Hair repair

Is your crowning glory less than lustrous these days – or do you simply have less hair? From thinning to frizz and dandruff, here are the top tips and tricks to revitalise lacklustre locks, whatever the cause.

We all have good hair days, where we wake up and everything just falls into place, and bad hair days, where unruly curls rule or that fringe refuses to cooperate. Is there anything we can do to get the best from our hair without spending loads of money on hair products, or is beautiful hair just down to luck?

We asked hair experts to take a look at the most common hair problems and conditions, and the best fixes for them.

Thinning hair

Hair extensions

One cause of thinning hair is traction alopecia. This results from prolonged tension on the scalp hair through certain hairstyles such as tight ponytails, braids, dreadlocks or hair extensions. At first, people with traction alopecia will present with thinning hair but after a while sebaceous (oil) glands and hair follicles become misshapen and scarred.

Treat it: People with this type of alopecia are advised to change to a looser hair style, cut some weight off their hair and avoid exposing the affected hair and scalp to chemicals and heat.

Postnatal

Hair can also thin in women after they give birth. This shedding of hair is caused by a drop in levels of the hormone oestrogen. The good news is this type of hair thinning is most often temporary. A new, shorter cut can help create a fuller look until hair grows back – usually within a few months to just before your child’s first birthday. The co-presenter of UK TV series Embarrassing Bodies, Dawn Harper, says post-birth hair shedding can seem more dramatic because normal shedding slows during pregnancy and catches up again after the baby is born.

“I frequently see new mothers terrified that they’re going bald,” Dr Harper says. “But what’s happening is that our normal hair loss (we lose about 100 hairs from our heads every day) stops during pregnancy. A few months after the baby is born, all the hair that would have been lost in the past year falls out quickly – so the hair loss feels dramatic. But it soon settles back to normal.”

Out of balance

Trichologist (hair and scalp specialist) Anabel Kingsley says around 80 per cent of her female clients come to her about hair loss. There are many possible causes, Ms Kingsley says.

“Adverse changes in hormones affect the hair (at menopause, for example), but crash dieting, too many processed foods, increased stress and certain oral contraceptive pills are also factors that play a role. Low iron is a major cause of hair loss,” Ms Kingsley says.

Other causes include thyroid disorders and polycystic ovary syndrome. Then there’s alopecia areata, an autoimmune condition where clumps of hair fall out, leaving bald patches (see Alopecia universalis, below).

Female pattern hair loss

A common reason for thinning hair is female pattern hair loss (FPHL), which affects around 40 per cent of women by the age of 50, and 45 per cent by age 80. According to dermatologist Rodney Sinclair, once FPHL starts, women tend to lose 5–10 per cent of their hair each year, mostly from the crown.

“It begins with diffuse thinning over the top and front parts of the scalp, most noticeably in the centre,” Professor Sinclair says.

“While the hair loss is most pronounced on the crown, hair can also thin from ear to ear (the back of the head and front hairline are least affected). Women who have long hair may first notice their ponytail becoming thinner. What’s happening is the follicle is shrinking and the hairs are becoming ever shorter and finer.”

According to DermNet New Zealand, FPHL has a strong genetic component, with multiple genes contributing to the condition that can be inherited from one or both parents. At this stage it’s unclear if male sex hormones called androgens are involved in FPHL. But treatment using a combination of a medication that blocks androgens, such as spironolactone, and a low dose of minoxidil, which dilates the small blood vessels, has been shown to ‘significantly improve hair growth, reduce shedding and improve hair density’.

Treat it: See your GP if you notice thinning hair – you may need tests to rule out a medical condition.

Chemotherapy side-effects

One of the distressing side-effects of cancer treatment can be the loss of your hair. Hair loss happens because chemotherapy targets fast growing cells, which includes hair follicle cells. According to the Breast Cancer Foundation, hair loss usually occurs from two weeks after the first treatment. Hair may fall out gradually or more quickly, in clumps. Even if hair doesn’t fall out, it often becomes dry and straw-like.

During this period, you have the option of wearing scarves, headwraps or a wig, or to just be bold, bald and beautiful. If you do opt for a wig, there is a Ministry of Health subsidy available to most people with medical or cancer therapy hair loss. Your GP or healthcare provider can tell you how to claim the subsidy and provide you with the necessary medical certificate.

Hair nearly always starts to grow back within weeks of stopping chemo, and it usually covers the head within three to six months. For reasons that aren’t fully understood, the colour may change and the texture may be different – curlier or straighter, for instance.

Hair that breaks

This is about the damage we inflict on our hair. If you subject yours to a lot of styling and heat, it can become so damaged and dry that it snaps off. Consultant trichologist Iain Sallis sees the problem a lot. “I regularly see women panicking because their hair has apparently started to fall out,” Mr Sallis says. “But, in reality, their hair is breaking off due to their straightener addiction.

“Any heat over 180°C will damage the cuticle of the hair (the hard, outer protective coating on each strand), and damage the cortex (a twisted bundle of protein fibres that give hair its internal strength and flexibility). The fibres unravel, which you first see as split ends, but the unravelling can reach all the way up the hair, causing it to break off,” he warns.

Treat it: To prevent damage, turn down the heat on your appliances. Blow-dry your hair using your hairdryer on its medium heat setting and keep your straighteners below 180°C. Once breakage has happened, the only thing you can do is cut your hair where it’s breaking. “Use a deep conditioner before shampooing,” Ms Kingsley suggests. “Work it into the hair with the fingertips – particularly the ends. Leave it on for 20 minutes or so, then wash it out with a moisturising shampoo and after-shampoo conditioner.”

Alopecia universalis

Alopecia universalis (AU) is an advanced form of alopecia areata, or spot baldness. Alopecia totalis is the complete loss of hair on the head, while universalis affects the entire body. Men, women and children may all be affected, and it can occur suddenly and randomly. AU is classified as an autoimmune disorder but the exact mechanism is not yet understood, according to the US Genetic and Rare Diseases Information Center. There is likely a genetic and environmental component to its onset.

Treat it: There is currently no reliable treatment for the condition. But people can experience spontaneous hair regrowth without treatment, and around 10 per cent of sufferers experience a full recovery. Some people seek counselling services to help them come to terms with the disorder and to regain confidence that can be lost with hair loss. Hairpieces and artificial eyelashes and eyebrows can help some people feel more confident about their appearance.

Frizz and scalp problems

Dandruff and itchy scalp

True dandruff is caused by an overgrowth of yeast-like fungi called malassezia, which feed on scalp oils, breaking them down into by-products, including oleic acid. Around half of us are sensitive to oleic acid, and our skin responds by trying to shake it off, causing skin to shed at a faster rate. Ms Kingsley says it can be caused by stress and hormonal changes that make the scalp more oily.

But what looks like dandruff may be something else. “Women are usually too embarrassed to talk about it, which means another condition can go ignored,” Ms Kingsley says. For example, flakes can be caused by a dry, irritated scalp, sunburn or general dehydration. “People pick up a medicated shampoo, which irritates the scalp more, and a vicious circle begins,” she adds.

It can be hard to spot the difference, but dandruff flakes are larger, yellowish and oily, while dry skin flakes are white and like dust. If your dandruff treatment doesn’t work, there’s a good chance you have dryness, or even an allergy to one of the ingredients.

Treat it: Dandruff loves moist, oily conditions, so shampoo regularly, advises Ms Kingsley. “During an outbreak, use a medicated shampoo containing zinc pyrithione, keto­conazole, salicylic acid or selenium sulfide. It’s a good idea to tackle stress, too – try a weekly session of yoga, pilates and/or meditation. Moderate exercise, or any activity you find relaxing, can also help.” For a dry scalp, she recommends natural coconut oil. “Put it on, massage into the scalp, then wash thoroughly the next day with a gentle shampoo.”

Oily hair

Greasy hair comes from an oily scalp. “I find it’s usually hormonal,” Ms Kingsley says. “It particularly affects teenagers and is common in early pregnancy.” She says stress can also be a trigger for excess oil, because stress encourages the production of androgens, such as testosterone, that trigger oil glands to be more active. “Testosterone is also the reason men tend to have greasier hair than women.”

Treat it: Wash oily hair daily, advises Ms Kingsley. “Forget the idea that frequent washing will make your hair greasier. It’s an old wives’ tale.” She also suggests avoiding products with silicones as these make hair soft and look shiny, but also weigh it down and make it appear greasier faster. And keep your hands off! Constantly playing with or touching hair can transfer oils and dirt from your hands onto the strands. This can make hair appear greasy and dull, as well as weigh it down.

Dry and frizzy hair

For plenty of women, the first sign of moisture means their dry hair turns into a mass of frizz. According to trichologist and hair stylist Guy Parsons, dry, coarse and frizzy hair can normally be attributed to a lack of moisture inside the hair.

“It feels drier, more brittle, and the cuticle will, perhaps, be raised, making hair look dull. Those cuticles can become interlocked and intertwined, creating tangling and knotting, too.” The driest types? Curly and/or black hair.

Treat it: As with hair that breaks, Mr Parsons says heat styling is a problem, as it causes yet more moisture to evaporate from dry hair. “You can’t change the internal make-up of your hair, but you can try to replace moisture by using masks and intense conditioners. Look for agents such as shea and cocoa butters. Natural oils, such as argan, jojoba, baobab and babassu, also hydrate and smooth without greasiness, and they’re water-soluble so you can rinse them away.
“Dampness in the hair will also cause frizz,” he explains. “So clever products that can coat and lie on the surface will prevent moisture getting into the hair and ruining your blow-dry, while allowing the hair to retain the moisture inside – almost like a shield.” You could also try sleeping on a silk pillowcase, which can help keep dry hair sleek and untangled as it absorbs less moisture and doesn’t roughen the hair cuticle.

How to eat for beautiful hair

Products and treatments are just part of the picture, nutritionist Amanda Ursell says. “To grow plenty of good quality hair you also need to ensure the root and follicle are in good condition. This is under the control of hormone levels, blood supply and overall health – all of which are affected by what we eat.” Here are her top diet tips for healthier, better-looking hair.

• Pump some iron: A gradual or sudden drop in iron intake is a cause of thinning hair. Good sources include fortified breakfast cereals, lean red meat, tofu, cashews and spinach.
• Pack in protein: It’s crucial to eat enough protein-rich foods such as fish, chicken, dairy products, pulses, nuts and meat alternatives, such as Quorn, so have some at every meal.
• Build up your microbiome: Keeping your gut in good condition is vital. If the digestive system isn’t absorbing nutrients well, however great your diet, the goodness won’t be delivered to nourish the follicles.
• Net some healthy oils: If you have a flaky scalp caused by dryness, or a skin condition, such as eczema or psoriasis, increase your intake of essential fatty acids. Find them in oily fish, nuts and seeds.
• Iodine to keep it growing: Iodine is a trace mineral essential for keeping the thyroid gland working. A lack of iodine leads to an under-active thyroid, which in turn reduces the activity of hair follicles and slows the rate of hair growth. Find it in fish and other seafood.
• Think zinc: A lack of zinc causes the hair to become excessively fragile and sparse. Find zinc in wholemeal bread, red meat, oysters, sesame seeds and oats.
• Seek out C: Vitamin C is needed to keep capillary walls flexible and a regular supply of nutrients flowing to the hair root, and to keep skin healthy. If you don’t get enough, hair follicles can become blocked with keratin, a process that forces hairs to grow in a corkscrew shape. Vitamin C also helps your body absorb iron. Find it in capsicums, berries, oranges, papaya, carrots and kumara.