From the contraceptive pill to vegan diets – two experts tell us what really affects our hair health.
Medically reviewed by Dr Louise Wiseman MBBS, BSc (Hons), DRCOG, MRCGP and words by Sophie Goddard
Worried about your hair health? If your tresses have seen better days and feel lacklustre or even start to fall out, you’d be forgiven for panicking! But can stress, over-styling, diet and the contraceptive pill have an impact on your hair health, and what can you do to ensure your locks stay in the best possible shape?
Dermatologist Dr Sharon Wong, from the London Bridge Hospital and trichologist Anabel Kingsley, from the Philip Kingsley clinic separate the hair health myths from the facts so you can get the very best from your tresses:
Stress and hair health
It’s a fact that stress can impact your hair health and can make it fall out or become thin. If your hair has started to fall out, it’s a good idea to write a timeline of your hair symptoms and significant events, plus other symptoms, illness and stress that occurred in the months before hair loss.
If you go to your doctor this will then help them start working out what the likely causes are. If the symptoms are say actually related to an underactive thyroid gland for example, then the doctor can see the whole picture before putting it down to just stress.
‘Stress definitely has an impact on health,’ says Dr Sharon Wong. ‘In my dermatology clinic, I see clear relationships between health levels and skin and hair. Things like stress-induced acne, eczema, psoriasis and hair shedding are common.’
Stress is one of the main causes of disturbing the hair follicle cycle and can affect the follicle’s cycle.
‘Generally, we lose hair in three ways – hair thinning with (and without) shedding, patchy hair loss or breakage. So if you’re experiencing hair loss, note the type of loss, in particular – stress-related hair loss is of a shedding type,’ adds Dr Wong. ‘Stress is one of the main causes of disturbing the hair follicle cycle and can affect the follicle’s cycle, shortening the anagen growth phase. Usually around three to four months after a stressful event, you’ll notice shedding, and improvements can take at least six months.’
Because hair loss doesn’t occur straightaway, it’s often difficult to pinpoint what’s behind any apparent changes, but stress can affect the hair in a big way, agrees Anabel Kingsley. ‘Most importantly, it can affect how we eat – turning to the wrong foods, or skipping meals – which has a knock-on effect on hair health,’ she says.
‘It affects the balance of the gut too – an upset tummy can significantly affect nutrition absorption. Stress can also increase testosterone levels, depending on your genetic disposition. which can also cause noticeable changes in your hair. Ongoing stress can even result in your hair moving out of the growth phase altogether.’
Over-styling and hair breakage
It’s a fact that spending too much time taking care of your tresses can also have an adverse effect. If you or your hairdresser suspects that over-styling is causing your hair changes, then work out a way to minimise this before damage or loss of hair becomes permanent.
‘Over-styling generally causes breakage and a difference in hair texture,’ explains Dr Wong. ‘Thermal injury and chemicals like hair dyes containing ammonia, peroxides or relaxing treatments for Afro- Caribbean hair can cause the cuticles to lift away from the hair surface, making hair appear dull, brittle, ragged and aged. It also exposes the core of the hair fibre to structural damage – making it break more easily.’
Over-styling generally causes breakage and a difference in hair texture.
Traction alopecia – caused by tight hairstyles or headscarves being tied too tight at the back, can also cause hair thinning over the frontal hairline and temples. ‘In the early phases, traction alopecia is reversible but if you leave it too long, it can cause scarring and permanent hair loss,’ says Dr Wong.
‘Over-styling can also easily cause breakage – often close to the root – but this is entirely reversible,’ says Kingsley. ‘It’s not uncommon for ballerinas – who have their hair tied up in a tight bun all day, every day – to experience traction alopecia, or women who braid their hair regularly.’
The contraceptive pill and hair health
It’s true that certain medicines and hormones can impact hair health. If hair loss has been a problem in the past, tell your GP before choosing a contraceptive pill, and consult them if hair loss starts a while after changing contraceptive. ‘Sex hormones have a huge affect on hair health – we know this from changes during pregnancy, post-pregnancy and the menopause,’ says Dr Wong.
According to Dr Wong, the following can impact hair health:
• Progesterone contraceptives
Some synthetic progesterones have a testosterone-like effect, which can cause hair loss, and progesterone-only contraceptives like the mini-pill or depo provera injections can aggravate hair shedding.
• The combined pill
Oestrogen in combined pills tends to have a more protective effect. Combined contraceptive pills like Dianette and Yasmin have an anti-male hormone effect which can be useful in protecting against female pattern hair loss, and those with PCOS.
Finally, Spironolactone (not a contraceptive) is a diuretic that can be used for hormonal acne and hormonal hair loss, but – as with all treatments – it’s generally better to start sooner rather than later.
Kingsley agrees, but says it depends largely on your genetic predisposition. ‘Oral contraceptives can help the hair, but some can make hair loss worse too, and it often depends on the individual,’ she says.
‘Dianette is regularly prescribed to people experiencing hair loss, for example, as it’s known for being “hair-friendly” but there are long term risks associated with it. Microgynon, on the other hand, isn’t hair-friendly for everyone. If you’re worried about your birth control or hair loss, your GP will be able to advise on options best suited to you.’
Over-washing and hair growth
You can’t actually wash your hair too much, so this one is a myth. While over-washing does not impact hair health, do remember if you have long hair to dry your hair thoroughly after washing (whether by air drying or hairdryer) before tying it up into a style so air can circulate around the scalp and there is less chance of overgrowth of yeasts and dandruff occurring.
‘I don’t think over-washing does anything to growth or loss directly, but it affects the hair’s aesthetics, and can lead to a dry scalp and hair,’ says Dr Wong. ‘There’s generally no one-fits-all for hair – it’s like skin, everybody’s different.’
Your scalp is the environment your hair grows in, so it’s crucial to keep it healthy for it to support hair growth.
However, your scalp health is really important and leave-on products can leave a film of residue which gives a tacky feel and look, as well as attracting dust and dirt. ‘This can potentially change the microbiome or balance of normal bacteria and yeasts on the scalp surface – aggravating conditions like dandruff. So it’s really important to wash regularly!’ adds Dr Wong.
‘Your scalp is the environment your hair grows in, so it’s crucial to keep it healthy for it to support hair growth,’ agrees Kingsley. ‘if you’re not washing your hair enough, you’re likely to experience flaking, which in turn can cause hair loss and inhabit growth. But non-washing is a complete myth – our hair won’t clean itself when you leave it long enough, no part of the body is self-cleaning. Think all of the pollution, car fumes, dust from building sites, dead skin cells – left on your hair to fester, it’s just not hygienic.’
Nutrition and your hair health
Does diet and nutrition impact the health of your tresses? This is partly true. ‘Hair follicle cells are one of the fastest-growing cells in the body but it’s not an essential structure, so our bodies don’t prioritise nutrition to the hair,’ says Dr Wong. ‘Dramatic weight-loss itself can cause hair shedding by depriving hair of nutrients – your hair is made from keratin which is protein – and a diet deficient in protein can cause loss, too.’
Hair follicle cells are one of the fastest-growing cells in the body but it’s not an essential structure, so our bodies don’t prioritise nutrition.
To keep your locks in check, aim to follow a healthy diet. ‘A well-balanced diet that includes lean proteins, complex carbohydrates, iron, Vitamin C to help absorb iron, B vitamins including biotin and essential fatty acids are all vital in providing the nutrition to keep hair follicle cells healthy,’ says Dr Wong. ‘Interestingly, Vitamin D receptors have been identified on hair follicles too, and play an important role in the hair growth cycle.’
Vegetarian or vegan diet and hair health
Can eschewing animal products transform your tresses? A carefully thought out healthy vegetarian or vegan diet may provide you with all the nutrients you need, with a clear focus on making sure you have plenty of protein from pulses and good sources of all vitamins.
‘It’s very difficult to get the nutrients we need through vegan or vegetarian diets alone, because they lack important proteins,’ argues Kingsley. ‘Plant proteins don’t contain all the essential amino acids our hair needs, and plant sources aren’t absorbed as easily by the body, as it’s non-heme iron, which is harder to break down.’
It’s very difficult to get the nutrients we need through vegan or vegetarian diets alone, because they lack important proteins.
‘Supplementation is definitely needed because vegan foods don’t contain all vitamins, like B12 for example, which vegans will need to look to supplements or fortified foods for,’ she adds. ‘The risk with taking a self-prescribed supplement, is that you might not be getting adequate levels, and it could interfere with existing medication – so speak to your GP before taking anything new.’
If you think you are lacking any nutrients then discuss with your GP before taking a new supplement that you may not need or could do harm.