Would a dermatologist know about hair loss?

What can be done against hair loss?

Hereditary hair loss

Not all hair loss is created equal and it can have various causes. Hereditary hair loss (androgenetic alopecia) is the most widespread hair loss, accounting for 95 percent of all hair loss.

In Central Europe, more than half of men over 50 are affected by hereditary hair loss. It also occurs in women, but much less often than in men.

Hair loss differs between the sexes. In women, the hair is first thinned in the area of ​​the middle parting, from there the light areas become larger. But it usually stays that way. The hair on the head thins, but baldness is extremely rare.

This is different with men: Here the receding hairline is clearly defined. At the same time, a bald spot forms on the back of the head, which, together with the receding hairline, expands into a bald spot over time.

Hereditary hair loss is triggered by a breakdown product of the male sex hormone testosterone, dihydrotestosterone (DHT). The hair root cells are hypersensitive to DHT, enter the hair growth pause too quickly and begin to shrink.

Instead of normal hair, the hair root gradually forms only hair fluff, which ultimately falls out completely when the hair root dies.

Circular hair loss

In contrast to hereditary hair loss, circular hair loss (alopecia areata) is disease-related. Round, bald spots appear on the head within a few days. Often the hair grows back on its own, but sometimes a total loss of the hair is inevitable.

The causes of alopecia areata are largely unknown, but an immunological disorder seems to trigger the hair loss. The scalp hair is viewed as a foreign body by the own immune system and is rejected.

At the beginning there is an inflammatory reaction, which has an irritating effect on the hair growth phases and ultimately causes hair loss. In the worst case, it comes to the loss of all scalp hair (alopecia totalis) or even to the complete loss of all body hair (alopecia universalis).

Diffuse hair loss

Diffuse hair loss (diffuse alopecia), in which the hair thins overall, is also due to the disease. Often, diffuse hair loss turns out to be a temporary phenomenon. The causes are extremely diverse.

Pregnancy, thyroid dysfunction and menopause can also be triggers for diffuse hair loss, as can infectious diseases, wrong and extreme diets or drug intolerance.

A case for the dermatologist

Hair loss can be hereditary, but it can also be a disease. Sometimes hair loss is also a symptom that indicates an existing condition. First and foremost, hair loss has nothing to do with the head of hair, but only has a negative effect on it. It is therefore advisable to consult a dermatologist first in the event of hair loss.

Many dermatologists offer hair consultations. The doctor then creates a so-called trichogram for the patient. He removes some of the main hair, and the scalp is often also photographed in order to record the extent of the hair loss and to be able to compare it later.

If it turns out that there is permanent and non-disease-related hair loss, medication can be administered to prevent hair loss and even stimulate hair growth again.

Hair restorer

What is it about hair restorers? Are there really remedies and tinctures that stimulate the hoped-for sprouting power of the thinning head hair?

First of all, the good news: In fact, for some time now there have been proven, scientifically tested preparations that not only promise renewed hair growth, but actually bring about it.

Therapy options

There are effective hair loss remedies available. Hair that has been lost does not come back, but medication can partially maintain the current state and achieve success in stimulating hair thickness and hair density.

Drug treatment should be given as early as possible. If you stop using the medication, the hair loss will progress again. In order to put as little strain on the body as possible, one starts with hair tinctures that are applied directly to the scalp. The first results can be seen after three to six months.

Only when hair tinctures are unsuccessful are tablets used. Most of the available preparations require a prescription. Because they contain hormones, they are not all suitable for men and women alike.

Three active ingredients have proven to be effective in use: finasteride, minoxidil and 17-alpha-estradiol. What all three have in common is that they must be applied consistently. However, not all of them can be used by both sexes.

For men and women

The active ingredient 17-alpha-estradiol is available as an over-the-counter hair tincture. This estrogen prevents the conversion of testosterone into its active form, dihydrotestosterone (DHT).

The active ingredient minoxidil is also available as a hair tincture. It is not yet known why it works. Presumably it stimulates the blood circulation and thus also the hair growth.

For men

Finasteride - available as a tablet - prevents the conversion of testosterone into DHT (like 17-alpha-estradiol). During the use of finasteride, a small amount of the active ingredient was also found in the seminal fluid of test persons.

The risk of malformations during pregnancy cannot be completely ruled out, according to the assessment in specialist journals, which is why the drug is not suitable for women. There are also risks for men: Possible side effects include impotence and decreased libido.