Frequent travel exposes the hair to frequent changes in water. As far as the water is concerned, it is not the question of good water or bad water or hard water or soft water, but it is the change in water that causes the hair loss. The fact that the new water is different in type and make from the old water is sufficient to trigger hair loss. This type of hair loss is known as Telogen Effluvium. The name is a combination of 2 words: Telogen which refers to the falling phase of the hair and Effluvium which means to evaporate. Thus as the name suggests the hair fall in this condition is so rapid that it simply seems to evaporate from the head.

Could this person have lost hair due to diet deficiencies?

Unfortunately dietary considerations in cases of hair loss are completely misunderstood. Most advises are so general that they make no sense at all. Consider this for example : “Eat plenty of green vegetables, drink enough water, have more protein like soy protein, tofu, soy milk, take iron rich food like beetroot, dates & dried foods, silica rich foods like raw oats, potatoes & peppers, wholesome foods like eggs, vitamin E rich food like avocados, nuts & seeds….etc etc.”

Is there anything missing here? Would it not be simpler to just tell the person to eat everything he can lay his hands on?

And most people are even otherwise eating the above items, to the point of becoming fat, and yet develop deficiencies and lose hair. This is because dietary deficiencies do not always result from poor intake but from poor absorption. For example, we find many women patients who are borderline obese but at the same time are quite anemic. Clearly there is no paucity of food here. The defect lies in absorbing the right ingredients. This is why in such cases simply increasing the food intake does not help. Because the body may not absorb the necessary ingredients and instead one may just put on extra weight.

Furthermore, some deficiencies cannot be fulfilled by dietary changes alone. For example, hair loss patients are often found to have Vitamin B8 deficiencies. Vitamin B8 is found in its natural form in bananas. But to get the right quantity one may need to consume 12 bananas on a daily basis! This cannot be obviously followed on a daily basis.

Specific deficiencies do play a role in accelerating the hair loss. There are 3 specific deficiencies which are most common – Iron deficiency, protein deficiency and in cases of strict vegetarians Vitamin B12 deficiency. Identifying a specific deficiency and correcting it, does play an important role in controlling the hair loss.

Apart from dietary supplements, some foods act as healing agents when consumed in high doses. These are typically organic food items which contain elements like inositol, choline etc. Here, however one has to be very careful as these are often prescribed in various combinations and therefore best done under the care of a medical expert.

The solution therefore lies in identifying the specific deficiencies and correcting it, rather than launching into more and more food intake and unnecessary supplementation.

Losing weight can lead to Telogen Effluvium in which there is a sudden onset of severe hair fall, often in clumps together. This happens typically after a drastic weight loss session. In some cases the hair loss starts immediately and in other cases it can start even 2-3 months after the weight loss has actually occurred. Women are more vulnerable here as they are prone to sudden drop in their iron counts during menstrual cycles. This causes latent anemia which when coupled with weight loss makes women become easy targets for hair loss.

The worst part is that the hair loss can be out of proportion to the weight loss. The person may have lost a mere 2-3 kilograms of weight, but the resulting hair fall can still be massive.

Men are not completely spared here. Men tend to develop hair loss when they over-exercise. Regular fitness exercises are not a problem, but trying to lose weight and build up muscles is the problem. Many trainers have this false notion of trying to convert their client’s body fat into muscle. While that may never happen, what certainly does happen is hair loss. In fact there is a big school of thought that believes that over exercising is detrimental to hair. There is also a lot of statistical evidence which shows that body builders and wrestlers tend to bald faster than the general population.

Latest studies have shown that men and women are going bald at an earlier age as compared to their parents. There are many cases wherein the patients report of balding in their early 20’s and a closer look at their family history reveals that their parents had suffered baldness much later in life by the age of 50 or 60.

The study was carried out at the University of London. In the study, samples of hair were taken from people staying in different areas. Scientists conducting the research found that samples removed from more polluted areas showed higher degrees of “oxidative stress”, a process known to cause damage to follicular hair growth leading to faster baldness.

This clearly shows that hereditary tendency alone does not play a role in premature baldness. It is the combination of hereditary factors and the added influence of environmental factors like change of water, traveling, exposure to toxins, dietary deficiencies, stress etc which hasten the process of baldness.

As the number of factors causing hair loss increases, so does the severity of hair loss. Refer to the below table for more details:-

The above scenarios are just some examples of how various causes can combine together playing havoc on your hair, almost like “a candle burning at both the ends”. The exact combination varies from patient to patient and to treat any case of hair loss, the exact combination of factors affecting hair loss should be elicited. This is one of the reasons why many over-the-counter products like oils and shampoos don’t work for everyone. Because they are not tailor made for specific cases and being general in nature, they are not equipped to tackle all the factors in a particular case.

The research has confirmed the belief that a holistic approach keeping genetics and environmental factors both in mind while treating a case gives a better long term control of hair loss.

There are 2 schools of thought here. One school believes that there is no relationship between exercising and hair loss and the other school believes that certain exercises do cause more hair fall.

Both above statements are true to a certain extent, because there are cases where a person starts exercising and loses more hair and there are other cases where such a thing does not happen. The differentiating factor which determines whether hair loss will occur or not, is the type of exercise done.

For example, if the exercising is done with the idea of losing weight in a hurry, one can be very sure of losing hair. The exercise regime triggers a medical condition called Telogen Effluvium. The hair loss happens due to nutritional deficiency which is inevitable with any program associated with quick weight loss, because one can never maintain the right balance of diet and lose weight quickly at the same time.

Similarly certain exercises which aim at increasing the body muscles mass are also liable to cause hair fall. Here the causative factor is believed to be protein redistribution, where the body takes protein away from other parts of the body, hair being one such part, and redirects it to building the muscle mass. Even taking protein supplements in such cases, may not help, for the following reason – Proteins are composed of 22 amino acids. Most protein supplements have a good combination of these, but hair needs a specific combination of 4 amino acids and if your protein powder lacks even one of those, then it may help build muscle mass, but will not help in controlling hair loss.

A study showed that strenuous exercises cause an increase in the blood testosterone levels by as much as 30% in some cases. As testosterone is linked to the causation of male baldness, increase in levels would definitely lead to an increase in hair fall and hasten the baldness. The problem however is defining what exactly constitutes strenuous exercises. The study defined strenuous exercises as that which involves lifting heavy weights, or muscle building or any changing in the body structure. More routine exercises like cardio exercises, jogging, running, treadmill exercises which are aimed at just fitness are not included in this category. However the demarcating line is not always very clear.

On the other hand exercises which involve the use of steroids are a definite threat. This is because most steroids resemble in their molecular structure the male hormone testosterone and thus can cause excess hair fall. It is not surprising therefore to see a lot of body builders who use steroids to build their six packs and eight packs often end up balding as well.

Other factors which come into play are increased sweating and sebum secretion on the scalp. Increase in sebum secretion can contribute to more hair loss. Because the scalp sweats a lot while doing even routine exercises, it is important to wash your scalp after the exercises.

The safest forms of exercises are those that are aimed at simple fitness. Exercise should not be done with the idea of losing weight drastically or developing muscles overnight.

Hair Loss in Summer

Summer can particularly affect certain people who have a hot constitution, known as “pitta”. These are people who are sensitive to heat and tend to sweat very easily; they are vulnerable to scalp infections at this time of the year.

The symptoms start with development of boils on the scalp. The scalp may become red, sensitive and flaky. There may be a lot of itching, irritation on the scalp and this may be accompanied with increased hair loss as well.

People who ride long distances to work on a two-wheeler wearing a helmet are more prone to get affected. Most helmets have very poor ventilation, not allowing the sweat to dry. Also because the inside of the helmets are seldom cleaned, the sponge lining often is greatly contaminated and the source of many a fungal infections.

Hair Loss in Winter

With winter comes itchy scalp, dandruff and hair loss. Dry hair is brittle and prone to breakage. Dryness of scalp leads to dandruff which makes the scalp itchy. Itching forces the patient to scratch the head repeatedly without even realizing it. Frequent itch and scratch cycle makes the scalp prone to infections. Most of this infection is passed on through contaminated hands which carry a lot of germs. These germs are unknowingly transmitted on to the scalp while scratching. These infections are usually contagious and can also be transmitted through contaminated combs, pillow covers, towels etc.

Furthermore, because of the cold weather, some people reduce the frequency of shampooing their hair. This is seen in BPO workers and school children, who leave their home very early in the morning. While there may be genuine concerns of catching a cold, a basic level of scalp hygiene is very essential. There was a case of a patient who preferred to shampoo his hair only once in a month for fear of catching sinusitis attack. Well, he did not catch sinusitis, but developed a massive scalp infection and suffered hair loss in the process. One can always find alternatives to the situation. For example during winters, shampooing can be done at a different time, like in the late afternoons or evening when the weather is relatively warmer.

Hair Loss in Monsoons

The monsoons may be romantic but it can take a serious toll on your hair. The risk of falling prey to a number of scalp problems and bad hair days increases with monsoons. The increased humidity in the atmosphere and the pollutants in the rain water encourage the growth of bacteria and fungi on the scalp. From Ringworm infections than can cause red, sensitive and flaky skin with patchy hair loss to staphylococcal infections which cause painful pus filled pimples, a host of these conditions are seen in monsoons. Lice infestation is also very common in monsoons as lice breed during this season. And such infestations are not just a poor man’s problem – well-to-do, hygiene-conscious people can also be easily infected. These scalp infections irritate and damage the hair roots causing considerable hair loss.

To prevent these monsoon related problems, it is necessary to shampoo frequently and keep the scalp dry in monsoons.

In today’s times it is increasingly common to find men and women balding in their early 20’s. These people are diagnosed to have hereditary baldness. However a look at their family history often reveals that their parent suffered from baldness only in their late 50’s or 60’s. Then why is it that people are now losing hair so early in life? The research below can answer this question.

In a research carried out at The University of London, scientists found that certain pollutants in the air affect the hair protein called keratin, thus hampering the process of hair growth. In the study, samples of hair follicles were removed from the scalp of people staying in different areas. The samples removed from more polluted areas showed higher degrees of “oxidative stress”, a process known to cause damage to follicular hair growth. This clearly shows that heredity alone does not play a role here. Environmental factors like change of water, stress, pollution, exposures to toxins etc play a role in hastening up baldness.

         

There was an interesting study which was carried out in the fishes in South China Sea, an area highly polluted with pesticides, revealing a shocking fact. Most male fishes either had completely lost, or were in the process of losing, most of their male characteristics and there were a high number of female fishes. The study concluded that many male fishes were simply converting into female fishes and this was believed to be due to high chemical content in the water there. This shows how adverse environmental changes can lead to a host of hormonal problems, leading to early and premature changes in the body.

These studies have confirmed the belief and now put the entire phenomena of early hair loss or premature baldness in more concrete terms. They have helped change the treatment approach as well. So far there has been an excessive hype, mostly driven by pharmaceutical companies on heredity or genetics being the sole cause of hair loss. Most patients continue to lose hair in spite of taking the medicines which deal with hereditary hair loss. This research has now explained why, and thereby has also removed the unnecessary emphasis that was placed on heredity or genetics. Instead a more wholesome approach where both genetics and environmental factors are taken into consideration helps in much better long term control of hair loss, and also allows the patient to be less dependent on medication.

Product incompatibility is a phenomenon in which products used at the same time react with each other causing damage to the hair. For example consider Shampoo A and Conditioner B, while individually they may be very good products, but when used at the same time, they react with each other and often aggravate the hair loss.

Product incompatibility is not only very common but unfortunately also goes unnoticed. While hair damage due to procedures like straightening, perming is seen in few people, product incompatibility affects a larger group of people, because this involves common every day hair care products like shampoos, conditioners, oils, hair dyes etc.

There is nothing like a completely right or completely wrong product. What may suit one person very well, may in fact worsen the condition for someone else. It is important to understand the scalp-type, and accordingly choose the product. For example a person with a dry scalp will be better with a moisturizing shampoo, whereas a person with oily scalp will be better with a deep cleansing one. However, most people do not choose products as per their hair or scalp type. They simply tend to use something that a friend recommends, because he or she got results using it or a husband ends up using his wife’s shampoo because it’s the wife who does the shopping at super markets. But this does not work.

Often products labeled “herbal” are misconstrued as safe to use, but the fact is that many of these products are not purely herbal, are often poorly manufactured and develop fungal growth when not stored properly.

If we see the hair care followed by the earlier generation, all they would do is wash the head regularly keeping it clean. Now we have a far greater choice of products to use, but the irony is that today’s generation seems to be losing hair at a faster rate than the earlier generation did.

The key here is to keep your hair care simple, avoid random usage of products and choose products carefully that match your hair and scalp type.

Thyroid disorders cause two types of hair loss. One is the severe but short lived condition which begins with severe hair loss in the initial stages but which comes under control as the thyroid functioning improves. This type of hair loss condition often does not need any treatment apart from correction of the thyroid imbalance.

The other more chronic condition seen with thyroid imbalance is the development of Pattern Baldness. People with a pre-existing family history of hair loss are more susceptible. The thyroid disorder triggers the hair loss which then becomes a self perpetuating entity. The hair loss continues unabated even when the thyroid imbalance is corrected. Such cases usually need an early diagnosis and medicinal intervention.

In today’s life and time, there can hardly be anyone without stress. Stress is not always overt. It can be in the subconscious form. When it comes to stress it is important to differentiate between the good stress called Eustress and the bad stress called Distress.

Eustress is the good stress, for example, making arrangements or packing bags for a holiday abroad is the good type of stress. This does not cause any damage.

High sales targets, night shifts, traveling long distances to work in peak traffic, lack of sleep, erratic sleeping patterns, skipping meals due to work pressure are all examples of bad stress or distress. Competition in a workplace can be a double-edged sword. On one hand it can improve performance but on the other hand it can cause severe stress. Maintaining a balance in life is perhaps harder today than ever. Demands in school or at work can push down on you. If you don’t set limits you can become drained, overworked and in the end even burn out.

Stress does not always have to be in the form of sleepless nights. If one is relocating every 2-3 years, and doing it with the entire family, then there is scope of stress affecting you. Settling in a new house with new neighbors, loss of old friends, finding new servants, getting children admitted in new schools all of that is stress as well and to top it all if one is anxious by nature, it would certainly add fuel to fire. All these factors can severely affect your hair and trigger baldness.

The above phenomenon is typically seen in executives and people in corporate life who travel to different parts of the world every few months and have high levels of stress to boot. A very typical thing that occurs in such cases is that not only does the hair fall occur fast, but the hair goes white very quickly as well. In fact the graying often extends to the body hair as well, so you will find the beard hair and the chest hair going white early as well. It’s almost as if these factors combine together to cause premature ageing of the hair roots.

Furthermore, a vicious cycle tends to develop wherein stress causes hair loss and the hair loss in turn causes more stress and this cycle can go on till the person goes completely bald.

Often stress caused by hair fall can get serious. While hair fall is never injurious to your health directly, there are health Health Related Quality of Life (HRQL) studies that have shown that the amount of stress some people experience with hair fall is comparable to that which patients experience when they suffer from cancer or any other life threatening disorder.

To avoid stress one cannot stop working or traveling and stay at home all the time. There is also no point in advising things like “don’t take stress”. It is cliché and has no meaning. What one can do is be aware and be prepared to face these problems. Very often the symptoms are there for one to see, but we choose to ignore and neglect it. Early diagnosis and medical intervention can prevent damage to hair roots at the right time. For example, when acute hair loss develops, there is change in the growth to fall ratio. The normal ratio should be 9:1, but in these conditions the ratio often becomes 7:3, or even 5:5 in worse cases. With suitable medication the damage to the roots can be repaired so that the ratio is reversed back to 9:1 or as close to it as possible. Thereafter following a certain maintenance therapy can help to prevent this condition from relapsing.

Some people are in a job where they shift to a new city or a country every 2-3 years. Naturally the whole family shifts as well and change of water thus affects the whole family. Shared stress of marital discard, financial worries or broken relations can affect couples or the family as a whole.

Another common reason is diet. Often people who are constantly on the move cannot adapt to the local cuisine. This is especially true for vegetarians who then suffer from dietary deficiency induced hair loss.

Contraceptive pills can affect the hair fall in 2 ways. It can lead to Telogen effluvium or it can aggravate the patterned hair loss.

Because of the influence of the hormones in oral contraceptive pills, a large number of hair follicles shift from the growing anagen phase to the falling Telogen phase. This causes sudden hair loss, often in bunches.

Because of the androgenic hormones in the oral contraceptive pills, it can trigger hereditary hair loss in women who are genetically predisposed to it. Progesterone based oral contraceptive pills are more often responsible here than estrogen based ones. The estrogen based oral contraceptives cause a rather opposite effect where the hair loss increases only after the pills are discontinued.

Pili Torti – is a genetic defect where the hair gets twisted around itself. Due to twisting, the hair breaks off at intermediate lengths leading to diffuse thinning of the scalp which is visible within the first few months after birth.

Monilethrix – This is a genetically acquired condition which develops at birth. The hair develops.

microscopic nodes along the hair shaft. The hair breaks off at the nodes repeatedly because of which the patient can never grow long hair

Pili Annulati – This is a genetically acquired condition in which there are alternating light and dark bands along the hair shaft. The dark areas could be air filled spaces. Such hair is prone to easy breakage.

The most common form of hair damage that we see in everyday life is split ends. Split ends develop due to micro trauma to the hair ends. Dry hair, repeating combing or brushing and long hair tend to develop split ends. The only way to correct it is to go for repeated trimming of the hair ends. The other more severe forms of hair damage are caused due to procedures like coloring, perming, straightening etc.

Damage due to hair color – With repeated coloring, the color begins to accumulate in the hair shafts leading to swollen areas known as nodes. As more and more nodes are formed the hair becomes dry, rough and develops a tendency to break. These damages are cumulative so that every coloring adds on to the damage caused the by the earlier one. Eventually the nodes begin to break leading to micro fractures along the hair shaft.

Damage due to Hair Perming or Hair Straightening

Perming is a process of changing the nature of the hair shaft. It involves breaking down the disulphide bonds of the hair and then rejoining them in a shape as desired. The risk is that if disulphide bonds are not rejoined correctly, then the very basic molecular structure of hair breaks down, leading to hair loss and thinning on the scalp.

Hair Straightening is a process of changing curly hair into straight hair. It is the opposite of perming. The process however is the same and involves breaking down of the disulphide bonds to change the basic hair structure to a more desirable pattern.

On a Tricho Analysis, even a single session of hair perming or straightening will show signs of fraying and damage. With multiple sessions marked increase in fraying and damage to the cuticles is seen.

Both perming and straightening are process which cause cumulative damage, so that even if the first procedure has not caused hair damage, then next one doubles the risk, the third one triples it and so on.