How to Keep Your Hair Healthy with Age

I see a number patients who are worried about their hair.  They are loosing hair or it is thinning.  They may think it is a phase and so they wait to see what happens and may even get concerned enough to try a few things on their own.  By the time they come into my office for care, they are really concerned. They may have a bags of hair that they show me and multiple supplements they have tried.  Not only do we want to understand why the hair loss started but we want to rule out any contributing medical conditions, then provide nutrients for building good hair.[i]

There are several types of hair loss. 

Non-Scarring Hair Loss Types include:

Alopecia areata

Androgenetic hair loss

Telogen effluvium

Anagen effluvium

Scarring Hair Loss Types include:

Lupus- the discoid variant

Lichen planopilaris

Central centrifugal cicatricial Alopecia

Radiation related hair loss

Mixed Hair Loss includes:

Trichotillomania

Traction alopecia

Hair is constantly replacing itself.  At any given time, 2% of hair is falling out and being replaced.  Active growth lasts 2-6 years.  This is why most treatment take awhile to implement.  Many women and men are trying to figure out ways to get that thick hair back or fill in bald spots.  There are some basic good for your hair tips that all of us can do.  A diet rich in plant based foods helps with healthy hair growth as well as adequate protein.  Oral hydration is often forgotten.  Adequate sleep drives the circadian rhythm, sex hormones and inflammation which all play a part in driving healthy hair growth.  On top of these basics, we like to check basic labs to be sure everything is optimal. Thyroid and the iron levels are important since both hypothyroid and anemias can cause hair loss. 

Biotin can strengthen what you have in your hair and nails but doesn’t really help with new growth.  We don’t want to take more than necessary because it can affect our thyroid or heart medication efficacy; 2.5-5 mg is plenty.  More than 10 mg is not needed.  You may have to take it for 6 months before it gets integrated in. 

Vitamin D on the other hand appears to stimulate dormant hair follicle.  Testing Vitamin D levels is discouraged nowadays in doctor’s offices but is a good idea when we are taking it as a supplement. 

Vitamin A is tricky because too much preformed Vitamin A can prevent hair growth so no more than 25,000 IU daily but in general, there should be a purpose that you are on Vitamin A for more than a month. 

Zinc can influence cell differentiation.  Patients with hair loss generally have lower zinc as well. 

Silicon, particularly cs-OSA can influence hair growth after 9 months or so but the absorption is highly dependent on digestion. 

Selenium can be particularly helpful if thyroid is involved. 

Other options depending on the individual such as DIM, Maca or topical miroxidil in either liquid or foam used before bed.  Low level laser light therapy (LLLT) or red and near infrared light aimed at the scalp have been shown to be helpful with 26 week minimum use.  There are several FDA approved devices.  Platelet Rich Plasma has also been helpful for bald spots but also genetic hair loss.  Often patients see results after 3 treatments even though the goal is 6 treatments.  Annual maintenance is needed to maintain the results but patients seem to be quite satisfied with the results.  Cosmetic tools or Camouflage is something else that can be used along the way.  Scalp coloring with pens, pencils, sprays or powders to make thinning or balding less obvious.  Hair pieces can be helpful too but the cap fit is the most important element.  Extensions and weaves are yet another options.

 

[i] Journey of Health, Updated 2019.