combination of reduced blood flow to the scalp and an adverse effect of testosterone on the hair follicles. In men, the hair disappears at the coves and on the crown. In women, the hair implant on top of the head becomes thinner. If you treat this in time, the hair will come back in some people.” Van Dongen understands that people try all kinds of things to improve their hair. “The psychological impact of hair loss is really huge, especially for women.” Van Dongen hopes that men will also find their way to the consulting room more often. “Unfortunately, people often only report to us after it has been going on for a long time. A lot of precious time has been lost as a result.”

Autoimmune diseases can cause hair loss

Fact. An immune disease such as alopecia areata, spot baldness, can make your hair fall out. Van Dongen: “In that case, the immune system does not recognize the hair as its own and fires continuous attacks on the hair follicle. Inflammations develop around the hair root that cause bald spots on the head. The cause is a combination of genetic predisposition and an external trigger such as stress or an infection. Some people only get bald spots, in others all the hair on the head and body disappears. In the latter case, it is also called alopecia universalis. We try to get it under control with anti-inflammatory medication. If successful, the hair can grow back because the hair follicles have not been lost.”

There is no herb against baldness

fable. Van Dongen: “The drug minoxidil that was once prescribed to lower blood pressure is known to make your hair grow better. It improves blood flow and stimulates the hair follicle. It is available as lotion or foam. How effective it is varies from person to person and like many other medications, it can have side effects.” In addition to minoxidil, the prostate drug finasteride has also been approved for use against male pattern baldness. According to Thuisarts.nl, the effect of both drugs is minor and temporary.

Your hair is also getting older

Fact. “A hair disease is different from the natural aging process of the hair. Like the rest of our body, hair follicles are also subject to aging. The hair is thinning and the hair is slowly turning gray,” says Van Dongen. “I think the best example is the actor Richard Gere. Although he hasn’t gone bald, he doesn’t have nearly as full a bush as he did in his younger years. What we do have control over is the rate at which the hair follicles age. As with the skin, a healthy lifestyle has a positive effect. The aging is less rapid if you do not smoke and drink, and eat a varied diet.”

The hair falls out by washing it too often

fable. If your hair is thinning, it is all the more important to treat it properly. Van Dongen: “If you wash your hair too often with shampoo, it will become dry. Shampoo affects the structure of the hair, as does frequent bleaching and blow-drying. However, that you lose hair from washing too often, as is sometimes claimed, has never been proven.”

Frequently wearing a bun, cap or headscarf can give you bald spots

Fact. “If you regularly pull your hair hard, it can fall out. So be careful with tight tails and buns or frequent braiding. If it’s pulled out too many times, it won’t come back. In people who often wear a cap or a tight headscarf, you see that the hair falls out in the places where there is permanent pressure. The hair follicles suffer greatly from the pressure on the scalp. Therefore, regularly massage the bald spots. If there is better blood flow to the skin, some hair can come back,” says Van Dongen.

Have hair loss examined quickly to prevent further hair loss

Fact. “If people have a hair disease in which the hair follicles are lost, it is important to catch it as soon as possible.” In the disease lichen planopilaris, people suffer from inflamed hair follicles on the scalp. In frontal fibrosing alopecia, the hair in the front hairline falls out. This is especially the case for post-menopausal women. “Go to a specialist to have it assessed and treated”, is Van Dongen’s advice. “In the past, a hair root examination was often done; some hairs were then pulled out to look at the hair roots. Today this is different. We examine the scalp with a trichoscope, a kind of digital microscope that allows us to zoom in very strongly on the hairs on the scalp. Sometimes we take a piece of skin containing the hair follicles; this is also called a biopsy. If we see that the hair follicles are lost due to the inflammation, it is important to start treatment quickly. The lost hair follicles do not come back.”

Some medicines make your hair fall out

Fact. Van Dongen: “Our hair grows on average about six years. Then it enters a resting phase and falls out. Because every hair is in a different growth phase, our hair does not fall out all at once as with animals that are moulting. Different types of medication, such as beta-blockers and drugs to treat acne, epilepsy or thyroid disorders, can disrupt the growth process and cause it to fail all at once. Unfortunately, as long as you take the medication, the problem will persist. Stress, anemia, a deficiency of iron, vitamin B, D or thyroid disorders can also affect the growth phase of the hair.”

Some supplements can help against hair loss

Fact. “In the past, it was sometimes thought that biotin, a vitamin in food, would help hair growth. But this has never been proven,” says Van Dongen. “However, some nutritional supplements, such as omega 3, zinc and selenium, can do your hair good. Do not take too much, because then it can have an adverse effect. Creatine and other strength sports supplements are also bad for your hair.”

This article previously appeared in Plus Magazine June 2021. Want to subscribe to the magazine? You can do that in an instant!