Hair Loss: Causes, Treatments, and Expert Advice

Hair loss issues

Hello, doctor.
I am 149 cm tall and weigh 48 kg.
I work as a civil servant and have been sitting at a desk for a long time.
Recently, I was transferred to a busy and high-pressure unit, and sometimes I even forget to eat breakfast due to the rush.
I've been experiencing hair loss for quite some time, but recently I've noticed a line on the top of my head that makes me feel like I might be developing baldness, which has caused me some concern.
I visited a well-known dermatology clinic not long ago, but it wasn't specialized in hair loss.
The doctor took a quick look and prescribed me Minoxidil 3% and 5% to apply, but after researching online, I found out that it requires lifelong use, so I decided to stop.
I read online that 95% of hair loss cases are due to androgenetic alopecia, and I would like to know if I could get a more accurate diagnosis with advanced equipment if I visit a major hospital's dermatology department.
Additionally, I have consulted with a traditional Chinese medicine practitioner who mentioned that my issues are related to stress and lack of sleep, and advised me to eat more fruits and vegetables and to go to bed earlier.
My symptoms include losing about ten strands of hair when I wash or comb my hair, and when I wake up.
My hair reaches about my chest.
I tend to be a bit picky with food, as I don't enjoy certain vegetables (like bitter melon, eggplant, and bell peppers, and I also avoid strong-smelling foods like garlic and onions).
During my days off, I often enjoy teppanyaki and hot pot, and I rarely eat vegetables when I have takeout or eat at noodle shops.
I usually go to bed around midnight.
My menstrual cycle is irregular but generally not too late or too early, with a variation of about a week.
I noticed that your expertise includes health check-ups, and I found some promotional health check-up packages for civil servants online, such as those costing 3,500 and 7,900 TWD.
I would like to ask if you have any recommendations for which health check-up plan I should pursue, or if it would be sufficient to just get a blood test at the hospital? (I read online that hair loss could also be due to iron or zinc deficiency, and I wonder if a blood test can check for that.
I'm also unsure about which supplements I should take.)
Based on the information I've provided, do you have any suggestions? I live in Yunlin, and the major hospitals nearby include National Taiwan University Hospital and Cheng Kung University Hospital, but I have difficulty finding dermatology clinics that specialize in hair loss.
Thank you for your patience in reading this, and thank you.

Niming, 20~29 year old female. Ask Date: 2019/04/19

Dr. Cai Dongqi reply Family Medicine

Hello, regarding dermatology consultation issues, it is recommended that you seek further advice or consult a dermatologist.
For health check-ups, it is advised that individuals over 40 years old should definitely undergo them.
You can inquire about the relevant items at various hospital health examination centers.

Reply Date: 2019/04/19

More Info

Hair loss can be a distressing experience, and understanding its causes, treatments, and when to seek help is crucial for managing this condition effectively. Based on your description, it seems you are experiencing significant hair loss, particularly at the crown of your head, which is often a sign of androgenetic alopecia, commonly known as male or female pattern baldness. This condition is indeed prevalent, with studies suggesting that approximately 95% of hair loss cases are due to this genetic predisposition.

Causes of Hair Loss
1. Genetics: As you mentioned, a family history of hair loss can increase your likelihood of experiencing similar issues. If your parents or grandparents had thinning hair or baldness, this could be a significant factor in your case.

2. Stress: You noted that your current job is stressful and that you sometimes skip meals. Chronic stress can lead to telogen effluvium, a temporary form of hair loss that occurs when stress pushes hair follicles into a resting phase, causing hair to fall out more easily.

3. Diet: A poor diet lacking essential nutrients can contribute to hair loss. Iron and zinc deficiencies are particularly noted for their role in hair health. Since you mentioned being picky with vegetables and having an irregular eating schedule, this could be impacting your hair health.

4. Hormonal Changes: Hormonal fluctuations, especially related to menstrual cycles, can also affect hair growth. If your cycle is irregular, it might be worth discussing with a healthcare provider.

5. Medical Conditions: Conditions such as thyroid disorders, autoimmune diseases, or scalp infections can lead to hair loss. It’s essential to rule these out through appropriate testing.

Treatments for Hair Loss
1. Minoxidil: This topical treatment is commonly prescribed for hair loss. While it does require ongoing use to maintain results, it can be effective in promoting hair regrowth for many individuals. If you have concerns about long-term use, discussing these with your dermatologist can provide clarity on the benefits versus the commitment.

2. Dietary Adjustments: Incorporating a balanced diet rich in fruits, vegetables, lean proteins, and whole grains can improve overall health and potentially benefit hair growth. Consider consulting a nutritionist to help create a meal plan that includes the nutrients necessary for hair health.

3. Stress Management: Techniques such as mindfulness, yoga, or regular exercise can help manage stress levels. Finding ways to relax and unwind can have a positive impact on your overall well-being and may help reduce hair loss.

4. Medical Evaluation: Since you have already seen a dermatologist, it might be beneficial to seek a second opinion from a specialist who focuses on hair loss. They can provide more advanced diagnostic tools, such as a scalp biopsy or trichoscopy, to assess the health of your hair follicles and scalp.

5. Blood Tests: A comprehensive blood test can check for deficiencies in iron, zinc, and other essential nutrients. This can help identify any underlying issues that may be contributing to your hair loss.

When to Seek Help
It’s advisable to seek help sooner rather than later, especially if you notice significant changes in your hair density or if hair loss is affecting your self-esteem. Early intervention can often lead to better outcomes.

Health Check Recommendations
For your health check, consider a full blood panel that includes tests for iron levels, thyroid function, and vitamin D levels. This can provide a clearer picture of your overall health and any potential deficiencies that may be contributing to your hair loss.

In summary, hair loss can stem from various factors, including genetics, stress, diet, and hormonal changes. A multi-faceted approach that includes medical evaluation, dietary adjustments, stress management, and possibly topical treatments like Minoxidil can be beneficial. Consulting with a specialist who focuses on hair loss can provide you with tailored advice and treatment options. Remember, you are not alone in this, and there are effective strategies to manage and potentially reverse hair loss.

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