I’m often asked by my patients who suffer from hair loss what over the counter hair products are most beneficial. What shampoo should I use? What about hair conditioners? Am I brushing my hair too much or too little? Is it safe to color my hair?
Hair Growth Basics
We are born with approximately 100,000 hairs on our scalp. Unlike many other cells, we do not create nor regenerate hair cells throughout our lifetime. In order to notice clinical baldness it is necessary to lose approximately 50% of the hair follicles in a specific area of the scalp, such as the frontal area or crown. Hair grows approximately 1.25 centimeter or ½ inch each month, and the growth cycle of an individual hair follicle varies from 2-7 years. The growth phase is called anagen. About 85-90% of hairs are in the anagen phase at any given time.
The catagen phase represents that time when the hair naturally sheds from the scalp and involves about 1% of hairs on our scalp. This phase lasts about two weeks. This is seen naturally as we shed about 100 hairs daily during shampooing and hair brushing.
The telogen phase is characterized by the hair follicle remaining in a resting state which varies from 1 to 4 months in duration. At any given time, approximately 10-15% of the hairs on our head are in this phase of the hair cycle.
It is very important to understand hair growth so that patients are not alarmed when they notice a daily loss of hairs from the scalp. The loss of hair is unaffected by showering, shampooing, the use of conditioners, and hair brushing. Coloring of the hair does not appreciably affect hair loss. However, coloring and perming your hair at the same time may be damaging to the hair shaft. Separate these two treatments by about two weeks to be safe. It is best to perm your hair initially, wait at least two weeks, and then color your hair. Some vitamin supplements like Nutrafol have been specially designed for patients suffering from hair loss. Topical agents and supplements have little to no scientific evidence of clinical effectiveness.
Rogaine is the only over the counter product which has scientific evidence demonstrating hair growth. Rogaine works by prolonging the growth of the hair cycle and increasing blood flow to the scalp. I advise both men and women to use the 5% product, which is the more concentrated formula and marketed towards men. You will not see an immediate response but continuous use should be part of your daily routine. Some people describe increased irritation or dryness with the 5% formula which is usually temporary. If it continues, I recommend the milder concentration marketed towards women.
There is recent evidence to suggest that low level light therapy may also be effective at stabilizing hair loss. While the exact mechanism is unknown, researchers believe the benefits are due to stimulation of increased blood flow to the scalp. There are no side effects to such treatments, and light therapy can be added to your daily hair loss regimen. Many products are available online, and I often recommend a laser cap designed by Capillus which many of my patients have found to be beneficial.
Hair loss is distressing for both men and women. However, it is important to understand the natural hair cycle so that you do not become unduly concerned by the natural shedding of hair from the scalp. If you are concerned about significant hair loss, then make sure to see a physician who has special expertise and experience in the management of hair loss including non-surgical and surgical options.