For centuries, hair has been perceived as a mark of beauty more so for women. And as such, anything that can lead to its loss can be discomforting. Hair loss can be caused by numerous factors that range from genetic to hormonal or even dietary factors.

Joseph Uwiragiye, the head of nutritionist at University Teaching Hospital, Kigali, says hormones are among the factors that bring about hair loss.

"There are some hormones that induce hair growth, so if one has imbalance of such hormones, hair loss comes about,” he says.

Prescribed medicine is another factor that can lead to hair loss according to Erick Musengimana, a nutritionist at Rwanda Diabetes Association.

He says medicine for ulcers as well as that for mental disorders contributes to hair loss and breakage.

Private Kamanzi, a nutritionist at Amazon Complimentary Therapy in Remera, Kigali, says deficiency of certain nutrients is a major cause of hair loss.

He explains that there are micronutrients that normally facilitate the growth of hair. Therefore, if one lacks them, it contributes a lot to hair loss and breakage.

Examples of such micronutrients, he says include; vitamin B-complex and vitamin C, as well as vitamins B6 and B12.

"Malabsorption can happen due to many factors, which also contributes to hair loss. This is when one has parasites in the intestines that inhibit the absorption of nutrients. Loss of nutrients is capable of contributing to hair loss,” Kamanzi says.

He points out that there are specific vitamins that help to maintain the health of hair. These include vitamins B and C, ascorbic acid, zinc as well as irons. Where one has deficiency of any of these vitamins, loss or breakages of hair can occur.

"Ascorbic acid, which is commonly known as vitamin C, helps in the absorption of vitamin B in the body. Zinc also plays a vital role when it comes to the growth of hair and its deficiency means one might lose hair,” Kamanzi adds.

On the other hand, Musengimana says there is also a relationship between proteins and hair. Lack of proteins, he says, might manifest as loss of hair or unhealthy or weak hair.

He adds that balancing the diet will not only ensure the health of the hair, but also prevent breakage as well as the loss.

"People experiencing hair loss are advised to increase the intake of vitamin B and whole grains. Green vegetables have a big percentage composition of biotin, which is vitamin B-complex found in egg yolk, liver, and yeast. It is involved in the synthesis of fatty acids and glucose, which contributes to healthy hair,” he explains.

Musengimana says individuals with a hair loss problem are advised to reduce the intake of vitamin A supplements as they are toxic to the body, which brings about hair loss.

Depending on the problem one has after assessment, Kamanzi says they advise them on what to increase or reduce in food consumption.

Alcohol and caffeine also contribute to hair loss, and he advises that one should stop or take them in moderation.

Dr Wilbur Bushara of Herna Medical care says for one to understand why hair breakage occurs they have to first understand what it is exactly.

He explains that hair breakage involves the hair shaft being broken which leaves the hair with split ends and in most cases shorter, whereas hair loss involves vanishing of the follicles.

He also mentions a deficiency of vitamins B and E as one of the causes that can lead to hair breakage.

Bushara agrees with Musengimana, pointing out protein as an element that largely constitutes hair and that a diet which is low in protein can lead to weaker and thinner hair.

"A deficiency in iron can also lead to hair breakage as iron is necessary in keratin formation. Keratin is a protein which is key in the structural building of hair,” he says.

Other factors and prevention

Dr Rachna Pande, a specialist in internal medicine, explains that hair breakage and loss can be due to multiple factors.

She says that around and after menopause, it is natural for a woman to lose hair, explaining a reduced estrogen level as the root cause of this and that it mostly comes with menopause.

Pande also points out that any sickness can cause temporary hair loss.

Adverse effect of corticoid therapy, anti-cancer drugs, infections of the scalp like fungal infections, dandruff, lice infestation, can also cause excess hair fall and baldness, she says.

"Hair loss can be due to poor hair and scalp hygiene, use of shampoos and hair conditioners with harsh chemicals, lack of regular combing or using a comb with sharp bristles,” Pande says.

She adds that stress, dandruff and infections of the scalp are some of the other factors that cause hair loss.

Increase in testosterone or androgen levels can cause baldness and this can occur due to stress, or hormonal disorders, Pande notes.

"Drugs like corticoids, cancer treatment drugs, are some of the common causes. Apart from this, genetic factors also play a part. Chemicals like sodium lauryl sulphate and polyethylene glycol present in shampoos lead to hair loss, hence one should look out for these, while buying a shampoo,” she says.

Pande is of the view that hair loss may also happen without an apparent cause, for instance in cases of alopecia areata. Alopecia areata is a type of hair loss that occurs when the immune system erroneously attacks hair follicles, this damage is usually not permanent.

According to Julius Habimana, a general doctor at La Medicale’ Clinic in Nyarutarama, Kigali, loss of hair can be due to excess dryness, which is brought about by use of shampoos and hair conditioners.

He, on the other hand, says hereditary factors can play as a crucial factor when it comes to hair loss.

Habimana says some persons inherit thick hair, whereas others inherit sparse hair.

Prevention lies in taking in a well-balanced diet and avoiding factors that are capable of causing hair loss or its breakage, according to him.

"It is important to keep the hair clean and well-groomed to prevent hair loss. Avoid shampoos and hair conditioners with harsh chemicals. Also, regular oil massage of the scalp at least once in a week or every 10 days is useful,” says Habimana.

He adds that coconut oil or olive oil is good in this regard and that the diet should have adequate proteins. If hair loss has already started, correction of any known underlying cause can stop it. Drugs like minoxidil and hair implants are other options for treatment, notes Habimana.

Hair loss in men

According to research done by WebMD, about 85 per cent of men will have major hair thinning by the time they are 50. Some men start to lose theirs before they turn 21.

Research from Healthline also indicates that one cause of male pattern baldness is genetics, or having a family history of baldness. Research has found that male pattern baldness is associated with male sex hormones called androgens. The androgens have many functions including regulating hair growth.

Inherited male pattern baldness usually has no medical ill effects. However, sometimes baldness has more serious causes, such as certain cancers, medications, thyroid conditions, and anabolic steroids, the research continues to indicate.

Health conditions may be a cause of baldness when a rash, redness, pain, peeling of the scalp, hair breakage, patchy hair loss, or an unusual pattern of hair loss accompanies the hair loss. A skin biopsy and blood tests also may be necessary to diagnose disorders responsible for the hair loss.

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Iba Mayale, gynecologist During pregnancy, women can experience falling hair. This is due to increase in the levels of estrogen hormone which causes hair to remain in the growing phase later leading to its loss. Most of the time it also happens during and after three to four months after delivery. In this case, one need not to worry as its normal and the hair follicles rejuvenate themselves after some time.

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Elias Ntwali, general practitionerLoss of hair in some people can be a sign of some diseases, which if left untreated can cause bigger problems in future. For instance, extreme dieting or problems with the body’s digestive and absorption processes can lead to hair loss due to malnutrition. That’s why it’s important to get checkups to find the real cause when one experiences loss of hair.

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Boniface Nsekanabo, physician at Avega Clinic RemeraAging and certain sickness such as ringworms are factors that increase the risks of one loosing hair. On the other hand, for the women, avoiding heat styling as much as possible is important as it prevents hair breakage.

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Celestine Karangwa, physiotherapistSometimes it’s hard for one to notice that they are losing hair, this is because their hair starts by thinning then falling out slowly. Generally, to avoid such cases, avoiding different types of chemicals and sticking to the right diet is important.

Complied by Lydia Atieno