[Health Byte] Hair Loss: Classification, Care and Common Misconceptions

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With hair loss now becoming a widespread sub-health problem, local medical experts have systematically sorted out mainstream types of alopecia (hair loss), standardized integrated traditional Chinese medicine (TCM) and Western medicine treatment and maintenance protocols, and corrected a series of prevalent but harmful scalp care misconceptions, including blind exfoliation and excessive cleansing.

There are mainly two dominant types of hair loss and standard intervention:

1. Androgenetic Alopecia

Androgenetic alopecia is the most common chronic hair loss condition, divided into male-pattern and female-pattern types. Closely related to genetics and strong scalp sebum secretion, it presents distinct clinical features in different genders. Men typically suffer from receding hairlines, thinning crowns, oily scalp and excessive dandruff. Women usually experience diffuse thinning and widened hair parting, with rare complete baldness.

Professionals vividly compare hair growth to tree planting: the scalp acts as soil, and hair follicles require a balanced, nutritious and stable scalp microenvironment to grow healthily. Excess oil accumulation destroys scalp ecology and hinders nutrient absorption, leading to progressive hair thinning and shedding.

Scientific intervention and maintenance strategies include internal conditioning and external professional care. Regulating daily lifestyle habits serves as the foundation, including relieving long-term mental stress, maintaining regular work and rest, and reducing intake of spicy, fried and high-sugar foods to inhibit excessive sebaceous gland secretion and stabilize physical constitution.

"We can offer integrated TCM and Western medicine. For clinical intervention, modern medical means such as low-level laser therapy, microneedling and growth factor injection can activate dormant hair follicles and repair scalp microcirculation. TCM adopts syndrome differentiation treatment, including oral herbal formulas, herbal fumigation and external scalp compresses, to nourish the scalp internally and externally and improve the overall physiological state," said Dr Li Xin, director of the dermatology department at Shanghai Yueyang Hospital.

For severe androgenetic alopecia that cannot be effectively improved by conservative treatment, hair follicle transplantation is a reliable solution, which transplants healthy donor follicles to sparse or bald areas to restore scalp aesthetics.

Experts emphasize the principle of early detection, early diagnosis and early intervention. More importantly, post-transplant integrated TCM and Western maintenance is essential. Standardized long-term scalp management can raise the survival rate of transplanted hair follicles to over 90%, with optimal and stable effects presented within one to two years.

2. Alopecia Areata

Commonly known as "ghost hair loss", alopecia areata is closely associated with immune disorders, characterized by sudden patchy hair loss with a rapid onset. Its severity is graded clearly: local patchy alopecia on the scalp, total scalp hair loss defined as alopecia totalis, and complete loss of scalp, beard, armpit and whole-body hair defined as alopecia universalis.

"Although the pathogenesis of alopecia areata is not completely clear, it is generally reversible through standardized treatment. The integrated treatment scheme combines modern Western medicine such as anti-inflammatory small-molecule drugs and local hormone injection to control acute inflammation and block disease progression, with characteristic TCM therapies, including fire acupuncture and customized internal and external herbal treatment, to regulate immunity and promote hair regrowth," Li said.

Core Causes of Hair Loss: Congenital Genes and Acquired Regulation

Hair loss results from the combination of internal congenital factors and external acquired factors. Genetic predisposition and gene mutation belong to irreversible innate causes. In contrast, acquired bad lifestyles, including irregular sleep, persistent stress, unbalanced diet and poor scalp care habits, are major controllable triggers of aggravated hair loss. Experts point out that improving daily living and scalp maintenance habits can effectively offset genetic risks and stabilize hair and scalp health.

Correction of Typical Scalp and Hair Maintenance Misconceptions

In daily scalp care, many popular folk methods and wrong habits accelerate scalp damage and hair loss, which need to be scientifically corrected.

1. Misuse of ginger for scalp rubbing

Ginger stimulation is mistakenly believed to cure hair loss. In fact, although mild ginger therapy may assist in relieving mild alopecia areata under professional guidance, frequent and high-intensity ginger rubbing will irritate the scalp, damage the skin barrier, cause inflammatory reactions and further aggravate hair shedding. Self-operation of ginger scalp care is not recommended.

2. External application of black sesame for hair regrowth

As a traditional medicinal food, black sesame can nourish the liver and kidney when taken orally and help improve physical conditions conducive to hair growth. However, external application of black sesame has no therapeutic effect, and may block scalp pores, hinder follicle respiration and affect normal hair growth.

3. Ignoring scalp sun protection

The scalp is vulnerable to ultraviolet damage. Long-term sun exposure damages scalp tissue and hair shafts, weakens hair quality and induces scalp aging. Scalp sun protection is an indispensable part of daily hair maintenance.

4. Blind and excessive scalp exfoliation

Many people pursue frequent and high-strength scalp exfoliation and repeated scrubbing to pursue an "ultra-clean" scalp feeling. In fact, scalp exfoliation is not a daily routine care step. Blind frequent exfoliation will peel off the scalp's protective stratum corneum, destroy the natural barrier, cause scalp sensitivity, itching and inflammation, and damage healthy hair follicles. Exfoliation must be carried out only when necessary and under professional doctor's guidance.

5. Excessive cleansing and over-degreasing

The misconception that "the cleaner and drier the scalp, the healthier" is extremely common. The scalp has a self-regulating negative feedback mechanism and a protective lipid film to maintain moisture and stable pH (potential of hydrogen) value. Excessive washing and thorough degreasing strip the scalp of natural protective oil, resulting in dryness and tightness. In response, the scalp will secrete more oil to repair the barrier and balance pH, eventually leading to "more washing, more oil secretion" and aggravated oily scalp problems.

Experts suggest maintaining mild and balanced cleansing habits, cooperating with dietary conditioning and long-term scientific scalp management to gradually stabilize scalp oil secretion and achieve real healthy scalp ecology.

"Hair status directly reflects human nutritional balance and visceral function. Modern trichology advocates holistic integrated management of TCM and Western medicine, combining internal physical conditioning, standardized clinical treatment and scientific daily scalp maintenance. Avoiding various maintenance misconceptions, adhering to mild, balanced and personalized scalp care, and implementing early intervention are the core ways to prevent and improve hair loss," Li noted.

Health Byte Tips

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About the Author

Cai Wenjun is a seasoned health reporter with Shanghai Daily. With extensive experience covering the local medical system, hospitals, health officials and leading medical experts, Cai has reported on major pandemics, including SARS, swine flu and COVID-19, as well as developments in the local health industry.