Hair loss treatment

With a balanced diet in our part of the world, there is rarely a nutrient deficiency and thus diffuse hair loss. However, (even short-term) crash diets, eating disorders (anorexia, bulimia), but also insufficient absorption of nutrients through the intestines in chronic intestinal diseases or after operations can lead to a nutrient deficiency.

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Nutrient deficiency, diseases

With a balanced diet in our part of the world, there is rarely a nutrient deficiency and thus diffuse hair loss. However, (even short-term) crash diets, eating disorders (anorexia, bulimia), but also insufficient absorption of nutrients through the intestines in chronic intestinal diseases or after operations can lead to a nutrient deficiency. In the course of serious chronic diseases, infectious diseases such as influenza or scarlet fever, but also after operations with general anesthesia, the hair can also thin out diffusely.

Chemotherapy, radiation therapy

Chemotherapy or treatment with so-called targeted substances against various types of cancer can (but does not have to) be associated with diffuse hair loss. Not only the scalp hair can be affected, but also eyelashes, eyebrows and body hair. The hair usually falls out a few days to weeks after the start of therapy and/or breaks off more frequently over the scalp. They usually grow back when therapy is complete. More on that in the Extras section below.

If a patient has to undergo radiation therapy as part of cancer treatment and the scalp is in the radiation field, this can also lead to increased diffuse hair loss. In most cases, hair begins to grow back some time after radiation therapy. With very high radiation doses, hair roots may also be damaged more permanently, so that the hair grows back more sparsely.

Medication, poisoning: Diffuse hair loss can show up as a side effect of medication, for example cholesterol-lowering drugs, blood thinners, retinoids for acne, beta-blockers for high blood pressure or a rapid heart rate. Very rare causes can be poisoning, for example with heavy metals such as thallium. In the rarest of cases, these are only associated with hair loss, but with other physical symptoms.

Diffuse alopecia areata / diffuse hereditary hair loss

These very rare special forms of the two diseases are difficult to distinguish from other causes of diffuse hair loss. For more information, see the relevant chapters in this article (chapter “Conditional hair loss” and “Circular hair loss”).

Diffuse hair loss: diagnosis

The diagnosis is based on the patient’s comprehensive medical and family history (anamnesis), a physical examination of the skin, hair and nails, and a plucking test. Of course, the dermatologist will take a close look at the scalp, sometimes using a magnifying glass (dermatoscope). Depending on the suspected diagnosis, further examinations follow (see chapter “Hair loss: overview…what men and women should know”, section: “Hair loss: diagnosis”).

Diffuse hair loss: therapy

Whenever possible, treatment is based on the cause. If medication is the trigger, another preparation may be prescribed in consultation with the doctor treating you (caution, do not discontinue medication on your own!).

In the case of an iron deficiency, for example, it is of course essential to clarify the causes and treat them in a targeted manner. Iron supplements can help against anemia associated with iron deficiency. If there is no anemia, treatment with iron is not a proven measure. If there is a thyroid disease, it must of course be treated.

If the hair loss is due to a diet, it should be stopped and an appropriate, balanced diet should be started instead. A nutrient deficiency that has arisen in a different way is then the cause of diffuse hair loss in the rarest of cases in this country.

In general, it can be said that diffuse hair loss can continue for two to three months even after the cause has been eliminated. This is because some of the hair has already entered the resting or shedding phase (telogen phase, see above) and “stubbornly” falls out after two to three months.

Hair loss with chemotherapy

Chemotherapy, as used for cancer, can (but does not have to) be associated with hair loss. Newer drugs in cancer therapy, such as the so-called targeted substances, can also change the hair. It can become more sparse, sometimes fail, and last longer (albeit temporarily), since the therapies usually last longer (see also the section above).

There is no uniform pattern. In addition to scalp hair, facial or pubic hair can also fall out. For many patients, especially women, this drug side effect in particular means great emotional stress in addition to the disease.

Cooling the scalp with so-called cooling caps while administering the medication can help reduce hair loss. A pump continuously circulates a coolant at a temperature of 3 to 4 degrees Celsius in the area of ​​the scalp. This cools down to around 21 degrees Celsius. The procedure is currently being examined in more detail, but is already being offered in some tumor centers.

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