Hair Loss Man

Hair Loss 101

“It's likely we are hardwired to feel emotionally connected to our hair,” says psychologist Vivian Diller, PhD. “We've associated it with status, wealth, and royalty since ancient times. Thick, rich hair has always meant health, sensuality, and youth, so it continues to mean that to men and women today.” 

The emotions tied to hair loss are variable person to person, men or women.  Perhaps because balding is more “socially acceptable” in men than women, the emotions experienced by women from losing hair can be nothing short of devastating.

Woman with hair loss

There are many causes of hair loss: 

  • Genetic -male or female patterned hair loss, a type of hair loss we all experience to some degree, whether or not noticeable
  • Telogen Effluvium -a sudden shedding of hair due to a physiological event such as illness, childbirth, big swings in hormones, some medications, thyroid disease, anemia or other untreated medical condition, severe stress, etc.
  • Infection- bacterial, fungal, parasite, etc.
  • Autoimmune disorder- lupus, thyroid, etc.
  • Chemotherapy (Anagen effluvium)

Over the last several years, there have been occasional reports of hair loss from Covid-19 or Covid-19 vaccination.  The jury is still out if this represents a telogen effluvium or some other immunological phenomenon.  Dermatologists are actively studying this, and have been successful with helping these patients with a variety of medications.

Social media, the “selfie” generation, and other forms of online image sharing has been a catalyst of the increasing anxiety associated with hair loss. Losing hair can have a devastating effect on a person’s physical and psychological well-being, impacting all aspects of people’s lives from schooling, relationships, self-esteem and career choices to social, intimacy and leisure activities. Additionally, so-called “hairfluencers”, who are social media users that put out content regarding hair loss, products, and trends which can be harmful and have no scientific backing, are big contributors to negative side effects and increased hair loss.

Let’s talk about hair anatomy and the causes of hair loss..


 Hair Loss: More than a Cosmetic Issue!

When Dr. Kenner was practicing as a dermatologist in Hawaii, her practice/outpatient facility was next door to a chemotherapy unit. She saw so many men and women struggling with hair loss due to chemotherapy. No matter the physical and mental toll that chemotherapy and cancer had on them, they expressed the importance of keeping their hair.

Man with hair loss

On top of the physical and mental impact that cancer had on them, they felt insecure, which can lead to more stress, anxiety, and depression.

Healthy or not, nobody likes losing their hair. The average person equates hair diseases, on the whole, as concerning as heart disease and diabetes. This is a universal phenomenon, transcending global, generational and socioeconomic boundaries, with ample and ongoing scientific study exploring the many facets of how this impacts the human experience.

Hair loss is noticeable in ~50% of the population by age 50 and is less common in Asian populations, equivalent in Caucasians vs Black/Brown populations. 

Those with hair loss want better options. 

  • 64% report that their hair loss has negative impact on their lives
  • 56% with hair loss have never sought treatment for hair loss and 19% said they tried but didn't continue due to lack of efficacy, cost, uncertainty how to seek treatment or lack of concern regarding their condition,

YET 74% are either likely (44%) or extremely likely (31%) to request a new therapeutic approach to hair loss!


Hair Anatomy 

Fully understanding the biology behind hair loss is important if you are experiencing it. Educating yourself on WHY these biological processes happen can help you in your process of healing physically and emotionally.

Hair anatomy


The hair follicle is the structure of skin from which the hair shaft emerges. The follicle is lined by inner and outer sheaths, which protect and shape the growing hair. A muscle called the arrector pili attached to the outer root sheath below the sebaceous gland. 

If someone gets a burn on skin and loses that surface skin, skin will be populated by cells from hair follicles which have primordial cells that rest in hair papilla. These undifferentiated stem cells take signals depending on what is needed such as hair, skin or oil glands. 

The hair shaft grows from stem cells in the hair bulb deep within the dermis. 

A single hair shaft is made up of three parts: medulla, cortex and cuticle

The medulla and cortex have pigment cells responsible for hair color. 

Hair anatomy


The cuticle is the outer and strongest part of the hair shaft. It is made up of dead flattened cells that overlap each other. The cuticle is keratinized (cells are largely made of a protein called keratin). The sebaceous gland produces oil (sebum) which protects the hair shaft and acts as a natural conditioner.


Hair Growth

Hair grows on most parts of the skin surface, except palms, soles, lips, and eyelids.

Hair thickness and length varies according to the site. Vellus hair is fine, light in color, and short in length; Terminal hair (most important hairs to a human for warmth and esteem: eyebrows, eyelashes, scalp) is thicker, darker and longer. A hair shaft grows within a follicle at a rate of about 1 cm per month.


Hair Cycles

Hair growth follows a cycle. However, these phases are not synchronized, and any hair may be at a particular phase at random. 

  • Anagen- Growing phase: 4-7 years for scalp hair; longer in certain groups 
  • ex) southeast Asians 
  • Catagen- In between phase: 2-3 weeks
  • Telogen- Resting phase: 2-4 months

A new cycle starts with an anagen hair shaft germinating within the same follicle, and pushing out the old telogen hair resulting in normal hair shedding or molting. 

At any given time, approx. 84% of scalp hairs are in the anagen phase, 1-2% are in the catagen phase, and 10-15% are in the telogen phase. 

Hair length depends on the duration of anagen. Short hairs (eyelashes, eyebrows, hair on arms and legs) have a short anagen phase of around one month. Anagen lasts up to 6 years or longer in scalp hair. 


Hair Follicles Vary 

The size of hair follicles varies considerably. 

Anagen hairs vary in size from large terminal hairs (such as scalp hairs) to the small vellus hairs that cover all skin except palms/soles.

Under hormonal influences, the vellus hair follicles in the male beard area usually thicken and darken at puberty. In predisposed individuals, the terminal hairs on the adult scalp can undergo miniaturization and become vellus hairs.

Although vellus hairs greatly outnumber terminal hairs, the latter are more important. 


Hair Loss

The medical term for hair loss is alopecia, and can be associated with scalp disease or scarring.

Alopecia can be localized or diffused (all over) and can affect the scalp or other parts of the body. It may be due to hair shedding, poor hair quality, or hair thinning. Some areas of the skin can be completely bald.

Who gets hair loss?

As all of our hair follicles are formed during fetal growth, it is inevitable that we will notice hair loss of some kind in later life.

Hair loss occurs in:

    • Males or females
    • Children and adults
    • People with any color or type of hair

Hair loss can be an isolated problem or associated with another disease or condition. This can be temporary or permanent, depending on the cause. 


Causes of Hair Loss

Hair loss can be due to:

  • The decrease growth of hair: anagen hair loss
  • Increased shedding of the hair: telogen hair loss
  • Conversion of thick terminal hairs to thin vellus hairs: male and female pattern hair loss
    • A "miniaturization" of the hair shaft, rather than a complete loss of the hair.  The miniaturized hairs of genetically wired male or female patterned hair loss cannot be seen with the naked eye, and therefore looks to be "bald".
  • Congenital or acquired hair shaft abnormalities
  • Inflammatory skin diseases that damage or destroys the hair bulb
  • Scarring processes of any type that destroy the follicle/bulb


Final Thoughts

In today’s excerpt we talked about hair loss, hair anatomy, hair growth, hair cycle, and hair diseases. . We want you to be expert’s on hair loss after our hair loss blog series, so keep an eye out for our second and third blogs coming soon! We will be talking about different types of hair loss (anlagen, telogen, PHL), causes of PHL (male and female), common hair and scalp conditions such as dandruff, alopecia, fungal infections, lice, psoriasis and more, as well as treatments and symptoms for all.

At SkinHappy, we want to help and support YOU through this process and be a guide, as it is difficult to navigate through the plethora of false information, false ads, and confusion that social media, online articles, news, and many forms of media can be portraying. 

Woman happy with healthy hair

With all infections and diseases to be aware about, especially in this day, hair loss can be ignored or pushed to the side for many people. But, it is extremely important to be self-aware, as our outer body can be a reflection of what is going on inside. Take care of yourself by educating yourself, doing what is best for you and your body with an expert’s advice, being consistent, and facing the world with confidence! 

At SkinHappy, we get that hair conditions have both a physical and mental impact. Our aim is to heal both outside and in, and allow patients to face the world with confidence, knowledge, effective and safe products and professional whole person care in their backing. 


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