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Understanding Hair Loss: The hair growth cycle

Hair loss, also called alopecia, is a disorder caused by an interruption in the body’s hair production cycle.

Hair loss can occur anywhere on the body, but most commonly affects the scalp.

On average, the scalp has 100,000 hairs that cycle through periods of growing, resting, falling out, and regenerating.

A hair growth cycle has three phases:

  • Anagen phase: Hair actively grows. This phase may last for years.
  • Catagen phase: Hair stops growing and separates from its follicle (the structure that holds the hair in place). This phase lasts about 10 days.
  • Telogen phase: The follicle rests for 2–3 months, then the hair falls out. The next anagen phase begins as a new hair grows in the same follicle.

Most people lose 50–100 hairs per day as part of this natural cycle.

If this cycle is disrupted, or if a hair follicle is damaged, hair may begin to fall out faster than it regenerates, leading to a receding hairline, hair falling out in patches or overall thinning.

Different Types of Hair Loss

Androgenetic alopecia is the most common type of hair loss. Commonly known as male pattern hair loss or female pattern hair loss, androgenetic alopecia is hereditary but can be managed with medication or surgery.

Male Pattern Hair Loss

In men, hair loss can begin any time after puberty and progress over the course of years or decades. It starts above the temples and continues around the perimeter and the top of the head, often leaving a ring of hair along the bottom of the scalp. Many men with male pattern hair loss eventually become bald.

Female Pattern Hair Loss

In women, hair slowly thins all over the scalp, but the hairline usually doesn’t recede. Many women experience this type of hair loss as a natural part of aging, although hair loss may begin any time after puberty. Female pattern hair loss can cause hair to thin dramatically, but only rarely does it lead to baldness.

Telogen effluvium, a type of hair loss, occurs when large numbers of follicles on the scalp enter the resting phase of the hair growth cycle, called telogen, but the next growth phase doesn’t begin. This causes hair to fall out all over the scalp without new hair growth.

Telogen effluvium does not generally lead to complete baldness, although you may lose 300–500 hairs per day and hair may appear thin, especially at the crown and temples.

A medical event or condition, such as a thyroid imbalance, childbirth, surgery, or a fever, typically triggers this type of hair loss. Telogen effluvium may also occur because of a vitamin or mineral deficiency—iron deficiency is a common cause of hair loss in women—or the use of certain medications, such as isotretinoin, prescribed for acne, or warfarin, a blood thinner. Starting or stopping oral contraceptives (birth control pills) may also cause this type of hair loss.

Telogen effluvium usually begins three months after a medical event. If the triggering event is temporary—for example, if you recover from an illness or stop taking the medication causing the hair loss—your hair may grow back after six months. Telogen effluvium is considered chronic if hair loss lasts longer than six months.

Alopecia areata is an autoimmune condition, which means the body’s immune system attacks healthy tissues, including the hair follicles. This causes hair to fall out and prevents new hair from growing. This condition can affect adults and children, and hair loss can begin suddenly and without warning.

Hair from the scalp typically falls out in small patches and is not painful. Hair in other parts of the body, including the eyebrows and eyelashes, may also fall out. Over time, this disease may lead to alopecia totalis, or complete hair loss.

Anagen effluvium is rapid hair loss resulting from medical treatment, such as chemotherapy. These potent and fast-acting medications kill cancer cells, but they may also shut down hair follicle production in the scalp and other parts of the body. After chemotherapy ends, hair usually grows back on its own.

Cicatricial alopecia, also known as scarring alopecia, is a rare type of hair loss in which inflammation destroys hair follicles and causes scar tissue to form in their place. After scar tissue forms, hair doesn’t regrow.

Hair loss may begin so slowly that symptoms aren’t noticeable, or hair may start to fall out all at once. Other symptoms include severe itching, swelling and red or white lesions on the scalp that may resemble a rash. This type of hair loss can occur at any age and affects men and women.

Types of cicatricial alopecia include:

Lichen Planopilaris

Lichen planopilaris, a type of alopecia, occurs when a common skin condition, called lichen planus, affects the scalp. Lichen planopilaris may cause a dry, flaky rash to appear on the skin that causes hair on the scalp to fall out in clumps. The scalp may also become red, irritated, and covered in small white or red itchy, painful, or burning bumps.

Lichen planopilaris is not common and affects more women than men. A doctor may prescribe medication to stop the hair loss.

Discoid Lupus Erythematosus

Discoid lupus erythematosus is a type of cutaneous lupus, an autoimmune disease that affects the skin. It can lead to inflamed sores and scarring on the ears, face, and scalp. Hair loss is one symptom of the disease. When scar tissue forms on the scalp, hair can no longer grow in that area.

Folliculitis Decalvans

Hair loss caused by folliculitis decalvans, an inflammatory disorder that leads to the destruction of hair follicles, is often accompanied by redness, swelling, and lesions on the scalp that may be itchy or contain pus, known as pustules.

This type of hair loss is not reversible, but dermatologists can offer medication to control symptoms and, in some instances, stop the progression of hair loss.

Dissecting Cellulitis of the Scalp

Dissecting cellulitis of the scalp, a rare condition, causes pustules or lumps to form on the scalp. This condition may also cause scar tissue to develop, destroying hair follicles and causing hair loss. Medications may help control symptoms.

Frontal Fibrosing Alopecia

Frontal fibrosing alopecia typically occurs in a receding hairline pattern and may also result in hair loss in the eyebrows and underarms. Frontal fibrosing alopecia most commonly affects postmenopausal women. Certain medications can manage symptoms and stop the progression of the disease. The cause is unknown.

Central Centrifugal Cicatricial Alopecia

Central centrifugal cicatricial alopecia may be caused by hair products or styling techniques that damage hair follicles.

The use of hair relaxers, perming treatments and hair extensions can cause central centrifugal cicatricial alopecia. Likewise, so can frequent use of oils, gels or pomades. This condition may be reversible if you stop using these.

Several types of hair shaft abnormalities can lead to hair loss. These conditions cause strands of hair to thin and weaken, making them vulnerable to breaking.

In this category, the hair loss doesn’t occur in the follicle; it’s from a break somewhere along the hair strand. This can result in overall thinning, and many small, brittle hairs.

Making simple changes to the way you style and treat your hair can reverse some hair shaft abnormalities. Other conditions may require medical treatment.

Types of hair shaft abnormalities include:

Loose Anagen Syndrome

This condition most commonly presents in young children, though it tends to improve with puberty. In those who have loose anagen syndrome, hair is not firmly rooted in the follicle and can be pulled out easily or fall out easily – even when it’s growing. For example, hair loss may accelerate overnight simply from the friction of a pillow.

The cause of loose anagen syndrome is unknown, though it may be related to a disorder in the hair growth cycle that prevents hair from staying in the follicle.

Trichotillomania

People with trichotillomania pull their hair out and find it difficult to stop. This results in hair loss on the scalp or elsewhere on the body. Hair often returns if the behaviour is stopped, but hair loss can be permanent if the pulling continues for many years.

Traction Alopecia

Some hairstyles, including tight ponytails and braids, pull hair away from the scalp with such force that hair strands are damaged and fall out. Unless the hairstyle is changed, traction alopecia may lead to thinning hair or bald spots. Most of the time, hair regrows after you alter the hairstyle.

Hypotrichosis is a rare genetic condition in which very little hair grows on the scalp and body. Babies born with this condition may have typical hair growth at first; however, their hair falls out a few months later and is replaced with sparse hair. Many people with hypotrichosis are bald by their mid-twenties.

The Causes of Hair Loss

Hair loss may be linked to a person’s genetics; however, medical and behavioural conditions can interrupt the growth cycle and cause hair loss.

There are many potential causes for hair loss in men and women:

  • Hereditary/genetics
  • Ageing
  • Alopecia areata
  • Frictional alopecia (constantly wearing a hat causing repetitive friction)
  • Traction alopecia (tight hairstyle regularly pulling on scalp)
  • Scarring alopecia
  • Cancer treatment
  • Hormonal imbalance
  • Pregnancy or illness
  • Other major life stresses such as grieving loss; death, divorce, home; family illness
  • Trichotillomania (psychological disorder, pulling on hair)
  • Hairdressing chemical damage (long-term perming, relaxing)
  • Scalp infection
  • Scalp psoriasis
  • Certain medications
  • Some STIs (if left untreated)
  • Deficiency in zinc, biotin, iron or protein
  • Poisoning (arsenic, thallium, mercury or lithium)

The Emotional Impact of Hair Loss

For many sufferers, hair loss leads to a diminished quality of life.

In medical terms, hair loss can cause antisocial personality disorder, posttraumatic stress disorder (PTSD), generalised anxiety disorder (GAD), major depression, adjustment disorders, obsessive-compulsive disorder, panic disorder and social phobia. Sometimes, it can even lead to suicidal ideation.

Some of the mild to severe symptoms of associated psychological problems with hair loss are anxiety, anger, depression, embarrassment, decreased confidence, reduction in work and sexual performance and social withdrawal.

To help cope with the emotions of hair loss, many individuals feel more secure and confident when wearing something to cover their head. Wearing a hat, scarf or other head covering can help disguise hair loss and provide an emotional sense of security and the feeling of replacing something that has been lost.

How Regenera Activa works

In the first stage of treatment, your doctor will administer local anaesthesia in the chosen area, minimising any pain or discomfort.

Your clinician will begin your procedure by extracting 3–5 very small tissue samples from the back of your scalp. Each sample is called a micro-graft. These micro-grafts contain several hair follicles each, as well as the surrounding fat and vascular tissue.

Importantly, they also contain cell precursors, growth factors and progenitor cells – a potent concoction with incredibly powerful regenerative abilities. This will be used to stimulate existing hair follicles into their growth cycle, thereby helping to prevent further hair loss.

To obtain this, your micro-grafts are placed in the Regenera Activa device to extract the progenitor cells containing growth factors.

Next, this is transformed into a solution, which is then injected into the targeted areas of the scalp that are thinning or balding.

Hair follicle regeneration will be prompted in the treated areas; the hair growth process is triggered, and hair retention is promoted, improving thickness and density of hair long term.

Pros and Cons of Regenera Activa

Regenera Activa offers multiple advantages in comparison to other hair loss treatments available, making it an attractive and convenient choice for people suffering from hair loss and thinning.

Benefits include:

  • Only one treatment required – no repeat sessions
  • Effective treatment for hair thinning and partial loss
  • Extracts growth factors from your existing tissue
  • Natural, gradual results are achieved – nothing artificial or sudden
  • No downtime – continue your usual activities

Disadvantages

  • Expensive for many of our patients (the main objection we hear), clinics charge anywhere from $2500 to $4000 per treatment
    • This is because the device has expensive consumables from the supplier that then must be passed on to the consumer.
  • Procedure takes 5 times as long as PRP, Scalp Exosomes with needling or LED light therapy.
  • Requires a punch biopsy from behind the ear. This carries a risk of infection and scarring.
  • Results not obviously superior to less invasive, less expensive options.

Post-treatment Care

The Regenera Activa treatment has no associated downtime, apart from some minor limitations for the 24–48 hours directly after their procedure.

Tiny circular marks from where tissue was extracted at the back of the head will become small scabs and heal within 7-10 days. If a faint circular mark remains, these are usually covered by growing hair and become invisible over time.

Just for the day or two following treatment, it’s best that you don’t wash your scalp in the shower or submerge your head in the bath – just keep it clean and dry for now.

Then, over the two weeks after your procedure, it’s recommended that patients avoid swimming, spas, baths and water sports. This is to prevent bacteria entering the scalp.

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