Hair loss impacts self-esteem and leads to stress, and that stress causes more hair loss, creating a vicious loop that’s hard to break. Addressing the stress through relaxation techniques, sleep, a nutritious diet, and sometimes treatments can help stop the cycle and promote hair regrowth, as stress-related hair loss is often temporary. Losing 50-100 strands a day is considered normal; more than this, or large clumps with bald patches, may need medical evaluation. Often, excess hairfall is caused by stress, nutritional deficiencies, hormonal imbalances, or improper hair care, and is reversible. Hair colour/dye causes hair breakage due to chemical damage, and generally does not cause deep-rooted hair loss. Washing hair with gentle shampoos keeps the scalp clean and does not cause hairfall. Hair thickness and density are determined by genetics, and follicles do not grow back thicker after shaving (“Tonsuring”). Hats and helmets do not cause hairfall, but improper use (tight fit, poor hygiene, constant pulling) can lead to temporary issues like breakage, thinning, or hairfall. Hair oil does not directly stop or cause hairfall, while heavy oils can make fine hair brittle or greasy, increasing mechanical shedding during combing. Applying too much oil can clog pores, attract dirt, and lead to dandruff or scalp irritation. Healthy hair requires gentle cleansing, scalp nourishment, balanced nutrition, protection from heat and pollution, and avoiding harsh chemicals.
MOVIES ABOUT HAIR LOSS
=Gone Kesh (2019): A Hindi comedy-drama about a teenage aspiring dancer diagnosed with alopecia, when she starts losing hair rapidly.
=Bala (2019): A Hindi satirical comedy about a man dealing with premature balding and the resulting loss of self-confidence.
=Ujda Chaman (2019): A Hindi film that also focuses on a young man struggling with premature balding.
=Hair Is Falling (2011): A Hindi comedy-drama about a model whose career and personal life face challenges after his hair starts to fall.
=Herman (1990): A Norwegian film about an eleven-year-old boy who loses his hair and deals with the emotional struggles of premature baldness.
=Nappily Ever After (2018): This film focuses on a woman’s journey of self-acceptance after she shaves her head following a mental breakdown, focusing on the cultural pressure regarding hair.
HOW STRESS CAUSES HAIR LOSS
=Hormonal Disruption: Stress increases cortisol, a stress hormone, which can disrupt the hair growth cycle, forcing hair follicles into the resting (telogen) phase prematurely.
=Telogen Effluvium (temporary shedding): This premature shift causes a large number of hairs to shed a few months after a stressful event, often noticed during washing or combing.
=Stem Cell Impairment: Chronic stress impairs the stem cells that regenerate hair, reduces circulation and nutrient supply to follicles, making hair weaker.
=Immune System: Stress can trigger Alopecia Areata, an autoimmune condition where the body attacks hair follicles, causing patchy hair loss.
HOW HAIR LOSS CAUSES STRESS
=Appearance & Self Esteem: Visible hair loss can negatively impact how people see themselves, leading to feelings of anxiety, embarrassment, and low self-worth.
=Social Withdrawal: Fear of judgment might cause individuals to avoid social situations, increasing feelings of isolation and stress.
=Loss of Control: Experiencing hair loss can make people feel helpless, as they see their body changing in a way they can’t easily control, escalating anxiety.
COMMON CAUSES OF HAIRFALL
=Nutritional Deficiencies: Lack of iron, zinc, vitamins (A, D, E, biotin), or protein.
=Stress & Lifestyle: Severe physical or emotional stress, inadequate sleep, and smoking.
=Stressful Events: Major surgery, high fever, emotional shock, rapid weight loss.
=Hair Care Practices: Overuse of heat styling tools, chemical treatments (dyes, perms), hot oil treatments, bleaching, and tight hairstyles (traction alopecia).
=Hormonal Imbalances: Pregnancy, childbirth, menopause, PCOS, or thyroid disorders.
=Genetics (Androgenetic Alopecia): Hereditary thinning, commonly male or female pattern baldness.
=Hair growth slows down with age.
=Medical Conditions & Treatments: Alopecia areata (autoimmune), scalp infections (ringworm), and side effects of medications like chemotherapy, antidepressants, or blood pressure drugs (Beta-blockers and ACE inhibitors).
MANAGEMENT OF HAIRFALL
=Medical Treatments: Topical minoxidil, oral finasteride, or light therapy.
=Supplements: Correction of nutritional deficiencies of iron, zinc, vitamins, protein, and omega-3s.
=Lifestyle Changes: Managing stress through yoga, exercise, and meditation, ensuring adequate sleep, and reducing alcohol consumption.
=Hair Care as detailed below.
PREVENTION, AND HAIR CARE TIPS
=Cleansing: Wash hair 2-3 times per week, if in a hot-humid-polluted environment (more if oily scalp, less if dry skin, and in cold weather), using sulphate-free shampoos to avoid stripping natural oils and rinse with lukewarm water, as hot water weakens strands. Over-washing strips natural oils. Leaving hair oil for too long without washing may weaken hair shafts, causing breakage that looks like hairfall. Rinse hair after exposure to dust/pollution. Do not aggressively brush wet hair, as it leads to breakage.
=Conditioning: Always follow shampoo with a conditioner to lock in moisture. Apply conditioner only to mid-lengths and ends, not the scalp. Use a deep conditioning mask once a week for dry-frizzy hair for extra hydration. Use leave-in conditioner for curly hair and avoid brushing when dry.
=Scalp Care: Gently massage your scalp for 5-10 minutes weekly to boost circulation. Sparing use of light oils (like coconut, argan, or jojoba) and washing within 6–12 hours can nourish without clogging pores or attracting dirt. Avoid aggressive rubbing of the scalp and excess hair oil, and keep the scalp clean to prevent dandruff and scalp irritation.
=Styling: Always use a heat protectant spray before styling. Limit heat styling (straighteners, curlers, blow dryers). Avoid tight hairstyles (ponytails, braids) that pull on the hair roots, and do not allow the scalp to breathe freely, to avoid hairfall, a receding hairline, and even headaches. Those with long, thick hair should sleep with a light, loose braid, held with a soft scrunchie or a fabric ribbon instead of a rubber band, and not leave the hair loose, to avoid tangles, knots, and increased breakage. A silk or soft cotton pillowcase reduces hair friction and increases breakage.
=Protection: Protect hair from the sun and pollution with an umbrella, scarf, or cap. Helmets should have a snug fit and have a hygienic silk or satin liner or a clean bandana for hair care.
=Nutrition: Eat foods rich in iron, zinc, vitamins (A, D, E, biotin), protein, and omega-3s.
=Stay hydrated: 2 to 3 Liters of water daily supports scalp health.
WIGS AND HAIR TRANSPLANTS
Hair loss is a top-searched beauty and health topic on the internet, and many dramas and movies have touched upon it. A 5,000% increase in searches for “alopecia areata” followed Chris Rock’s supposed joke about Jada Pinkett Smith’s shaved head at the 2022 Oscars, which led to her husband Will Smith slapping Chris Rock on the stage. Several celebrities openly wear wigs, hairpieces, or extensions to manage hair loss, including many Indian and Hollywood stars like Jada Pinkett Smith, Viola Davis, and Keira Knightley. Wigs present several common challenges, including their maintenance, physical discomfort from heat retention, itching, and potential scalp irritation, especially with synthetic materials. Many other celebrities are reported to have initially dealt with noticeable hair loss by wearing wigs or patches, but later opted for hair transplant surgeries to permanently address the issue. Hair transplants succeed in pattern baldness by relocating Dihydrotestosterone (DHT) resistant hair follicles from the back/sides (donor area) to thinning areas, usually requiring 4,000–7,000 grafts for full coverage. It is unsuitable for active autoimmune conditions like Alopecia Areata or scarring alopecia, where the immune system may destroy new grafts. Gen Z is experiencing earlier hair loss primarily due to a combination of high-stress lifestyles, poor nutrition, and environmental factors. The Czech Republic has the highest prevalence of baldness, where over 40% of adult males are affected. Anxiety about it increases hair loss. The many myths and doubts about hairfall have been addressed above. Awareness and preventive measures discussed above are the best way to ensure a healthy hair and scalp.
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Dr P.S.Venkatesh Rao is a Consultant Surgeon, Former Faculty CMC (Vellore), AIIMS (New Delhi), and a polymath in Bengaluru, drpsvrao.com
