Thinning hair, dandruff… and more hair mysteries explained

Hair is an important aspect of our appearance, and that can affect self-esteem and identity. So it’s best to know all the facts about your follicles.

If you notice a gradual reduction in the overall volume of your hair – but you don’t notice an unusual amount of hair fallout – it’s probably androgenic alopecia. Androgenic alopecia is commonly known as male pattern baldness – but it occurs frequently in women as well. It happens when hair follicles on the scalp develop a sensitivity to androgens, a male hormone. This type of hair loss is largely genetic and is relating to ageing, says trichologist, Anabel Kingsley. You’ll probably find that the hair shaft itself becomes thinner too, as follicles are gradually shrinking. Kingsley says this type of hair thinning is the most difficult to treat, but a topical or oral medication can prevent further hair loss. Regrowth is possible, she says, but not in everyone; it simply depends on the person.

If you notice a drop in overall hair volume, but it’s not gradual – as in, you see more hair than usual in your shower drain or hair brush – you probably have telogen effluvium, says Kingsley. This type of hair loss is not hereditary. Rather, it can be the result of stress, a thyroid condition, childbirth, a nutritional deficiency, and even the flu. “Hair is an inessential tissue,” says Kingsley – despite it seeming sometimes essential to our self-image. “So whenever there is an internal imbalance, or we’ve been unwell, [our systems] will stop sending essential nutrients to our hair.” If Kingsley suspects telogen effluvian, she’ll usually send her client to a medical professional to address the underlying issue. Mercifully, this telogen effluvian is usually temporary, and most clients see regrowth.

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It was once thought that temporary bald patches were caused by stress and nerves, but dermatologists now know that isn’t true. This condition, known as alopecia areata, is actually an autoimmune disease. It occurs when the immune system literally attacks hair follicles on the scalp. It can happen to hair follicles on the face and other parts of the body, too. Alopecia areata doesn’t discriminate either; the Australian Alopecia Areata Foundation estimates that 2 per cent of the population will be affected by the condition at some point in their lives. Alopecia areata is treatable, though, though the hair may be absent, your follicles are actually still alive. This means regrowth is always possible, though not guaranteed. Doctors typically treat this type of hair loss with oral or injectable medications.

Male pattern baldness is the most common type of hair loss affecting men according to the Australian Government department of Health. Though it’s exactly the same type of male pattern hair loss that affects women, androgen alopecia presents differently in men. Male pattern baldness is hormonal and hereditary, and it’s caused by “a genetic predisposition to follicle sensitivity to circulating androgens, or male hormones,” says Kingsley. “However, as men naturally have higher levels of androgens, the volume reduction tends to be more severe. The pattern of volume loss is also usually different in men and women. In men, androgenic alopecia starts with a typical bi-temporal recession and thinning of the vertex, which can progress to the point where a man is left with only a ‘horseshoe’ of hair around the scalp from ear-to-ear.” Once you’re bald, often the only solution is to mask the area where hair has thinned. A new ‘Hairline Rescue’ treatment uses micro-blading – like a semi-permanent tattoo – to recreate the look of missing hair strands stroke by stroke. “It gives the realistic effect of lush, healthy hair,” says Ramon Padilla, founder of EverTrue Microblading Salon. The treatment lasts about 18 months.

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Flaky scalp is typically caused by dandruff, a benign condition that usually results in little more than self-consciousness. But it can be controlled or avoided completely. “Dandruff is simply a less severe form of seborrhoeic dermatitis,” says Kingsley of the dermatological condition. “Both are caused by an overgrowth of Malassezia yeast on the scalp.” Kingsley says dandruff’s biggest culprits are stress and a poor diet, which can weaken the body’s defences against the yeast. It can flare up if you haven’t shampooed in a while, but it’s not the result of poor hygiene, according to the Australian Government Department of Health. Men and teens tend to develop the condition most often, and it’s notoriously hard to treat. If you have dandruff that does not respond to dandruff shampoo, visit a dermatologist to rule out a more serious condition such as seborrheic dermatitis, psoriasis, eczema, or a fungal infection, all of which require intervention.

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Fun fact: human hair is made of keratin, the same substance that comprises animal horns, hooves, claws and feathers. The hair shaft itself has three layers, according to Kingsley. The medulla is the centre, the cortex is the pigment-rich mid-layer, and the cuticle covers and protects the hair shaft. When the cuticle lies flat, hair is shiny and frizz-free. The cuticle is delicate, though, and things like moisture and chemical processing can get inside and lift it. You can tame frizz by smoothing the cuticle layer with conditioners and specially formulated serums. But the best way to ward off frizz is to prevent it. Experts recommend being kind to the cuticle by brushing your hair only when it’s wet, blow-drying just the roots, and avoiding heat styling and processing as much as possible.

“Split ends occur when the distal (end) portion of the hair becomes overly weathered and, as a result, ‘splits’ apart,” Kingsley says of this all-too-common hair nuisance. Like frizz, split ends are a sign that the cuticle has been penetrated and the hair shaft weakened. Aggressive treatments like colouring and heat styling are the usual culprits, but using a boar-bristle hairbrush can contribute to the damage, too. So can waiting too long between salon appointments. “You can’t heal split ends – the only cure is to cut them off,” says Kingsley, though hair serums can temporarily “glue” them together in the meantime.

For most people, spotting that first silver hair gleaming in the mirror can be a dreaded moment. But grey hair is a natural part of the ageing process, and can begin as early as your twenties. If you do prematurely grey, don’t go blaming your kids! Contrary to urban legends, there’s no strong scientific case for stress or trauma causing grey hair. Genetics and age dictate when your follicles will start to run out of melanin, the pigment that gives your hair its hue. Scientists believe that hair follicles, to some degree, are on a timer. When each follicle reaches a point in its life where its melanin reserves have run dry, the hair returns to its natural state: white. Because each hair goes white in its own time, we get the appearance of ‘grey’ hair.

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Ringworm is a highly contagious infection – and no, it’s not associated with a worm at all. The fungus can live inside things like hair brushes, hats, and bed sheets, and can easily transfer on contact. This particular fungus feed on dead skin, which is essentially what hair is. It proliferates in moisture, so poor hygiene can make a person particularly susceptible. When ringworm affects the scalp, it can be pretty distressing. Its hallmarks are scaly grey or red patches that tend to be itchy, tender or painful spots, and hair breakage at the affected areas. The good news is doctors can help banish ringworm with prescription antifungal medication and medicated shampoos.