How to help your clients with hair loss

Hairdressers will know better than anyone that, for many people, hair is a fundamental aspect of their appearance. A recent Nioxin survey found that 73% of people said their hair was important to how they felt about themselves, and 80% of women said losing it would affect their self-esteem. In fact, people generally said they felt more comfortable talking about being overweight, bad teeth, dandruff or chewed fingernails with their partner than approaching the topic of hair loss - which is why for lots of clients suffering with this problem, a visit to the hairdresser can be daunting. With all this worry and embarassment surrounding hair loss, particularly for women, it is essential that hairdressers are understanding and sensitive when it comes to dealing with the issue. Clients should feel that they can place their confidence in stylists and receive knowledgeable advice, flattering cuts and helpful product recommendations in return. WHAT CAUSES HAIR LOSS? In order to understand hair loss, it is essential to have an idea of the causes behind it. We spoke to some of the country’s leading trichologists about the main factors influencing hair loss, and what, if anything, can be done to combat them. DIET “Diet is extremely important to hair growth,” says Philip Kingsley, who has his own trichology clinic in London. “Hair is made of 85% protein and is the second most prolific growing cell in the body, so its demand for energy is high. It is important to eat proteins for hair strength as part of a moderately balanced diet, and not to leave it too long between meals. The energy used to form hair cells diminishes four hours after eating a meal, so snacking between meals will help boost those energy levels. The best energy-boosting snacks are complex carbohydrates such as fruit.” Excessive hair loss is another factor which can cause hair to thin, says Philip. “If a slim person loses 2kg for example, they may find their hair begins to thin,” he says. “Your hair is not a vital tissue, like bone marrow, nor is it a vital organ, like your heart, liver or kidneys. Therefore, what little nutrition you are getting through a restrictive diet will go to these parts first. Even though hair is very important psychologically, the body is much more concerned with keeping the internal organs healthy. “ Dr Bessam Farjo, Medical Director of the Institute of Trichologists, agrees that dieting can have a big influence on hair loss. “While the idea of a crash diet might seem like an appealing quick fix for some, it is quite likely that the hair will suffer as a result,” he says. “Foods such as salmon, beans, leafy dark green vegetables are among the best sources of nutrients for maintaining a luscious head of hair. Hair loss can also be a symptom of low mineral levels, specifically zinc, calcium, sodium and potassium. Eating a diet rich in these nutrients will help promote healthy growth and may prevent thinning.” HORMONES Hormonal changes caused by the contraceptive pill, pregnancy and the menopause often contribute to female hair loss. For example, consultant trichologist Tony Maleedy explains: “During pregnancy there is a major increase in female sex hormones, mainly oestrogen, which reduces the amount of hair falling out naturally during this time. However, after the baby is born, there is often a great loss of hair because these hormones fall back to normal levels. The hair that would normally have fallen out during the nine months of pregnancy now falls out at a rapid rate.” Tony continues “Post-natal hair loss affects approximately 40% of all women with children and can be a very frightening and upsetting experience, especially because many women do not understand the exact cause and when the hair loss will stop. Reassure them that this excessive hair loss usually lasts between three and six months and stops as suddenly as it has started, with all the hair being replaced in time.” Taking contraceptive pills can also cause hormonal shifts resulting in hair thinning, says Philip Kingsley. “Several widely prescribed contraceptive pills, such as Logynon, Microgynon, Ovranette and Loestrin contain the highest level of male hormone derivatives linked to thinning hair. They cause the hair follicles to get smaller, and therefore each strand of hair to be thinner, rather than making the hair actually fall out,” he reveals. This side effect won’t affect all women - “only those sensitive to hormonal change”, says Philip – but those who do suffer should be encouraged to talk to their GP about changing their prescription. “They should ask for a Pill that has little or no androgenic action, like drospirenone in Yasmin, norgestimate in Cilest and desogestral found in Marvelon,” says Philip. “Dianette, which works as an oral contraceptive, contains cyproterone acetate, and this be helpful in treating thinning hair, along with acne and facial hair growth.” “It is worth noting that HRT given during the menopause, which uses the same hormones, can have the same effect,” says Philip. “This type of hair thinning can be partially reversed with the correct treatment from a trichologist.” GENETICS “Hereditary hair loss can strike both men and women, although it tends to happen at different times – men from post-puberty onwards and women usually near or after the menopause,” says Iain Sallis, a trichologist with ten clinics throughout the UK. Male pattern baldness (MPB) is certainly the most commonly known type of hair loss, and is responsible for 90% of hair loss in men. “MPB is defined as hair loss at the front, top and/or crown of the scalp – the non-permanent area,” says Bessam. “The back and sides of the scalp – the permanent area – are spared and usually grow hair for life. “The cause of MPB is the presence of hormone receptors in the hair roots of the non-permanent area, which don’t exist in the permanent area,” continues Bessam. “These receptors attract the male hormone dihydrotestosterone and, as a result, the hair loss process begins. The number and location of these susceptible hairs is determind by inherited genetics from both or either parents.” Female pattern hair loss (FPHL) is also an inherited condition, which can be acquired from one or both parents. “This type of hair loss is triggered by androgens (male hormones),” says Bessam. “All women have a small amount of male hormones in their body, produced by the adrenal gland. These levels can become more pronounced if levels of female hormones decrease during the menopause. However, FPHL doesn’t tend to progress as far as MPB due to women having lower levels of male hormones.” STRESS “Stress comes in all shapes and sizes and can affect us all differently,” says Iain. “It’s certainly not as straightforward as saying ‘Oh Mrs Jones, your hair seems to be coming out in handfuls, are you stressed?’ It is a very subjective and emotive problem.” Interestingly, stress is also the factor most widely recognised as causing hair loss in women, according to a survey by Aveda. When thinking about the causes of hair loss, 81% of British women believed it was due to emotional stress - ahead of hormones which 73% saw as influential. Iain says that severe stress – “an emotional or psychological shock such as bereavement, a car accident or an assault” – can lead to acute telogen effluvium, causing the hair to shed excessively around two months after the trigger event. “As long as there are no other problems, the hair should start to rectify itself within a few months,” says Iain. According to Philip, more long term problems such as a difficult relationship, money worries or a miserable job can also lead to hair loss. Here, it is about treating the stress itself, rather than trying to remedy the hair loss directly, that will lead to the problem ceasing. “I highly recommend yoga, it is brilliant for lowering stress levels,” says Philip. “In fact, any hobby that the client finds interesting or takes their mind off stressful things is beneficial, whether it’s walking, reading or going to the cinema.”

HOW SHOULD YOU CUT AND STYLE THINNING HAIR? As a hairdresser, you may often be faced with a head of hair that has seen more plentiful days, but that doesn’t mean you can send the client out feeling anything less than groomed and gorgeous. In fact, for clients with thinning hair, a successful visit to the salon can be even more of a confidence boost, as it gives them a chance to see the lacklustre tresses they are unhappy with transformed into a crowning glory. But which styles are most flattering, and how can you go about making hair look voluminous and healthy?

Gary Taylor, HJ's North Western Hairdresser of the Year 2012, runs a hair loss service at his salon Edward & Co in West Yorkshire, and has this advice;

“Anyone who feels their hair is thinning will be less confident about themselves. With these clients, I feel it is important to spend longer on the consultation. It’s important to reassure clients that while their hair may be fine, it is still a head of hair and we can get good results out of it to increase their confidence. “For me, the cut is the starting point, and establishing the most flattering length for the hair. For women with very fine hair, I find bob lengths work well, as they make the hair appear thicker than when it is very long, but still leave plenty of room to colour and style in order to complement the client’s look. “The male market is growing at a speed of knots and I’m finding men are far more conscious of their appearance than they were 10 years ago. Most of the men who are going thin or bald opt for very short hairstyles – some have it more or less all off which is luckily seen as fashionable and acceptable on today’s high street. The positive side of this is that we find our clientele visit the salon every two weeks or so to keep it short and tidy. “Some clients with baldness choose our hairpiece services. From supplying full wigs, to templates to help those with small areas of hair loss, we can help. When I see a client who has an area of the scalp where the hair does not grow, I check first whether we can cover it with the existing hair. If not, then we look at options such as extensions which can help cover the bald spot. However, there are occasions where this would not be suitable due to excess tension on the scalp and hair. If this is the case, I make a template around the bald area and have a piece made to fit. We then place this onto the scalp and style the hair to connect to the client’s existing hairstyle. “Finally, teaching the product how to style their hair at home and recommending the right hair products is crucial, whether the client has fine hair or wants to wear a hair piece.”