“Is hair loss reversible?”
This is a question I’m asked regularly, but one that can be difficult to answer in a few short sentences.
With that in mind, I’ve dedicated an entire article to this very topic.
This article will touch on the basics of the hair growth cycle and the main causes of hair loss. I’ll then answer the question that everyone’s asking – is hair loss reversible and, if so, how?
Finally, I’ll share a few tips on how you can slow your hair loss and, in some cases, even reverse it.
What Causes Hair Loss?
To understand why hair loss occurs, it’s first important to understand how hair grows.
The Hair Growth Cycle
There are three phases that the follicle goes through during the growth cycle (1). They are anagen (active), catagen (transition), and telogen (resting).
Hair growth only occurs when follicles are in anagen phase. The majority of your follicles are in anagen at any given time, and healthy follicles will remain in anagen for years at a time.
The next phase is catagen, which only lasts a few weeks to a few months.
The final phase is telogen, which is when the majority of hair shed occurs.
As you’ll see below, this cycle plays into many forms of hair loss. Now, let’s look closely at some of the most common types.
The most common form of hair loss is Androgenetic Alopecia (AGA), also known as male-pattern baldness (2).
Androgenetic alopecia is a hereditary condition in which sufferers (who can be male or female) experience progressive thinning and balding of the scalp.
In men, the first signs occur at the temples and forehead. In women, it often is most noticeable at the crown.
The cause of AGA is hotly debated and, in truth, there are likely many contributing factors (3). However, the most commonly held belief is that those with pattern hair loss are sensitive to the androgen hormone Dihydrotestosterone (DHT) (4).
DHT is an important hormone in men as it’s necessary for sexual development and function (5). For those with AGA, though, when the androgen attaches to the hair follicles it triggers a process known as miniaturization (6).
If left untreated, the follicle will suffer from chronic inflammation that eventually cuts it off from its blood supply. This results in death of the follicle.
There are other causes of hair loss, too.
A few of the more common ones include alopecia areata, anagen effluvium, and telogen effluvium.
Alopecia areata is an autoimmune skin condition that causes hair loss on the scalp and, less commonly, on the face and entire body (7).
The condition is characterized by “transient, non-scarring hair loss” and, more importantly, preservation of the follicle.
The condition has no known triggers. Because of this, it’s difficult to manage medically.
It’s alarming to lose your hair at any stage in the hair growth cycle. When you lose it during anagen phase – the active phase of growth – though, it’s even more concerning.
This occurrence has a name though, and it’s Anagen Effluvium (AE) (8).
So, what causes hair loss during anagen phase?
The most common trigger for AE are illness and medication.
There are certain illness – particularly autoimmune diseases – that interrupt hair growth. Alopecia areata is one of these conditions, but others include Lupus and Hashimoto’s.
And when it comes to medications that trigger premature hair loss, the most commonly thought of one is chemotherapy.
Chemotherapy drugs are toxic to the body, which is why they’re so effective at killing cancer cells. Unfortunately, this can interrupt processes within the body such as hair growth.
Other conditions that may trigger anagen shedding include scalp infections (such as ringworm) and abscesses.
It’s common for hair shedding to occur at the final stage in the hair growth cycle, telogen. But when too much shedding occurs, it becomes a condition known as Telogen Effluvium (TE) (9).
Just like anagen effluvium, TE can also be caused by illness or medication. However, another cause is stress.
A 2017 study performed on college students at various stages in the final exam cycle shows the exact role that stress plays in hair loss (10).
The study was split into three periods:
- T1 – before the start of the learning period
- T2 – between the 3-day written exam and oral exam
- T3 – after 12 weeks of rest following exam period
As the results show, student perception of stress during T2 increased in the 18 students who were taking exams but remained the same for the 15 control students.
Beyond perception, though, the scientists also saw an increase in TH1/TH2 cytokine balance between T1 and T2.
So, what does this have to do with hair loss?
As further measured by researchers, the exam students saw a decrease in anagen phase hairs and an increase in telogen phase hairs during T2.
With more hairs in telogen phase, there will be more shedding present. This is known as telogen effluvium.
But whatever the cause, there is one thing for certain. Once the hair follicle has died, there is no way to revive it.
So, what does this mean for reversing hair loss? Let’s take a look.
Can Hair Loss Be Reversed?
As mentioned above, the hair follicles play a major role in determining whether hair loss can be “reversed.” So, what does “reversed” mean?
In simplest terms, to reverse hair loss means to stimulate hair growth. In order to do that, we need a few things.
The first are living hair follicles.
Hair follicles are organs that reside at the base of the skin. And because they’re organs, this means that it is possible for them to die.
So the second thing we need for reversal is a healthy blood flow.
The hair follicle is connected to the body’s circulatory system via blood vessels that connect to the dermal papilla. It is here where follicles receive the oxygen and nutrients they need to survive and, even more importantly, thrive.
The base isn’t the only important part of the follicle, though.
Towards the top of the follicle is the Arrector Pili (AP) muscle. And interestingly, it’s been found that those with AGA are more likely to lose the connection to the AP muscle just the same as they lose connection to the dermal papilla.
Why does this matter for hair growth?
Because it appears that loss of connection to the AP muscle is linked to a higher rate of irreversibility of hair loss (11).
In other words, no connection to the AP can mean it’s impossible to reverse balding.
This doesn’t mean that reversing hair loss – especially that which is caused by AGA – is impossible. But the sooner you start, the better your odds.
How to Slow / Reverse Hair Loss
Now that you know that some types of hair loss can be reversed, you may be wondering how you can go about it.
Here are a few tips to get you started on the right path.
Discover the Cause
There are many causes of thinning and balding, and I’ve covered a few of them above. The only way to treat the hair loss at its source, however, is to discover the cause.
There are many balding treatments – including minoxidil and finasteride – that aim to treat the problem by covering it up. These treatments may work in the short-term, but unless you target the actual cause of hair loss you’ll just be buying yourself some time.
This is why it’s critical that you discover the underlying cause of your hair loss, and then treat it directly.
The best way to do this is by making an appointment with a dermatologist who specializes in hair loss, also known as trichologist.
Your doctor can perform numerous tests, including blood panels, biopsies, and physical exams, to get a better picture of your scalp’s condition. They can then use this information to piece together the reason for your thinning in the first place.
Once a diagnosis has been made, you can then create a treatment plan that’s backed by research.
As stated, drugs like minoxidil and finasteride will only buy you time. Once you stop using them, the results will fade.
And while your doctor may recommend these drugs as part of your treatment plan, they’ll likely have other suggestions for you as well.
One of the likeliest suggestions? Scalp stimulation.
Stimulate the Scalp
Whether your dermatologist has recommended it or you want to give it a try yourself, you’ll be happy to know that scalp stimulation is supported by research.
Scalp stimulation exercises, including massage and microneedling, have been practiced for decades. However, only in more recent years have they been put to use in the treatment of alopecia.
Standardized Scalp Massage Results in Increased Hair Thickness by Inducing Stretching Forces to Dermal Papilla Cells in the Subcutaneous Tissue (2016)
One study, performed in 2016, followed the progress of patients who received standardized scalp massage over the course of 24 weeks (12).
There were numerous factors that were evaluated, including:
- Total hair number
- Hair thickness
- Hair growth rate
- Gene expression changes
At the end of the study, the results were clear.
Scalp massage results in an increase in hair thickness, as well as significant changes in gene expression.
Two thousand six hundred and fifty-five genes were upregulated and 2,823 genes were downregulated.
This is great news for anyone who suffers from androgenetic alopecia (13).
What about microneedling?
That shows promise, too.
Microneedling is a procedure that uses tiny needles to puncture the skin. As the skin heals, it triggers a process that leads to stimulation of hair follicles (14).
You don’t just have to take my word for it, though.
A Randomized Evaluator Blinded Study of Effect of Microneedling in Androgenetic Alopecia: A Pilot Study (2013)
A 12-week study followed two groups of patients diagnosed with androgenetic alopecia (14).
The first group received a weekly microneedling treatment, and twice daily application of 5 percent minoxidil lotion.
The second group received just the twice daily application of 5 percent minoxidil lotion.
The goal of the study was to compare the hair growth results seen in the men in each group.
As the researchers hypothesized, the group to receive both microneedling and minoxidil saw better results.
How much better? In the words of the scientists, “the mean change in hair count at week 12 was significantly greater for the Microneedling group compared to the Minoxidil group (91.4 vs 22.2 respectively).”
Why is that the case?
The dermal papilla, as mentioned above, is an important part of the hair follicle. It not only is the follicle’s only connection to the circulatory system, but it’s also where cells for hair growth are produced.
Microneedling or, more specifically, the wound healing process, has been shown to stimulate dermal papilla associated stem cells.
In this way, microneedling works to induce the activation of growth factors which directly contribute to hair growth.
Change Your Lifestyle
There are forms of hair loss that are considered to be more aggressive than others. One thing that’s true across the majority of hair loss types is that lifestyle choices can contribute.
Alcohol, smoking, and inactivity are common lifestyle “choices” that may contribute to an unhealthy scalp and hair. The underlying commonalities amongst them are inflammation and poor oxygen intake.
Chronic inflammation and reduced oxygen can starve the hair follicles. If left untreated, this can cause irreversible hair loss as the follicle suffocates and finally dies.
If poor lifestyle choices are the cause of worsening hair loss, then better lifestyle choices are the answer.
The most obvious changes to enact are to quit smoking, reduce (or stop) drinking alcohol, and increase your activity levels. These will improve your overall health immeasurably.
But a change that’s less known to be linked to hair health is diet.
Fortunately, you can combat the effects of this diet by making a few changes.
These include adding in more lean meats, greens, and healthy fats.
There may also be evidence to suggest that an alkaline diet can contribute to your overall health, including “an increase in intracellular magnesium” and improvements in cardiovascular health, memory, and cognition (17).
These changes, when combined with the above techniques, may help to promote hair growth.
Hair loss is a general term applied to an array of conditions. It can be temporary and mild, or permanent and severe.
The one question that everyone wants the answer to is “can hair loss be reversed?”
The short answer is, yes, there are many cases of hair loss that can be stopped and even reversed.
However, this will depend on many factors including how long the issue has been occurring and the condition that caused your loss in the first place.
The best place to start is with a dermatologist. They can discover the underlying cause, and even help you to get started with a treatment plan.
But so many other steps – including lifestyle changes and techniques – will be up to you.