"It is quite normal to lose a certain number of hair strands every day. However, there are factors that can lead to excessive shedding."

Losing some hair every day is quite normal when it is a certain limited number of hair that would naturally be expected to shed. We shed hair every day in amounts that are considered normal – 50 – 60 hair strands or, better, between 40 to 120 hair strands if we consider that shedding is proportional to the amount of hair that a person has, which can vary a lot. Anyone with a larger hair density in the scalp will of course shed more hair.

Hair renews itself

Each hair is composed of a visible outer portion which comes out of the scalp - the shaft - and an inner part, the hair follicle. The higher the number of follicles, the more dense the mass of hair. 

Throughout a person's life, hair continuously cycles through growth and resting phases, hence we speak of hair growth cycle.

The three stages of hair growth are:

•  the ANAGEN phase, or growth phase, is the phase when hair grows longer. It’s the longest phase, with an average duration of several years.
•  the CATAGEN phase, or involuting phase, is when vital functions diminish and hair growth stops. This phase lasts for 2-3 weeks.
•  the TELOGEN phase, or resting phase, is when functional activity ceases completely, but the hair is still anchored to the hair follicle, and will fall eventually upon hair being washed or brushed. This phase, which on average lasts for 3-4 months, marks the beginning of a new hair cycle.

The hair in the anagen phase is strongly anchored and can only be removed by pulling it out strongly and causing some slight pain. When instead it is lin the telogen phase, the anchoring systems are loose and a modest pulling force is enough to remove it, i.e. the massaging we do while we wash hair or even just brushing our hair.

Even if hair is gone, the hair follicle hasn’t disappeared because actually the germinal matrix of the bulb is ready, if negative factors leading to scalp imbalance do not occur, to trigger a new growth cycle.

Each follicle follows its own growth cycle that is not in synchrony with other hair follicles, which means that every day some hair strands will fall out, yet they don’t shed all together. This asynchrony allows human beings to always have a regular mass of hair and not experience periods of time hair density is significantly reduced.

A healthy scalp shows these amounts of hair in the different growth phases at any given time (the so-called trichogram):

A healthy head of hair will have most hair follicles in the growth phase, the anagen phase.

Conversely, if negative factors occur that cause the natural hair growth cycle to become imbalanced, we can have two situations, sometimes occurring at the same time:

• an important number of follicles enters telogen prematurely, causing strong hair loss, consequent hair thinning and a larger portion of the scalp to be exposed

• hair is miniaturised and it is turned into vellus hair, shorter and with a greatly reduced diameter of the shaft compared to terminal hair, which instead are bigger and pigmented. Miniaturised hair have less "volume", which shows as thinning hair.

Causes of excessive hair shedding

In the human being, as in animals, there is a physiological hair loss defined as seasonal defluvium, typical occurring in spring and autumn. It shows with abundant hair loss (100-300 hair strands shed per day) and can last for 1 or 2 months. This seasonal hair loss usually stops by itself, though it may abnormally last for longer sometimes.

Excessive hair loss also occurs under particular conditions: following stress, upon crash dieting or alcohol abuse, in lactating and menopausal women, as well as upon long-term use of certain drugs and in connection with pathological conditions (thyroid disease, anemia) or surgery.

Also UV radiation and cigarette smoke may be counted amongst possible hair loss causes.

Can we prevent hair loss? A first approach can be to eliminate the most common causes, thus quit smoking, improve eating habits and, to the extent possible, avoid taking non-essential drugs.

On the other hand, the use of topical treatments and taking dietary supplementswhen in stressful situations, at season change, when following a diet or when in menopause can indeed bring good results, especially in terms of stabilising and improving the existing situation.

Since the hair growth cycle occurs through a long time, it is important to stress that the effectiveness of these treatments may become visible only after regular, constant use (at least 3 months) and can vary in relation to how the single user responds to it.

Anti-hair loss treatments

The main objective of these treatments is to extend the duration of the anagen phaseand stimulate hair follicles in the telogen phase to resume a new cycle, thereby supporting the growth of terminal hair and countering the miniaturisation of the hair follicle, and consequently of hair. To achieve this objective, such treatments are formulated to work on the imbalance factors that have driven the follicle out of the "ideal" growth cycle.

What are the factors most responsible for leading to scalp imbalance?

Hair research has identified micro-inflammation states and oxidative stress as key factors triggering excessive hair loss.

The term "micro" is used because there are no visible effects on the scalp, i.e.  redness, but indeed we spaek of inflammation because typical inflammation mediators are involved, which are called prostaglandins (PGs). Some of these positive influence hair growth, whereas others hamper it. When the latter prevail, excessive shedding occurs. Conversely, there are some substances that resemble  the "good" prostaglandins that can trigger a biomimetic mechanism that makes the follicles in the telogen phase to quickly pass into the anagen phase, that also results longer.

Oxidative stress is a situation where there is an imbalance between oxygen free radicals (ROS) generated both endogenously (triggered by mental and physical fatigue) and by exogenous factors (pollution, UV radiation, nutritional deficiencies) and the availability of natural antioxidant defences.

There is clear evidence indicating oxidative stress as a major factor in both gray hairand excessive hair loss. Stress that continues over time can damage the hair bulb cells, resulting in weakened, brittle hair that is prone to shedding.

Other factors that can alter the ideal hair growth cycle and thus cause further hair fragility and increased hair loss are hormonal effects:

• men may show increased 5-alpha reductase activity. This enzyme converts testosterone into dihydrotestosterone, the androgen hormone which increases hair loss  

• women, especially in menopause, see their estrogen hormones drop. These female hormones have a positive effect on hair growth, thus their reduction may lead to hair loss.    

Treatment strategies

Topical treatments stand as the primary means to control excessive hair loss and promote hair re-densification because, applied onto the scalp, they work locally on the causes of hair follicle weakening and / or atrophy and they also supply nutrients directly to the bulb.

Since the main factors of the imbalance of the hair growth cycle are the micro-inflammation states and oxidative stress, any topical formulation should include active ingredients that work on both causes to truly be effective.

A topical treatment is generally in the form of a hydroalcoholic lotion, which allows to apply it on either dry and wet scalp, after shampooing, and thereby avoid oiliness or heaviness feelings when the lotion is applied to the hair and scalp. 

A shampoo especially developed for hair prone to shedding is useful when combined to the use of the anti-hair loss lotion.

Is the shampoo so important?

When there is hair loss, especially when abundant, we tend to wash hair less because it takes just the mechanical rubbing of the washing to shed hair, which is no longer firmly anchored to the follicle because it is in the telogen phase.

Because of the short contact time, the shampoo cannot significantly affect hair regrowth, yet it is an important means to keep other factors that increase excessive hair loss under control, such as excessive sebum secretion. Sebum that builds up on the scalp may increase the micro-inflammation, as well as the oxidative stress, because of pollutants and impurities absorbed from the environment (smog, dirt). Hence, in the case of oily hair, it is useful to wash hair frequently, even every day. 

The effectiveness of topical products can also be supported by specific dietary supplements through the adoption of a sort of IN & OUT strategy (working from the inside and from the outside of our body).

This is proper approach because the health of the hair follicle changes also according to our general health, to what we eat and to the environment we live in. The hair follicle is influenced by dietary deficiencies (low-calorie diets) and situations that require increased nutrient intake (such as periods of physical and mental stress), as well as pollutants, smoking and age.

A food supplement developed to promote the health of hair is traditionally based on a number of vitamins (biotin, niacin), special minerals (zinc, copper, selenium) and sulfur amino acids like cysteine, important for the synthesis of keratin. Since oxidative stress plays a key role in hair loss, adding vegetable antioxidants, such as a prickly pear extract, i salso important. The most innovative formulations are designed to promote the our body’s own antioxidant potential, thus should be “supplementary” to our normal food to quickly and effectively target the problem. One cutting-edge strategy is to provide our body with the necessary elements for the synthesis of glutathione (GSH), the most important antioxidant and cell-detoxifying substance. By doing this, we ensure glutathione bioavailability and make a powerful anti-oxidant available according to the real needs of our body. 

<adapted from bionike.it>