Proper diagnosis is the key to treating hair loss, says Yatin Deshpande, who tells you what causes it and how you can treat it

Hair loss in women is a common and highly distressing problem. One in every two women is affected by it at some point in her life. And while it's notexactly a terminal problem, it does tend to seriously affect a person's self esteem. Though women tend to think of hair loss as something that affects only men, hair loss of varying degrees affects women of all ages.

At the outset, it is important to realise that hair fall is a normal phenomenon. On an average, most people have about a lakh to 1.2 lakh strands of hair on their head. You could lose up to 100 hair strands a day and anything inside this figure is considered normal hair loss. In fact, hair goes through three phases before it eventually falls. During its growth or the Anagen phase, hair grows at the rate of half an inch a month for about six to seven years. It then enters the resting or the Catagen phase before going into the moulting or Telogen phase. About 15 per cent of a person's hair is in the Telogen phase at any given time.

Sometimes certain conditions cause the early onset of the Telogen phase, which results in widespread hair loss. Such hair loss occurs mainly after pregnancy, major surgery or due to severe emotional problems. Certain drugs can also create similar conditions causing hair loss. This condition is called Telogen effluvium.

A person could also start losing hair because of Androgenetic hair loss or male pattern baldness, which affects 95 per cent of men, as they get older. A lesser-known fact is that female pattern baldness affects about 50 per cent of women after menopause. Instead of balding, women tend to have thinning hair with the scalp showing through the strands.

Most often, hair loss in women is also attributed to the incorrect use of permanent waving or hair colouring agents, which may really not be the case because these agents act on the hair above the scalp and not the hair root. In fact, a person's age, genetic makeup and hormones are the three major factors that influence hair loss. Hair loss in younger people is often attributed to genetic reasons.

Hormones also play a very important role in contributing to
hair loss. Male hormones combined with other factors tend to shrink the hair follicles and shorten the hair growth cycle. It is normal and even essential for women to have a large amount of the male hormone testosterone in their body, although most of it is biologically inactive due to blood globulins in the body. Some part of the hormone comes from the ovaries and some from the adrenal gland. Androgens (male hormones) target tissues such as the skin where they get converted to more potent androgens. The sebaceous gland and the hair follicle are androgen sensitive.

Women who have androgenetic hair loss very rarely have abnormal levels of testosterone. Their hair follicles are more sensitive to androgens. The hair follicle also has estrogen receptors, which maintain the growth and rest cycle resulting in a luxuriant mane during pregnancy and thinner, finer hair after menopause. The side effects of excessive androgens in women include acne, hirsutism and thinning hair.

Medical conditions like
* Liver or thyroid gland disorders
* Anorexia
* Iron deficiency and
* Diabetes
can also cause hair loss. Chemotherapy can also cause 90 per cent hair loss. Thinning hair can often be seen as a side effect of certain medication including blood thinners, anti-arthritis drugs, blood pressure medication, antibiotics and cholesterol lowering agents. Normal hair growth usually returns once the medication is discontinued.

The release of the stress hormone can also stimulate the production of androgens in the body leading to hair loss. Stress is also linked to Alopecia, which is a disorder that causes a person's blood cells to attack their hair cells. This results in the hair falling out in clumps leaving round, bald patches on the scalp. This disorder is also difficult to diagnose, which often leads to a delay in treatment.

How do you stop it?
Proper diagnosis is the key to successful hair loss treatment. The solution could lie in stimulating blood circulation, which helps blood flow to the follicles or by cosmetically altering the appearance of the hair to appear fuller.

Any treatment for thinning hair will take at least 18 months to have a noticeable effect. Anti-androgen enzymes applied to the scalp are more effective than cosmetic solutions. Although expensive, anti-androgenic enzymes, which stop testosterone from being turned into dihydro-testosterone in the scalp, have shown positive results.

The intake of Minoxidil, a well-known drug, is known to dilate blood vessels and stimulate hair growth as side affects. Other treatments include the use of steroid creams, systemic steroids, immuno-suppressive drugs and large doses of zinc (although this can cause severe nausea). But it's important to remember that the intake or application of these drugs and creams needs to be approved by a qualified doctor before use.

Hair transplant surgeries though effective are not very popular among women. Styling techniques may camouflage thinning hair upto a certain extent. Colouring the hair, body waving it and highlighting it can also help disguise thinning hair. Hair colour and body waving products are alkaline, which cause the hair shafts to swell.

Back combing can also make the hair look fuller. A lot of hair additions and weaves look and feel natural. Improperly attached and maintained weaves can cause the scalp to develop infections leading to hair loss. Micro cylinder intervention is a non-surgical procedure that restores your hair to the desired volume. It allows you to swim, shower or brush your hair without any restriction. Partial or full wigs are the other options for camouflaging thin hair.