Ask The Kit is the real-talk advice column you never knew you needed. Every Tuesday, editor-at-large Kathryn Hudson answers your pressing beauty and style questions. What’s the best blazer for work? How should you deal with errant chin hairs? What’s the best way to fight frizz? Send your Qs to ask@thekit.ca.

“I’ve noticed my hair thinning and more hair coming out in the shower and in my brush. It’s very upsetting. I want to try the supplements I see at the pharmacy. Do they work?” —Maddie, Toronto

We probably shouldn’t care as much about hair as we do—after all, it’s just a collection of cells and swirls of DNA, but unlike, say, a toenail or a bellybutton, hair is often wrapped around our identity and our self-confidence. No matter how rattled you are though, you shouldn’t rush out to drop your hard-earned money on hope and maybe-remedies.

“The most important thing by far is to get the right diagnosis,” says Dr. Jeff Donovan, a dermatologist specializing in the treatment of hair loss and president of the Canadian Hair Loss Foundation. “What you have is not what your sister has or what your girlfriend has. There are a hundred reasons to lose hair—and usually there is more than one thing going on.” So before you start testing out symptomatic remedies, seek out the root issues: “If you can’t state the cause of your hair loss in one sentence,” says Dr. Donovan, “you shouldn’t be starting treatment.”

There are some more common offenders to consider, the most prevalent of which is genetic hair loss—also called genetic alopecia or female pattern hair loss—which affects about 30 per cent of women by age 45, says Dr. Donovan.

This often goes undiagnosed among women because it’s simply less talked about and less recognizable. (We should get a special bell to ring every time women’s health and wellness is de-prioritized, though I suppose the constant, deafening clanging would quickly become annoying.)

“Men can identify that they have male pattern baldness because it recedes at their temples and crowns and they realize they look like their dad or their uncles, but it doesn’t tend to even get considered for women and often women think they have hair loss from low iron, thyroid problems or stress,” explains Dr. Donovan. “These certainly are causes of hair loss, but they tend to be overemphasized because we want quick fixes. When our blood test comes back showing that we have slightly low iron, we jump on it.”

Unfortunately, just because you want a vitamin or over-the-counter supplement to cure your issue doesn’t it mean it will.

The correctable factors Dr. Donovan just outlined are the second category of common culprits, which range from insufficient iron to a new medication or birth control, from hormone replacement to rapid weight loss caused by crash dieting. “People tend to focus on these issues because once these factors are corrected, the hair goes back to normal,” he explains. But unfortunately, just because you want a vitamin or over-the-counter supplement like Biotin to cure your issue—and who could blame you for preferring a tidy solution?—doesn’t it mean it will.

“If a family doctor is in favour of starting a multivitamin, that can be reasonable if your diet hasn’t been great, but patients should not be popping zinc or iron supplements unless they have a reason to believe that they could be low,” cautions Dr. Donovan. “Most supplements are low-risk, but we’ve learned in the last few years that supplements can mask all sorts of abnormalities in blood tests, so it’s important to consider any possible side effects. Patients need to first ask: what’s the worst thing that could happen when taking this supplement?”

You also, somewhat surprisingly, need to ask a similar question to your hair stylist, since problematic hairstyling practices are the third most common trigger for partial baldness: think tight braids or ponytails that pull at the scalp, damaging flat ironing, or chemical irritation from bleach and dye. “This is certainly an important category because if it’s identified early, it can be completely reversed,” explains Dr. Donovan, “but, if the particular practice goes on for even six months, there may be some limits on how much we can return the hair to its original density.”

There are now plasma treatments that can be effective, in which a patient’s blood is collected, spun and then re-injected in the scalp.

So while it’s key to pause and consider the context for your hair loss, it’s also vital not to ignore it. Start by booking an appointment with your family doctor to get a broad screen, including a basic iron and thyroid panel. “These are absolutely essential, and if some of these levels are abnormal, it’s reasonable to try to correct them, but if the shedding doesn’t stop within four to six months, you need to consider a specialist referral.” (Pro tip: given the long wait times for most specialist appointments, get the referral right away and try to correct your low iron in the interim.)

Then, once you have your diagnosis, you can get on with an appropriate treatment. Over-the-counter minoxidil—branded as Rogaine—can certainly help a large proportion of people, for example. But one must be patient and stay the course: “It can be messy and time-consuming, so a large number of women will use minoxidil for a month or two, then give up because they didn’t see results—but that could be because they didn’t have a good understanding of how to apply it and they weren’t aware that it was going to take six months to work,” explains Dr. Donovan, who also mentions that the low level, red-light laser devices available for at-home use can also help, but again, they don’t help everyone. Prescription-based treatments such as anti-androgen tablets that block the male hormones might also be suitable, if recommended by your doctor.

Dr. Donovan explains that, in fact, the array of treatments is exploding. There are now plasma treatments that can be effective, in which a patient’s blood is collected, spun and then re-injected in the scalp (a medical cousin of the now-infamous “blood doping” Lance Armstrong made famous) as well as transplant treatments, which unfortunately, tend to be less possible for women than men. “The most important treatment rule for genetic hair loss, though, is that the treatments are lifelong. Patients need to not only consider what it might cost over the next six months, but what it could cost over the next 70 years. A typical hair transplantation could cost $17,000 and plasma treatments are around $600—three to four times per year.”

Whatever you decide to do, try to keep your perspective by your side and enlist a trusted friend or partner as a sounding board. That’s a prescription we should all fill, because, as Dr. Donovan says, “We become emotionally invested in our hair to degrees that we never thought would have been possible.”

Shop the Advice

  • The Dry Shampoo

    OUAI dry shampoo foam, $37, sephora.com

  • The Shampoo

    Kérastase shampoo, $45, sephora.com  

  • The Conditioner

    Aveda conditioner, $43, aveda.ca

  • The Treatment

    Rogaine hair regrowth treatment, $60, well.ca

  • The 5-in-1 Treatment

    Perfect hair Day styling treatment, $29, livingproof.com

 

    More Ask The Kit