Daily Health

Hair Loss 101

For many of us, hair loss is inevitable — a natural part of aging.

Even so, there may come a time when you look in the mirror and realize your hair is not as voluminous as it once was, leading you to begin your search for an effective treatment  — and then the trouble may really begin.


Losing your hair can not only hit your confidence, but it can also be scary when you don't know what’s causing it. Unfortunately, there is a ton of misinformation on hair loss out there to lead you astray and add to your anxiety.

Understanding the reason your hair is thinning is key for people who wish to treat their hair loss effectively. Having clear insight into the cause of your hair loss is the key to finding the right treatment that’s both safe and effective.

In this beginner’s guide to hair loss, we’ll help you sort out facts from fiction to discover the truth behind your disappearing hair. We’ll cover everything you need to know — from causes and hair loss types to potential treatments. 

What causes hair loss?

Like the rest of your body, your hair is greatly affected by many different health and lifestyle-related factors. If you notice your hair has begun to thin, narrowing down which of these factors are contributing to the issue will help you find the best treatment option.

There are many potential causes behind balding, including:

  • Genetics: A person’s genetics tend to be the most common cause of hair loss and thinning. Luckily, bad genes are not a death sentence for your hair and the loss can be stopped or slowed with proper treatment.
  • Hormonal changes: Both increases and decreases in male hormone levels can cause hair loss, depending on the hormone in question. These hormones include testosterone, dihydrotestosterone (DHT), and androgens.
  • Certain medications: A plethora of medications can lead to temporary or persisting hair loss. These can include medications for acne, high blood pressure, antidepressants, cancer-treating drugs, and more. Always consult with your doctor about potential side effects before beginning a new prescription.
  • Radiation or chemotherapy: Chemotherapy and radiation are intense treatments that target cancer cells. During the duration of treatment, normal cells also suffer damage — including cells that make up hair follicles. However, hair can grow back once these treatments have concluded.
  • Autoimmune diseases: If you suffer from an autoimmune disease, chances are hair loss may be one of the first big side effects you notice. Though alopecia areata (more on this later) is the most common autoimmune disease to cause hair loss, others associated with hair thinning include Crohn’s disease, lupus, and psoriasis.
  • Stress: Like it or not, your mental health matters. When you undergo a period of time or event that causes you extreme or prolonged stress, your hair may face the consequences. Stress-related hair loss is often attributed to a type of hair loss known as telogen effluvium, and regrowth is possible over time.  
  • Lifestyle habits: Diet and exercise play an important role in all aspects of your life. Your general health and wellbeing will have a notable impact on your hair, and maintaining proper health has a lot to do with your dietary and lifestyle choices. Additional choices that can affect your hair include substance use, such as smoking and drinking.
  • Hairstyling: We all love to get our hair done from time to time — but over-styling can cause damage that affects the growth of your hair. If you are someone who loves bleach, perms, hot-oil treatments, and everything in between, you may need to give your hair and scalp some much-needed recovery time.

Hair loss symptoms to watch out for

No matter how healthy your hair currently appears, it is important to keep an eye out for certain symptoms and indicators of hair loss. Early intervention can help drastically reduce the effects of balding and hair thinning in many cases.

Here are some signs and symptoms to watch for that may signify the beginnings of hair loss:

  • Gradually thinning patches of hair on the top and back of the head.
  • Hair loss on other parts of your body including your eyebrows, facial hair, nostrils, eyelashes, and pubic hair.
  • Unusually large clumps of hair come out when you comb or brush your hair.
  • Scaling, redness, or irritation around your scalp and hairline. These may also indicate other health-related issues, such as an autoimmune disease or infection.

Keep in mind that while most hair loss is gradual, for some people the process can come on very quickly. If you are experiencing sudden and rapid hair loss, this does not mean it is irreversible! However, sudden hair loss can be highly distressing.

We recommend visiting your doctor or seeking medical guidance as soon as possible for both gradual and sudden thinning of your hair.  

Is there a way to stop hair loss?

The first step towards slowing or stopping your hair loss begins with determining what type of hair loss you are experiencing. Finding the cause behind your thinning hair will have a tremendous impact on what type of treatment is recommended.

When it comes to stopping hair loss entirely, typically the best solutions are clinically approved prescription drugs. However, there are other more natural remedies and treatments that work for slowing the hair loss process as well.

Ultimately, every person is different — and so is their individual journey with hair loss and regrowth. The key is to keep an open mind and consult with professionals in related fields. 

The different types of hair loss

Many culprits hide behind the struggle of hair loss — and figuring out which one is causing your hair to thin should be a priority.  

The reality of hair loss is that there are many different types, all with their own sets of causes and symptoms. According to the Canadian Hair Loss Foundation, there are actually over 100 potential causes of hair loss.

In this section, we’ll take you through the many different types of hair loss and the causes behind them. We will cover five of the most common types of hair loss:

  • Androgenetic alopecia
  • Maturing and receding hairlines
  • Alopecia areata
  • Telogen effluvium
  • Hair shaft abnormalities

Though this information can help identify what may be behind your thinning hair, it’s still a good idea to talk to your doctor about a diagnosis.

Androgenetic alopecia (male pattern baldness)

The most common cause of hair loss in people with male hormones is androgenetic alopecia, more commonly known as male pattern baldness.

According to the Canadian Dermatology Association, male pattern baldness affects roughly 50% of men. Additionally, a person can begin displaying symptoms of the condition as early as their teens. By the time men reach the age of 70, 4 out of 5 will experience baldness to some degree.

There are two telltale signs of male pattern baldness:

  1. A receding hairline
  2. The formation of a bald or thinning spot at the top of the head

This condition is genetic in nature and can be inherited from both your mother’s and father’s sides of the family. Aside from the loss of hair, androgenetic alopecia is generally considered an asymptomatic condition and does not pose any serious health risks.

Luckily, if you suspect you may have this condition, healthcare practitioners have the technology to provide a clinical diagnosis. This will remove the mystery behind your hair loss and help you to reach a treatment plan with greater speed.

Treatments for androgenetic alopecia usually come in the form of medications — typically finasteride or minoxidil, which we will discuss more later.

When determining if you have male pattern baldness, medical professionals will often use the Norwood Scale. This scale was developed by Dr. James Hamilton and Dr. O’Tar Norwood as a system of classification to help diagnose male pattern baldness.

The Norwood Scale consists of seven stages:

  1. Stage 1: The control stage in which hair loss is not visibly noticeable.
  2. Stage 2: This stage involves a slightly receding hairline that is most noticeable around the temples. When hair is in this stage, it may simply be the result of a maturing hairline rather than male pattern baldness.
  3. Stage 3: The receding hairline becomes much more noticeable, forming a prominent “M” shape with significant hair loss around the temples.
  4. Stage 4: Significant hair loss becomes apparent across the entire hairline, with the “M” shape transforming into a more rounded “U”.  Baldness on the crown of the head is noticeable in this stage.
  5. Stage 5: This stage is similar to stage 4 but to a more severe degree. The bald spot on the crown of the head is larger, making the strip of hair between the crown and the front of the hair much smaller and thinner.
  6. Stage 6: Hair on the front and crown of the head will be mostly gone in this stage. However, there will still typically be hair around the sides of the head, as these areas are more resistant to balding.
  7. Stage 7: Loss of hair will begin on the sides of the head in this stage, eventually leading to most or total baldness. Any remaining hair will be weak and thin as it grows in.

A diagnosis is made on your hair loss pattern, and air that has reached stage 3 or later on the Norwood Scale is indicative of male pattern baldness.

Maturing and receding hairlines

Your hairline is the edge where your hair stops growing on your head. The term maturing hairline simply refers to the natural recession of your hairline as you age.

Though often attributed to androgenetic alopecia, maturing hairlines are not inherently indicative of male pattern baldness. The connection between the two conditions has much to do with the role of dihydrotestosterone (DHT) in both types of hair loss.  

When DHT binds to hair follicles, those follicles then shrink in size. As this happens, your hair begins to fall out — a process seen in both male pattern baldness and normal maturing hairlines. The difference between the two conditions is that male pattern baldness is genetically inherited while maturing hairlines are not.

In fact, maturing hairlines are not considered true “hair loss” by many medical professionals. Most people with male hormones will experience a maturing hairline to some degree. The severity of this will depend on a slew of other factors, such as additional medical conditions or lifestyle choices.

Alopecia areata

Sometimes, there are more serious medical causes behind the loss of your hair.

Alopecia areata is an autoimmune disease that has a specifically detrimental effect on a person’s hair. This disease causes the body’s immune system to wrongfully identify and attack hair follicle cells, causing the hair to fall out while also repressing regrowth.

According to the Canadian Alopecia Areata Foundation, there are seven types of alopecia areata that affect how the condition presents itself:

  1. Localized alopecia areata: Hair is lost in patches on the head.
  2. Alopecia barbae: Hair is lost in patches on the face.
  3. Ophiasis alopecia areata: Hair is lost on the sides of the head and back of the scalp.
  4. Sisaipho alopecia areata: Hair is lost on the top of the scalp and head.
  5. Alopecia totalis: Hair is lost on the entirety of the head.
  6. Alopecia areata incognita: Hair is thinned and diffused on the scalp, but full bald spots are not formed.
  7. Alopecia universalis: Hair is lost on the entire body, including eyelashes and eyebrows.

Experiencing alopecia areata firsthand can be alarming and frustrating, especially since more research is still needed to learn how to effectively treat the condition.

Currently, there is no cure for the autoimmune disease; however, certain treatments can be used to suppress the immune system and encourage regrowth. These treatments will often involve corticosteroids and other anti-inflammatory drugs.

People suffering from alopecia areata are often referred to a dermatologist. Dermatologists use both visual exams and blood tests to help diagnose the disease and determine treatment plans. 

Telogen effluvium

Telogen effluvium is a type of hair loss that occurs when hair follicles enter the resting phase of the hair growth cycle but fail to re-enter the growth phase within the cycle.

This type of hair loss usually results from or is triggered by a specific medical condition or scenario, including:

  • Surgery
  • Prolonged fever
  • Thyroid imbalance
  • Vitamin or mineral deficiencies
  • Use of certain medications
  • Extreme or prolonged stress

This condition can be acute or chronic and can result in significant losses of hair. However, this type of hair loss does not generally lead to total baldness. The average amount of hair lost per day can vary but can be upwards of 300 hairs per day at its worst.

Like alopecia areata, there is currently no cure for telogen effluvium. However, the condition is known to resolve itself without medical interventions in most scenarios.

For those who wish to seek treatment, a doctor or dermatologist will likely ask for a sample of your hair and carry out blood work. Treatments given will help to reduce the amount of hair shedding occurring as the condition runs its course.

Hair shaft abnormalities

Hair shaft abnormalities refer to hair loss that occurs due to a break in the strand rather than damage to the hair follicle. These conditions are characterized by specific changes, including changes to:

  • Hair colour
  • Density
  • Length
  • Structure

There are a variety of different hair shaft abnormalities that can affect a person’s hair loss and regrowth. Here are three of the most common hair shaft abnormalities:

  • Trichotillomania: This condition is often related to a person’s mental health and any psychological disorders they may have. When a person suffers from trichotillomania, they pull their hair out compulsively and cause bald spots and patches as a result. If left untreated, this can result in scarring and permanent loss of hair. Treatment will often involve psychotherapy and behaviour modification.
  • Loose Anagen Syndrome: Loose anagen syndrome is most commonly seen in children, but can affect adults as well. With this condition, the hair follicles are not connected firmly and can easily be pulled out or shed due to friction. Research on the syndrome has found that hair pull tests and trichograms are essential for diagnosis, and that most cases are spontaneously resolved on their own.  
  • Traction Alopecia: Traction alopecia refers to hair loss that occurs due to specific hairstyling that puts immense strain on hair strands. These strands become damaged and can fall out when this strain is prolonged over a long period. Hairstyles that can result in this condition include tight ponytails and braids. Treatment is often as simple as changing one’s hairstyle and avoiding tight updos.

Are there any types of hair loss that prevent regrowth entirely?

Unfortunately, certain medical conditions do prevent the regrowth of hair entirely.

These conditions are known as scarring alopecia, a diverse group of disorders that result in permanent hair loss. This hair loss can occur all over the body but is especially prevalent on the scalp.

The Canadian Dermatology Association reports that scarring alopecia affect roughly 3% of individuals experiencing hair loss. During this condition, the hair follicles are permanently damaged and lost, replaced with scar tissue that prevents any sort of regrowth from occurring.

Early diagnosis of scarring alopecia is essential for preventing the scarring that stops regrowth. However, no cures are currently known and treatment can vary in its effectiveness in these more rare hair loss conditions. 

Hair loss treatment options

Treatment for your hair loss is dependent on the cause and type. Luckily, for most hair loss conditions there is a wide range of safe and effective treatment options.

As we have covered, several conditions such as androgenetic alopecia and alopecia areata do not have formal cures. Despite this, medications and natural remedies can be used to help slow the hair loss process and promote regrowth.

Before diving into the different natural remedies and medical interventions, let’s quickly examine what the diagnosis process looks like — and how you can go about receiving a diagnosis.

Diagnosis

Diagnoses for hair loss conditions can be given by both primary care doctors and dermatologists. Oftentimes, a primary care doctor may carry out an initial assessment before offering a referral to a dermatologist who offers the treatments needed.

The diagnostic process may involve one or several of the following steps:

  • A review of your family history
  • A blood test that can reveal underlying diseases and medical disorders
  • Pull tests wherein a doctor pulls out a few of your hairs. This test allows them to determine what stage of hair loss you are currently at.
  • Scalp biopsies that look for infection
  • Light microscopy that helps uncover hair shaft disorders

Your doctor or dermatologist is also likely to question you on your diet, hair styling routine, and general lifestyle when assessing your hair loss. It is important to be completely honest to receive the optimal treatment and recommendations.

Receiving an assessment and diagnosis is as easy as getting in contact with your doctor. Creating a list of symptoms you are experiencing can help you remember everything you wanted to mention in your initial assessment.

Remember that no detail is too small when it comes to medical diagnosis of hair loss. The more information you can give to your doctor, the better they can provide the right treatment.

Natural remedies for hair loss

Starting a new medication for hair loss can be intimidating, especially for those who prefer natural remedies over medical interventions.

For certain hair loss conditions, such as scarring alopecia, natural remedies may not be enough to stop the loss of hair. However, less severe conditions can benefit from solutions that focus on diet, nutrition, and behaviour.

The most effective natural remedies for hair loss are often behaviour and lifestyle-centric. These remedies can include:

  • Eating a more balanced diet
  • Avoiding harsh hair stylings, such as bleaching and straightening
  • Using gentler hair care products that promote scalp circulation and exfoliation

Additionally, mineral-based treatments used to address deficiencies are sometimes used to slow or stop hair loss. Increasing your nutritional support by including more foods that contain necessary vitamins and minerals can aid in promoting hair regrowth.

Recent research has also revealed that Lindera strychnifolia roots (LsR) extract can serve as a natural solution for hair loss. Subjects investigated in this study all experienced decreases in the amount of hair lost during day-to-day activities and stimulation of hair growth when given the LsR treatment.

The current findings certainly support the idea that natural remedies for hair regrowth are possible. However, much more research is needed into the efficacy of LsR and other natural treatments for hair loss.

If you want to get a head start on treating hair loss naturally, the best place to start is with your nutrition and lifestyle.

Medical intervention for hair loss

There are many medical interventions for hair loss, including:

  • Hair follicle transplants
  • Laser therapy
  • Platelet-rich plasma (PRP)
  • Corticosteroid injections
  • Medications

Medications are generally the most common treatments utilized for hair loss and regrowth. These medications can be pills or topicals, depending on the brand and ingredients.

Common medications used for the treatment of hair loss include:

  • Topical minoxidil: Minoxidil is a topical solution that can treat many of the common types of hair loss, including male pattern baldness, alopecia areata, and telogen effluvium. This medication is available without a prescription but is recommended to be used under the supervision of a dermatologist. It is important to note that while minoxidil has shown to increase regrowth, the medication is not widely understood in terms of how it works.
  • Oral finasteride: Finasteride is an oral medication used specifically to treat male pattern baldness. This medication is available only through prescription and is taken at the same time every day. While finasteride can have impressive effects, it is only effective for the duration it is taken — meaning it will be a lifelong treatment for those who choose this option.
  • Corticosteroids: Corticosteroids are anti-inflammatory medications that help treat auto-immune diseases. For people with alopecia areata or scarring alopecia, these medications can help to counteract the effects of such medical conditions. Steroid treatments are typically administered every 4-to-6 weeks and are prescription-only.
  • Antiandrogens: Androgens are sex hormones that can damage or destroy hair follicles. Antiandrogens are the medications given to help inhibit these hormones. These medications are prescription-only and start being effective between 2-to-4 months of daily use. Like finasteride, these medications must be continually taken for effects to remain.
  • Other medications: If your hair loss is the result of less common causes, such as infection to the scalp, a variety of additional medications can help. These include antifungal medications, antibiotics, and antimalarial medications. A doctor or dermatologist will need to assess what medication you need in this scenario.

Although not all of these treatments require prescriptions, it is highly recommended to consult with a professional dermatologist or medical team before beginning any new medication.

With this in mind, let’s take a closer look at the medication regarded as the most effective at treating male pattern baldness: finasteride.

Treating male pattern baldness with finasteride

Finasteride is the active ingredient in the popular hair loss medication Propecia. Finasteride comes in a generic option alongside brand-name formulations.

Originally developed to treat the enlargement of the prostate, researchers discovered that finasteride produced the beneficial side effect of hair regrowth as well. From here, the drug quickly became a staple in the fight against balding — specifically, male pattern baldness.

How does finasteride work?

Finasteride is a 5-alpha-reductase inhibitor. It slows the rate of hair loss and stimulates growth by inhibiting the body’s ability to produce DHT — the male hormone responsible for damaging and destroying hair follicles.

The drug is considered to have a good tolerability profile, meaning it can be used in many different male patients (because finasteride affects hormones, it can only be taken by people with male hormones).

Will finasteride regrow your hair?

Finasteride is generally treated as a preventative medication, rather than a regrowth solution. However, results can vary from person to person, and some patients have seen significant regrowth following the continued use of finasteride.

Research is currently ongoing into the efficacy of using finasteride alongside minoxidil for hair regrowth. One 2020 study found that the index of hair growth rose from 30% to 60% within three months of the “combined drug regimen.”

So — does finasteride regrow your hair?

The answer is that it depends. The medication has been proven as a powerful preventative to hair loss, with several reports of increased regrowth from patients. But as with any medication, your mileage may vary.

Your next steps for preventing hair loss

Now that we’ve covered the basics of hair loss causes, types, diagnosis, and treatment — it’s time to plan your next steps.

Having a clear plan of action is the first stage to feeling more confident in your hair and secure in your health.

Here are your next three steps for starting your hair loss treatment journey today:

1. Manage your expectations

While medications such as minoxidil and finasteride can have powerful results, there is no guarantee of total regrowth.

Part of treatment for hair loss is coming to terms with change. As you begin this journey, it is important to manage your expectations and work to build a sense of confidence in your appearance. Baldness and thinning hair are worthy of love too, after all!

2. Consult with your doctor or dermatologist

If you suspect your hair loss is caused by a more serious medical condition, you should consult with a medical team as soon as possible.

For less serious conditions, such as male pattern baldness, there are many convenient and online solutions (like Felix!) that can help you get the treatment you need faster than ever.

3. Get started with Felix today

Felix offers clinical diagnosis and hair loss prescriptions all from the comfort of your home.

That’s right — Felix’s system works entirely remotely. This eliminates the need for clinic wait rooms, pharmacy pickups, and — most importantly — awkward conversations.

To get started with Felix, simply follow these three easy steps:

  1. Complete an online visit: We’ll ask you some questions about your medical history and symptoms.
  2. Get your prescription: We carry generic finasteride for treating hair loss, among other medications. Our team will work to prescribe you the best medications for your specific needs.
  3. Receive your fast and free delivery: With Felix, your medication is shipped directly to your door in discreet packaging — and totally free of charge!

Please note that the current medications we offer at Felix for hair loss are only safe for people with male hormones.

We can't wait to help you regain confidence in your hair. 

WRITTEN BY
Felix Team
Updated on:
October 4, 2021
Medically reviewed by
Dr. Sarah Lasuta
Family Physician, MD, CCFP
Disclaimer

The views expressed here are those of the author and, as with the rest of the content on Active Ingredients, are not a substitute for professional medical advice, diagnosis, or treatment. If you have any medical questions or concerns, please talk to your healthcare provider.

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