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Alopecia

A functional medicine approach to alopecia.

Curious about the functional medicine approach to treating alopecia and hair loss? This page covers:

Understanding your condition

What is alopecia?

The term “alopecia” refers to hair loss. While thinning or balding hair is a common concern for both men and women, around 2% of the population develops a specific type of alopecia called alopecia areata. Living with alopecia areata can impact self-esteem, confidence, and mental health.

Alopecia areata is an autoimmune condition where the immune system mistakenly attacks the hair follicles, leading to hair loss on the scalp, body, or in patches. The three most common forms are areata (patchy scalp hair loss), totalis (complete or near-complete scalp hair loss), and universalis (total loss of hair on the scalp, body, eyebrows, and lashes). However, there are various subtypes based on the location and pattern of the hair loss.

Alopecia

Functional medicine for alopecia.

Hair loss can stem from a range of factors, including medical conditions, hormonal changes like those experienced after childbirth, nutrient deficiencies, stress, genetics, and certain medications.

Natural remedies using the functional medicine approach can help prevent additional hair loss and encourage new growth, depending on what’s causing your alopecia.

What amount of hair loss is considered normal?

The average person loses around 100 hairs per day, often without even realizing it, as new hair is constantly growing in. Hair growth happens in three distinct stages:

  • Anagen: The anagen phase is an active period where new hair is formed and grows, pushing out the old, club-like hair that is no longer in the anagen phase. This active growth phase typically lasts 2-6 years, during which time the hair grows around 1cm every 28 days.
  • Catagen: During the catagen phase, about 3% of your hair enters a transitional period that lasts around 2-3 weeks. At this stage, hair growth stops and the outer root sheath shrinks, attaching to the root and forming a club-like structure.
  • Telogen: About 7% of your hair is in the telogen, or resting, stage at any given time. This stage lasts around 100 days for hair on your scalp, and even longer for hair on your arms, legs, eyebrows, and eyelashes. It’s perfectly normal to shed 25-100 of these fully-formed, dormant telogen hairs each day.
  • Exogen: After about 3 months, hairs naturally shed during the exogen, or shedding, phase. This is commonly viewed as the second part of the telogen phase.

Genetics play a major role in most hair loss. Androgenetic alopecia, the technical term for this type of hair loss, is linked to how hair follicles produce 5-alpha reductase. This enzyme converts testosterone into DHT, which then affects the growth phase of hair strands. As a result, the hair growth cycle becomes shorter, producing thinner and shorter hairs. Additionally, it delays the growth of new replacement hairs.

What typically causes alopecia areata?

Emerging research suggests that people with a genetic predisposition may develop autoimmune conditions when they encounter an environmental trigger. For instance, in alopecia areata, the immune system is believed to mistake hair follicles for a pathogen due to heightened vigilance at the skin level.

Possible triggers for hair loss include:

  • Microtrauma to the skin
  • Bacterial infections like Lyme disease
  • Viral infections such as hepatitis B, Epstein-Barr virus (causing glandular fever/mononucleosis)
  • Parasites
  • Stress, anxiety, or trauma
  • Allergies or histamine reactions
  • Disruption of gut flora
  • Other autoimmune diseases (e.g., vitiligo, lupus, Hashimoto’s thyroiditis)
  • Thyroid disorders
  • Scalp trauma from head injury or hair transplant surgery
  • Certain medications
  • Vasculitis
  • Skin allergies to products like skincare or sunscreen
  • Chronic fever
  • Exposure to environmental chemicals, heavy metals, or mold

Aside from the main causes, there are other factors that can contribute to alopecia, or general hair loss, including:

  • Eczema and dermatitis
  • Hormone imbalances
  • Polycystic ovary syndrome (PCOS)
  • Stress or physical/emotional shock
  • COVID-19, which has been linked to a type of hair loss called telogen effluvium

Other common causes of hair loss include:

  • Nutrient deficiencies, either from dietary issues or absorption problems
  • Traction alopecia, caused by tight hairstyles like braids, pigtails, or ponytails
  • Trichotillomania, a mental disorder where people pull out their own hair
  • Harsh chemicals that can thin and damage hair
  • Certain medications such as birth control pills, anti-inflammatory drugs, and some acne treatments

The good news is that in most cases of alopecia areata, the hair follicles can still regrow hair, even though they’ve been damaged. This means the hair loss is usually not permanent.

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Types of alopecia

The three main types of alopecia are areata, totalis, and universalis. In all forms of alopecia areata, the hair follicles remain alive and ready to resume normal growth. Alopecia areata can be further broken down into the following subtypes:

Alopecia areata is a condition that can manifest in various forms:

  • Alopecia areata monocularis: Only one spot of baldness, anywhere on the scalp.
  • Alopecia areata multilocularis: Multiple spots of baldness on the scalp/head.
  • Alopecia areata barbae: Hair loss limited to only the beard.
  • Alopecia areata totalis: Hair loss to all of the scalp.
  • Alopecia areata universalis: Hair loss to the whole body, including the scalp, limbs, pubic, and facial hair.
  • Alopecia areata ophiasis: Baldness from ear to ear, at the back of the head.
  • Alopecia areata incognita and diffuse alopecia areata: A rapid, widespread, and diffuse hair loss pattern common in women aged 20-40.
  • Perinaevoid alopecia areata: Spots of differently colored skin, called pigmented nevi (usually, moles).
  • Cicatricial alopecia: A rare and diverse group of disorders that destroy hair follicles and replace them with scar tissue, causing permanent hair loss.
  • Triangular alopecia areata: A rare form where baldness occurs in a triangular shape.
  • Reticular alopecia areata: A net-like pattern of hair loss, with areas of hair in between on the scalp.
  • Lichen planopilaris: An autoimmune condition and variant of lichen planus.
  • Diffuse/androgenetic alopecia areata: A short ‘anagen’ phase of growth, causing an inability of the hair to grow, resulting in incomplete hair loss to the whole scalp, but without distinct patches. A subset of this category is called Female androgenetic alopecia (FAGA).

The conventional approach to treating alopecia.

There is no one-size-fits-all treatment for alopecia areata. However, depending on your specific condition, your provider may prescribe medications such as:

  • Corticosteroids are powerful anti-inflammatory medications, but they’re only meant for short-term use.
  • Topical sensitizers like squaric acid dibutyl ester (SADBE) and diphenyl cyclopropenone (DPCP) can create a reaction that causes itching, scaling, and eventually, hair growth.
  • Anthralin (Dithrandol) is a tar-like synthetic substance that alters the immune function in the skin. It’s applied to affected areas for 30 minutes to a few hours, then washed off.
  • Regenerative injections use the patient’s own platelet cells, drawn and centrifuged to isolate the platelets. This contains growth factors that can stimulate the healing of soft tissues.
  • Immunomodulatory drugs, especially JAK inhibitors like tofacitinib and ruxolitinib, can help manage hair loss.

For androgenetic alopecia (also known as male or female pattern baldness), your provider may prescribe 5-alpha reductase inhibitors or other medications to help manage your hair loss, such as:

  • Minoxidil (Rogaine) – a topical solution used for male and female pattern hair loss
  • Ketoconazole

In 2022, the FDA in the US approved the systemic anti-inflammatory drug baricitinib (Olumiant), which has shown promise in treating alopecia. However, this medication can also have a number of side effects.

Your provider may recommend laser treatment or surgical hair follicle transplantation as additional options.

Conventional medications from an alopecia specialist can be helpful, but it’s important to note that all medications carry the risk of side effects. This leads many people with alopecia to explore natural hair loss treatments that aim to address the underlying cause and improve overall health, rather than just suppressing symptoms.

The alternative approach to treating alopecia.

When it comes to natural functional medicine for alopecia treatment, the process starts with an in-depth investigation to pinpoint the underlying cause and contributing factors. Even in cases with a genetic component, there are often modifiable factors that can prevent further hair loss or even stimulate regrowth. Unlike conventional treatments, functional medicine takes a whole-person approach to address the issue.

In our initial, in-depth consultation, we’ll explore:

  • Your medical history
  • Medications and supplements
  • Surgeries and accidents
  • Family and genetic history
  • Environmental exposures
  • Symptom history
  • Nutrition, diet, and absorption
  • Lifestyle factors and stress

Functional Testing

Your alopecia treatment may include some helpful functional tests, such as:

  • Microbiome and stool testing to check for gut flora imbalances or parasites
  • Tests for inflammation, digestive function, and nutrient absorption issues
  • Evaluating food sensitivities and allergies
  • Screening for heavy metal or environmental toxin exposure
  • Assessing your hormone levels
  • Checking for other autoimmune markers

Natural Treatments

Depending on your specific condition, a personalized functional medicine approach to treating alopecia (hair loss) may involve addressing the following:

  • Removing potential causative factors, such as certain hair care products, hairstyles that pull on the hair, environmental chemical exposures, or mold exposure.
  • Supporting detoxification and the health of the liver, kidneys, and gallbladder, especially if there has been exposure to heavy metals, environmental chemicals, or mycotoxins. This is done through a careful strategy to bind to and eliminate toxins, without overstressing these vital organs.
  • Restoring a healthy gut microbiome, as the health of the digestive system can directly impact immune function and play a role in alopecia.
  • Addressing any nutrient deficiencies or poor nutrient absorption that may be hindering hair growth, such as lacking in vitamins A, C, D, zinc, silica, or omega-3 fatty acids.
  • Resolving intestinal hyperpermeability (leaky gut), which can allow particles to enter the bloodstream and trigger an overactive immune response.
  • Balancing hormones, such as testosterone, DHT, and thyroid hormones.
  • Reducing inflammation through diet, herbal medicines, and supplements.
  • Modulating the stress response through practices like mindfulness, nature therapy, meditation, yoga, and tai chi.
  • Minimizing the impact of any medications or other health conditions that may be contributing to the hair loss.

Other strategies

Dietary, herbal, and supplemental strategies to support your health may include:

  • An autoimmune diet, anti-inflammatory diet, or a personalized plan that eliminates any food intolerances, allergies, or sensitivities
  • Foods high in zinc, such as seafood, oysters, pumpkin seeds, and legumes, to support testosterone production, skin and hair health, and immune function
  • Reducing or eliminating alcohol, which can impact testosterone levels and disrupt a healthy gut microbiome, important for immune health
  • Increasing intake of omega-3 rich foods like grass-fed meat, wild-caught fatty fish (sardines, mackerel, anchovies, salmon, herring)
  • Optimizing vitamin D status, if needed
  • Herbal medicines like horsetail, saw palmetto, green tea, ginkgo, rosemary, prickly ash, Korean ginseng, Siberian ginseng, ashwagandha, or schisandra

Discover a personalized, natural functional medicine treatment tailored just for you. Our unique care model was designed with your needs in mind. Learn more below and book a call today!

FAQs.

Why is my hair falling out?

First, it’s important to know that losing around 100 hairs per day is normal and part of the natural hair growth and shedding cycle. When these longer hairs fall out, it can look like a significant amount. However, if you’re losing more than this, there are several potential reasons:

These can include:

  • Hormone imbalances and androgenetic alopecia, which is linked to how hair follicles convert testosterone to DHT, affecting the hair growth phase. This leads to shorter growth cycles and thinner, shorter hair strands.
  • Nutrient deficiencies from an inadequate diet or absorption problems
  • Traction alopecia from tight hairstyles like braids, ponytails, or pigtails
  • Harsh chemicals that cause thinning and breakage
  • Medications like the birth control pill, NSAIDs, and some acne treatments
  • Shock-induced telogen effluvium, where an event like illness, stress, or childbirth triggers accelerated hair shedding, which may be temporary and accompanied by scalp discomfort
  • Alopecia areata, an autoimmune condition where the body attacks hair follicles, leading to patchy or total hair loss. This is influenced by both genetic and environmental factors.

If you’re looking for natural hair loss solutions, feel free to contact us to learn more.

What vitamin deficiency is causing my hair to fall out?

Your hair loss could be caused by a dietary lack of key nutrients like zinc, selenium, silica, folate, vitamin D, omega-3 fatty acids, or biotin. However, the reason for each person’s hair loss is likely different, as there are many potential causes.

To get to the root of your hair loss, it’s best to work with a functional medicine specialist who has expertise in alopecia (hair loss). They can help determine the specific cause and contributing factors in your case, and provide natural, evidence-based functional medicine treatment strategies to address the issue.

Can stress cause severe hair loss?

A recognized condition called telogen effluvium can cause temporary hair loss. This occurs when a stressor like illness, shock, trauma, starvation, childbirth, medication, or an immune disorder disrupts the hair growth cycle, causing more hairs to enter the shedding phase. The hair loss typically happens some time after the triggering event.

Stress can also be a factor in developing the autoimmune condition alopecia areata, where the body mistakenly attacks hair follicles. Hormonal changes brought on by stress can also trigger alopecia areata.

Our natural alopecia treatment can help address the root causes of your hair loss. We’ll work with you to reduce stress and support your body’s natural hair growth processes. Contact us to learn more about our alternative alopecia treatment options.

Is alopecia an autoimmune disorder? How do you get alopecia areata?

Alopecia areata is an autoimmune disorder where the body mistakenly attacks the hair follicles, causing hair loss in patches or all over the body. While the word “alopecia” simply means hair loss, there are many potential causes beyond just autoimmune issues.

Some of the other common triggers for different types of hair loss can include:

  • Exposure to environmental chemicals, heavy metals, or mold
  • Bacterial or viral infections like Lyme disease or Epstein-Barr
  • Stress, anxiety, or trauma
  • Allergies and histamine reactions
  • Gut flora imbalances
  • Other autoimmune conditions like vitiligo or thyroid disorders
  • Scalp injuries, hair transplants, or certain medications
  • Skin allergies to products like sunscreen
  • Hormone imbalances or PCOS
  • COVID-19 infection leading to telogen effluvium (shedding)

So while alopecia areata is an autoimmune disorder, it’s important to be aware of the wide range of potential causes for different types of hair loss. Working with a functional medicine provider can help identify the underlying reason and develop the best treatment plan.

How can I reverse alopecia naturally?

To address your alopecia naturally, your functional medicine practitioner will first need to identify the underlying causes and contributing factors. They can then design a personalized, holistic treatment strategy to address these issues.

Natural treatments may include lifestyle changes to help you better manage stress, improve sleep, and reduce exposure to environmental chemicals. Your practitioner may also recommend herbal medicines to boost circulation and nutrient delivery to affected areas, such as rosemary, ginkgo, yarrow, or prickly ash. Silica-rich herbs like horsetail may be beneficial as well.

Depending on your specific needs, your treatment plan could involve bioidenticals to balance hormones, like green tea or saw palmetto, as well as herbs to calm the nervous system, such as Siberian ginseng, schisandra, and/or ashwagandha.

While there’s no one-size-fits-all alopecia diet, your plan may include dietary changes to address nutritional deficiencies, reduce inflammation, and eliminate any foods you’re intolerant or allergic to. Your practitioner will also consider factors like nutrient absorption, gut health, infections, parasites, and exposure to mold or toxins, creating a multi-faceted treatment approach.

By working with a functional medicine-trained practitioner, you can find a holistic solution that not only addresses your hair loss, but also improves your overall health and well-being.

Request a personal consultation.