Myths and rumors about hair loss


Dear readers,

The styling of human hair has always been a process of great social and cultural importance. The faithful of various religions had accordingly, since a very long time, endeavored to present their sociocultural status visibly through hair styling. Although the fact that the hairstyle makes it possible to be attributed to certain social groups this may be less important today; though, it must not be forgotten that almost everyone has incorporated the appearance of the hair into his or her aesthetic self-assessment. Hence, the hair in former times served the definition of one’s social class, in the modern world it serves primarily the traceability of the aesthetic self-efficacy and is accordingly important for the individual and his well-being. For these reasons, it is no wonder that an uncontrolled and possibly disease-related loss of hair (alopecia) poses major problems for the affected individuals. That is why, humanity has already been concerned with the question how the hair loss can be stopped or even reversed , before the beginning of modern sciences. In this context, numerous myths have developed over the course of time, about how hair loss is supposed to arise and how it can be prevented.

In this article we present you a selection of myths and legends about hair loss. These are sometimes amusing; but partly dangerous and harmful to health, if they are actually implemented,. Therefore, please do not forget that the presented myths are only amusing in the second line; first, they are historically grown legends, which should not be mimicked.

Therefore, enjoy reading!


Yours, Angela Lehmann

Myths about the causes of hair loss

This section contains myths about the causes of hair loss. As you will see, however, they do not stand up to today’s scientific knowledge. Accordingly, they can be excluded as the underlying causes of hair loss.

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Negative emotions and melancholy

For a long time it was believed to have observed a link between alopecia and negative emotions and melancholy. Therefore, these affects must be responsible for hair loss. People who often suffer from bad mood or stressful feelings would accordingly be exposed to a greater risk of hair loss.

From today’s point of view, it is not easy to oppose this myth, because does the observation not seem to apply actually? From a statistical point of view, it may even be a little too often, because every human being will come to a point of depression or grief in his life without being able to escape these feelings. The cause of this could be, for example, a misfortune or a stroke of fate, but scientists do not observe an accumulation of the suddenly occurring hair loss in people who have suffered a great misfortune. Such an observation would be expected, for example, during wars, but such an observation could not be made yet. There seems to be no causal link between a subjective disaster and hair loss.

But how are things when looking at a disease which is characterized by the experience of a great subjective misfortune, although there is no objective reason for it? From medical point of view, for example, depression is a disease that is characterized by a serious experience of suffering. In this case, no accumulation of alopecia has been observed among depressed people, too. Hence, the negative affects do not trigger the loss of hair. In order to remain factually, however, there is a disease that is closely associated with depression and which is actually associated with loss of hair. This disease is called trichotillomania; affected persons suffering from the compulsion to pull their hair out. This disease often occurs together with depression, but tearing hairs out is not an actual loss of the hair, as is traditionally observed.

In summary, negative feelings or subjective suffering can not cause hair loss. For the connection between quality of life and the hair loss there seems to be a different cause-and-effect relationship: Not a reduced quality of life causes the hair loss, but hair loss causes a lower quality of life!

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Great mental or physical exertion

But how are things when looking at a disease which is characterized by the experience of a great subjective misfortune, although there is no objective reason for it? From medical point of view, for example, depression is a disease that is characterized by a serious experience of suffering. In this case, no accumulation of alopecia has been observed among depressed people, Historically, it was quite common to make great mental or physical exertion responsible for alopecia. The conceptual spectrum, which is covered by mental and physical aspects, is a very broad one: On the one hand, this means constant grumbling or developing a solution to a great mental task, as it is indicated by the term “thinker’s brow”. Also, someone who can not solve a problem says that this “makes him want to tear his hair out”. On the other hand, a strenuous, Cyprian sexual life was also made responsible for hair loss. . Hence, the negative affects do not trigger the loss of hair. In order to remain factually, however, there is a disease that is closely associated with depression and which is actually associated with loss of hair. This disease is called trichotillomania; affected persons suffering from the compulsion to pull their hair out. This disease often occurs together with depression, but tearing hairs out is not an actual loss of the hair, as is traditionally observed.

Concerning hair loss the mental effort is similar to negative feelings: No one is protected from mental exertion during life; and so it seems intuitive that an activity which is almost exclusively done with the head exerts its most serious effect in an appearance change of the corresponding body part. To make things worse, a thought-provoking person is often stylized sitting, and if the hand does not move the pen to the paper in front of him, the person usually touches her forehead or temple, which seems to aggravate the causal relationship. However, empirically, there is no evidence that thinking or problem solving lead to alopecia, because otherwise, large numbers of people with no hair could be found before central examinations in schools or universities. But this is not the case. However, a different context should not be neglected: Just as in the case of depression, it is also possible that people who spend an excessive amount of time thinking about problems forget a balanced diet or suffer from a general lack of appetite. This can lead to an under-supply of important nutrients in both cases. Such a under-supply of nutrients over a longer period of time can then cause hair loss.

Again, things are a little different when a strenuous sexual life is thought to be the cause of alopecia. In this case excessive physical exertion is not associated with the increased risk of alopecia. In fact, it is rather the insinuation that a person with such a life would have numerous changing sex partners. Actually, there is historical evidence for a scientific link between alopecia and frequently changing partners: In the past, syphilis was one of the most frequently sexually transmitted diseases. This is an infectious disease caused by the bacterium Treponema pallidum, which can be transmitted, among other ways, by mucosa contact. The syphilis runs in four stages, with a great number of infected people in the second or third stage of the disease additionally suffering from hair loss (Alopecia syphilitica). The alopecia appears as a small-spot, moth-like hair loss mainly at the sides and the back of the head. During the twentieth century, however, the disease has been confined to large parts of the world, since both better methods of prevention and more effective antibiotics have been developed. For these reasons, a syphilis infection should not generally be excluded in the case of a sudden idiopathic alopecia, but it can be reasonably assumed that the syphilitic hair loss plays a very subordinate role among all cases of hair loss. In addition, in the case of syphilis infection other symptoms occur which become a burden for the affected person before an alopecia syphilitica develops at all.

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Parasits und commensal

Since the researchers have developed microscopes and other devices for the magnification of small and smallest objects and creatures, humanity has always been surprised by the diversity of microorganisms that are living with them and especially on their body surfaces. Some of these microorganisms were quickly identified as pathogens or parasites, as they cause specific complaints. Others remained undetected for a long time, since they were simply not noticed. The partners of such inconspicuous togetherness would be called commensals.

It did not took long before one of them was thought to be identified as the cause of hair loss: microorganisms of the species Trychophyton ssp. This is a group of fungi that can colonize human skin and nails, causing skin diseases. If the scalp is affected by an infection, this can lead to the formation of a tinea capitis, fungal eczema. In order to survive this parasitic fungus penetrates the scalp to the hair and feeds its keratin (main compound of the hair), which causes the affected hair to become brittle and break off briefly over the scalp at a low mechanical load. People with such a disease show sharply defined obviously hairless areas on the scalp (historic: Alopecia celsi). Such diseases are readily treatable with fungicidal shampoos and common antimycotics, so that this is a reversible form of hair loss.

Additionally, about 70 percent of all people live together with eyelash mites (Demodex ssp.). While this type of mite is parasitic to most mammalian species, it seems to occur almost exclusively as a commensal in humans. However, for eyelash mites as well as for the fungus mentioned above, colonization does not necessarily result in hair loss, since whether this occurs depends on several factors. The most important one is the person’s immune system, and this is determined by other infectious diseases, dietary habits, daily stress levels, and others, rather than the presence of a fungus or a mite.

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Hair loss due to headgear

A more modern myth about hair loss suggests that the frequent and long wearing of headgears would lead to a loss of hair. As a matter of fact, it is often underlined that a tight-fitting headgear would impair the microcirculation in the scalp and thus the oxygen and nutrient supply of the hair follicles, finally, leading to their atrophy over a long time.

However, it can be argued that the supply of oxygen and nutrients to the hair roots is ensured via the blood circulation, and that the wearing of a headgear regardless of type (in the case of proper application) can not lead to a disturbance of the microcirculation.

A special form of this myth is often asked by young men who have just completed the recruit training. They are concerned about a potential hair loss, which they attribute to wearing the helmet during the training. This is a special case insofar as the recruits are biologically at the end of puberty and a stable sex hormone level has now established in their bodies (see also the following section). In individual cases, stabilization of the hormonal balance can be associated with the onset of an (androgenetic) alopecia. Since the end of the recruit training, or rather the longer wearing of a helmet, coincides with the onset of alopecia, it is often concluded that the helmet must be responsible for the hair loss. This is not correct, but rather due to the stabilization of the hormonal balance at the end of puberty.

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What really causes hair loss

After the myths and their possible connections to the reality have been discussed in the preceding four sections, we shall now consider how alopecia actually arises.

The answer is, as in many cases, very complex. Medication and an insufficient diet can be a cause as scarring due to accidents, burns or chemical burns. Also hormonal changes during life, pregnancy, or menopause can be responsible for the hair loss. The cause must therefore always be determined individually based on proven facts.

The most common type of hair loss, however, is androgenetic alopecia. Every person can suffer from this type of alopecia because it is mediated hereditarily. The androgenetic alopecia is based on hypersensitivity of hair follicles to the hormone derivative dihydrotestosterone. Since this hormone also occurs in the scalp, it can get into contact with the hair follicles and shorten their growth phases in such a way that the balding is the result. In the end, the affected follicle becomes stunted.

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Myths about the treatment of hair loss

About the treatment of hair loss just as many myths evolved as concerning its onset. The most common myths are discussed below. Again, it should be noted that these measures may seem amusing or whimsical to you, which is undoubtedly intended. However, none of the following measures will help to stop an alopecia or even restore the lost hair. In the worst case, such methods can even cause damage to health.

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Oils and fats

Probably the oldest concepts for treating hair loss are based on the use of oils and fats. These are massaged, applied or otherwise brought into physical contact with the (remaining) hair or the scalp and should lead to a strengthening of the hair or the scalp. The fact that oils and fats are proposed for the treatment of hair loss is not due to the fact that this has been tried with great success. Rather, these substances are the oldest natural products available to mankind for body hygiene.

First, oils or fats on the hair can not have any physiological effects. This is due to the fact that the visible part of the hair (the hair shaft) is not alive and does not have its own metabolism. For this reason applied fat can have no effect on the hair. This myth, however, kept being alive for so long because a lively-looking hair has a gloss resulting from a certain (physiological) fat content; on the other hand, glossless and low-fat hair is often associated with the property of brittleness. Nevertheless, oils and fats have any effect on the hair loss.

But how are things when the oil or fat is applied to the scalp? Can it then penetrate to the invisible, living part of the hair (the hair root) and exert healing effects? No, it can not. The skin is a strong barrier to the environment through which the oil can not easily pass; this is even more difficult in the case of bioactive molecules or substances. The human skin is evolutionarily designed to let no surrounding substance pass into the organism. In the worst case, oils and fats cause skin problems, because too heavily applied oils and fats are not removed by body hygiene. This can lead to the closure of the skin pores and thus to pimples and local infections damaging the hair roots through inflammatory processes.

Another often propagated method has exactly the opposite aim. It was about the degreasing of the hair with soaps, alcohol, alkaline or acid solutions. It has to be pointed out that the superficial treatment of the scalp with aggressive chemicals, including high-percentage alcohol, is associated with unforeseeable consequences for the skin and thus health. In addition to the fact that alcohol has a dose-dependent carcinogenic effect, a common property with alkaline and acidic solutions is that they can destroy the physiological conformation of proteins (denaturation). Apart from the fact that this affects the metabolism of the skin in an unpredictable manner, there is the danger of acute chemical burns by strongly alkaline or acidic solutions. If the solutions come into contact with the eyes, this can also lead to blindness.

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In the western world as well as in the Near and Far East, garlic and onion have been used as a treatment option for hair loss. As in the case with oils, it can be assumed that these plants belong to the oldest cultivated plants of mankind, and thus enough time has passed when humans could investigate the effects of hair loss. A recipe suggests, for example, to insert a half-cut onion in spirits and to massage it into the scalp.

It is at least obvious that onions or garlic can have an effect on the body. This is evidenced by the smell that a person emanates after consuming larger quantities of these plants. However, the consumption is not the same as the superficial use. The numerous compounds, which are, for example, responsible for the characteristic smell of garlic, can not pass through skin when used externally. This also applies to onions.

Although there seems to be not necessity, it should be mentioned, that the treatment of the scalp with onions or garlic should be done in such a way that the ingredients do not come into contact with the eyes, since the chemical compounds of the leeks may have a more or less strongly irritating effects on the eyes and mucous membranes. This should be considered, in particular, when the onion has previously been placed in a high percentage alcoholic solution. The treatment also leads to a disturbance of the natural moisture balance in the skin by dehydration. This can cause the skin to dry out, crack, and tear under mechanical stress causing inflammation and, in the worst case, unaesthetic scarring.

However, the following must be noted: Although onions and garlic have no effect on the loss of hair, there are good reasons for the consumption of these vegetables: On the one hand, they are they have been used for a long time as an enrichment in nearly all kitchens around the world; on the other hand there is increasing evidence that the consumption of garlic can reduce arteriosclerosis risk.

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Other herbal treatment methods

Other recommendations suggest herbs and fruits of all kinds for the treatment of hair loss. These include, for example, sage, thyme, juniper, rosemary, burs, nettles, fenugreek or calamus. Lemon peels are also recommended. However, there is no empirical evidence for the efficacy of these plants, which is partly due to the above-mentioned reasons. Nevertheless, risks arising from the consumption of some plants or their parts are very well documented. For example, the asarones, compunds of calamus, are proven to be mutagenic, carcinogenic and toxic to reproduction.

The same applies to the use of a special oil, the croton oil. This is obtained from the purging croton and was a home remedy in the so-called folk medicine, especially for digestive disorders. However, it is also recommended for treating hair loss in contemporary medicine. In addition, this oil can also be found to damage the genotype and contribute to the development of tumors, the treatment also leads to another highly unpleasant effect: Within a short time after the oil came into contact with the skin, it leads to severe skin irritation and inflammation. The effect is dose-dependent and also depends on the individual composition of the oil. In animal experiments it was shown that the contact with the oil causes an inflammatory reaction, which leads to the migration of granulocytes into the epidermis. Even if this inflammation subsides after 30 hours, the oil mediates a permanent genotype damage.

Another important plant-derived substance is also believed to promote hair growth. Here, caffeine is addressed, which naturally originates mainly from the coffee bean. Caffeine in the human body shows numerous physiological effects, but another myth suggests that it would promote hair growth when applied superficially. However, there have been no patient studies which demonstrate the effects of hair growth in case of superficial application. Although some studies investigate the effects of caffeine in model systems, such data is still missing for patients suffering from hair loss. So far it could only be shown that the shampoos and tinctures are not harmful when applied to the scalp.

In summary, therefore, regarding the treatment of the hair loss with herbal remedies, it can be said that these in the best case have no effect at all on the alopecia and mediate also no physiological effects. In the worst case, dry and brittle skin, superficial injuries, infections with scarring or even tumors can be the result. Caution is therefore especially required, when patients apply herbal products without knowing their composition.

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Mineral treatment methods

In this section methods can be summarized that include the application of minerals such as sulfur or petroleum fractions. Here, it must be mentioned too, that tar, petroleum fractions and the mineral-like substances potentially contain carcinogenic compounds. However, recommendations suggesting such mineral treatment methods are rather marginal phenomena, the exact application is often not described in detail. Considering the potential dangers, they appear to be generally negligible.

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Spanish fly

In a common health glossary of popular medicine from the year 1920, Spanish flies “as alcohol, soaps, pomade or plasters” are also recommended for treating hair loss. This fact deserves a special attention because the beetle known as the Spanish fly (Lytta vesicatoria) has been used as a panacea in popular medicine in many parts of Europe for centuries. This application is based on the fact that the hemolymph (comparable to blood of mammals) of the beetle contains large amounts of a substance named cantharidin. This substance has been used widely since antiquity. Evidence is available for use as an impotence drug, resulting in a long-lasting erection that could be very painful. This is evidently attributed to a massive irritation of the urinary tract. For this reason, cantharidin is also kidney-damaging. In larger doses, it also shows a neurotoxic effect, which can lead to death even at low concentrations. Concerning the application as a remedy for hair loss, it could be said that cantharidin acts as a strong stimulant when used externally and causes severe inflammation and necrosis. Perhaps the recommendation suggesting the beetle as substance for hair loss is based on the fact that it promotes the blood circulation in the skin and thus stimulates the hair growth. There is, however, no empirical evidence for this effect and regarding the potential threat by the cantharidin, home trials with the Spanish fly must strongly be disadvised.

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Excessive combing

One thing seems to be proven: It is of crucial importance for hair growth to ensure blood circulation and nutrient supply in the scalp. This is a fact which undoubtedly should be followed by everyone. In order to promote the flow of blood and thus stimulate the growth of the hair, one more or less often can read that this should be achievable by intensive combing of the hair. In this case, the comb tips should ideally touch the scalp to achieve a maximum effect. First of all, it is true that the supply of blood and nutrients is essential for hair growth, but any efforts should aim to permanently improve this supply. On the other hand, a strong mechanical stress which is locally and temporally limited does not meet this goal. Rather, there is the risk of superficial injuries due to the strong application of the comb. The tensile forces can also lead to tearing of micro vessels, which can result in hematomas. Both can not be desired. Thus excessive combing means: The correct goal is pursued with the wrong means.

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How hair loss can actually be treated

The preceding facts may have made clear that during the history of humanity the most diverse and creative efforts were made to stop or even reverse the hair loss. According to the present state of science, all the methods discussed here are, at least ineffective, in some cases they even might be harmful.

In order to treat alopecia effectively and achieve an aesthetical result for the patients, it is necessary first to clarify the causes of hair loss. Many factors must be considered here: If a drug or a longer deficiency diet causes the hair loss, this cause can be eliminated and a natural hair growth (reversible alopecia) will occur. If scarring due to accidents, operations or animal bites is the cause of the loss of hair, the severity and course of the scarring play an important role for considering certain intervention. It is also necessary to take into account the age of the patient; is it possible that alopecia will progress, which influences the choice of a treatment method?

As you can see, a generalized treatment recommendation is impossible in the case of a responsible patient care. For this reason, we would like to encourage you: If you are suffering from hair loss and feel therefore impaired in your quality of life, do not hesitate to ask for a personal consultation in our clinic. However, in the case of an honest and responsible care, it is essential that, in addition to the possibilities of a hair transplantation, the limitations of this method are discussed. We are glad to meet these requirements at any time.

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