How do I stop my hair loss?

Proceed with caution before starting treatments, advises The Kit’s editor-at-large

“I’ve noticed my hair thinning and more hair coming out in the shower and in my brush. It’s very upsetting. I want to try the supplements I see at the pharmacy. Do they work?” Maddie, Toronto

We probably shouldn’t care as much about hair as we do — after all, it’s just a collection of cells and swirls of DNA, but unlike, say, a toenail or a belly button, hair is often wrapped around our identity and our self-confidence. No matter how rattled you are though, you shouldn’t rush out to drop your hardearned money on hope and maybe-remedies. “The most important thing by far is to get the right diagnosis,” says Dr. Jeff Donovan, a dermatologist specializing in the treatment of hair loss and the president of Canadian Hair Loss Foundation. “If you can’t state the cause of your hair loss in one sentence, you shouldn’t be starting treatment.”

There are some more common offenders to consider, the most prevalent of which is genetic hair loss — also called genetic alopecia or female pattern hair loss — which affects about 30 per cent of women by age 45, says Donovan.

This often goes undiagnosed among women because it’s simply less talked about and less recognizable. (We should get a special bell to ring every time women’s health and wellness is de-prioritized, though I suppose the constant clanging would quickly become annoying.)

“Men can identify that they have male pattern baldness because it recedes at their temples and crowns and they realize they look like their dad or their uncles, but it doesn’t tend to even get considered for women and often women think they have hair loss from low iron, thyroid problems or stress. These certainly are causes of hair loss, but they tend to be overemphasized because we want quick fixes,” says Donovan. “When our blood test comes back showing that we have slightly low iron, we jump on it.”

The correctable factors Donovan just outlined are the second category of common culprits, which range from insufficient iron to a new medication or hormone replacement therapy.

“People tend to focus on these issues because once these factors are corrected, the hair goes back to normal,” he explains. But unfortunately, just because you want a vitamin or over-thecounter supplement to cure your issue — and who could blame you for preferring a tidy solution? — doesn’t it mean it will.

“If a family doctor is in favour of starting a multivitamin, that can be reasonable if your diet hasn’t been great, but patients should not be popping zinc or iron supplements unless they have a reason to believe that they could be low,” cautions Donovan. “Most supplements are low-risk, but we’ve learned in the last few years that supplements can mask all sorts of abnormalities in blood tests, so it’s important to consider any possible side effects.”

You also, somewhat surprisingly, need to ask a similar question to your hairdresser, since problematic hairstyling practices are the third most common trigger for partial baldness: think tight ponytails that pull at the scalp, damaging flat ironing, or chemical irritation from bleach and dye.

“If it’s identified early, it can be completely reversed,” explains Donovan, “but, if the particular practice goes on for even six months, there may be some limits on how much we can return the hair to its original density.”

So while it’s key to consider the context for your hair loss, it’s also vital not to ignore it. Start by booking an appointment with your family doctor to get a broad screen, including a basic iron and thyroid panel.

“These are absolutely essential, and if some of these levels are abnormal, it’s reasonable to try to correct them, but if the shedding doesn’t stop within four to six months, you need to consider a specialist referral.” (Pro tip: given the long wait times for most specialist appointments, get the referral right away and try to correct your low iron in the interim.)

Then, once you have your diagnosis, you can get on with an appropriate treatment. Over-the-counter minoxidil — branded as Rogaine — can certainly help a large proportion of people, for example. But one must be patient and stay the course: “It can be messy and time consuming, so a large number of women will use minoxidil for a month or two, then give up because they didn’t see results — but that could be because they didn’t have a good understanding of how to apply it and they weren’t aware that it was going to take six months to work,” explains Donovan, who also mentions that the low level, red-light laser devices available for athome use can also help, but again, they don’t help everyone.

Prescription-based treatments such as antiandrogen tablets that block the male hormones might also be suitable, if recommended by your doctor.

Whatever you decide to do, try to keep your perspective by your side and enlist a trusted friend or partner as a sounding board. That’s a prescription we should all fill, because, as Donovan says, “We become emotionally invested in our hair to degrees that we never thought would have been possible.”