Not too long ago I was in a pharmacy. An Arab-ish woman covered in a full hijab was screaming and crying to the lady pharmacist. She wanted Viviscal. Even though she was covered up from head to foot, she didn’t want to lose her hair.
Dr Sophie Shotter believes hair loss is the last taboo. Shotter, who goes by Dr Sophie and whose own hair is bouncy and glossy, specialises in transformative skin tweakments and hair. She is big on empathy and has seen it all. Through her Kent clinic (www.illuminateskinnclinic.co.uk) she has run hair loss virtual coffee mornings, because she believes that women’s baldness is even less discussed than female incontinence.
About midlife hair loss
“By the age of 60, 50% of women will have experienced some kind of hair loss,” says Dr Sophie.
That is a pretty huge percentage for it to be a taboo. There are various different kinds of hair loss — it can sometimes be hard to determine which is which. Anything with the word alopecia in it is frightening. For me, it started with a blood test.
“Hormonal shifts can mean a lot (these can occur in pregnancy, post pregnancy and with thyroid problems). There can also be vitamin deficiencies like vitamin D or B12 of other B Vitamins and iron and anaemia can be a cause. There can be certain medications that cause hair loss and more common in certain ethnic groups, styling. For instance, in Afro-Caribbean women might wear their hair in corn rows which can cause traction alopecia.”
I have always been fascinated by hair and sexuality, how they are inextricably linked. I would have dreams of falling hair like other people have dreams of falling teeth.
My bald patches
I first noticed bald patches on my head when I looked at a video of a friend’s birthday party on Instagram. We were all wearing Barbra Streisand masks over our faces, but only one of us had bald patches. We had gone to see the original A Star is Born in London then on to tapas. As the camera panned around the restaurant amid the bad singing and the toasts, I was horrorstruck to realise the bald patches belonged to me. It was in a state of disbelief that I went to visit my hairdresser of almost two decades, Mark Smith of Nicola Clarke at John Frieda.
He has seen me through various traumas and tantrums. When I said, “My hair is falling out, look at this bald patch,” he tried not to say anything. His face went frozen and said, “Let’s talk to Jessie [Renyard, the senior colourist who happened to be walking by].”
What was actually going on in his head?
It’s quite difficult. If a man says I am losing my hair you can gloss over it and say that is kind of what happens. When a woman says that, it’s very sensitive. I felt that even if I could see it, my instinct is to tell a little white lie. It was very difficult…
Jessie actually took pictures of it so I could see it, the bald patch at the back and its general thinness. I was on high alert. I wanted advice and I was willing to take it from anybody who would give it. “You threw the book at it,” Mark agrees.
I veered between being frozen in denial, wanting people to say, “No, I really can’t see it,” which some friends did. I loved them, then hated them for it, then I wanted to confront it by visiting every hair loss doctor ever known to human hair. I was living mostly in Los Angeles at the time. Fortunately, I owned many hats, essential for the sun, now essential to disguise the hair. That year I bought hats obsessively, good ones, expensive ones. I was on a mission: My Hair or My House. I stopped paying the mortgage.
I remember going to one interview with Elisabeth Moss at The Four Seasons. We sat inside. I wanted to bond with her so badly, but I knew that if I kept my hat on indoors, she would think I was weird. If I wore a wig, she would think I was having chemo (and perhaps attention seeking). Or I could just sit there with limp, thin hair and look at her glorious bright blonde shining hair. I had hair envy. I almost couldn’t speak. Her hair never looked that amazing on screen but the sight of it all gold and Marilyn-like in the sunlight. I was sad.
I saw an American doctor who prescribed something that would make me incontinent…but at least I wouldn’t be bald. It was a tough call. He also advised Rogaine but warned me if I got it on my fingers, I could get hairy hands. (I’ve seen women with these. I had thought it was hormones but it must have been hair drops!)
The first treatment I started was Viviscal, because one of Mark’s clients had found it helped — just like the weeping lady in the pharmacy.
Hair loss and Covid
All my hair loss happened in the summer of 2019 and now because of Covid, the stress of pandemic and lockdown, hairdressers are experiencing widespread hair loss with their clients and also because so many people have become vegan and automatically don’t ingest certain nutrients.
“We come into the salon to feel good about ourselves because of the transformative quality of hair, but if the hair isn’t there we can’t feel good,” Mark says. “Covid hair loss; it’s a thing.”
The New York Times confirms Google searches went up 8% this last year and the topic was searched for on average 821,000 times per month in the US. A mixture of stress and post viral inflammation causes temporary hair loss.
John MacPherson is an iconic hair stylist who has a hair studio/salon in Ladbroke Grove. He once recalls a client going vegan and her hair fell out. “A lot of clients are experiencing hair loss due to stress and Covid,” he says. “They took B vitamins and zinc and biotin and silicone and conditioned their scalp to reverse it.”
Expert advice from a trichologist
Many people who have suffered hair loss see the UK’s premiere trichologist, Annabel Kingsley. Hair is in her DNA. Her father Philip was hair doctor to the stars and Philip Kingsley in Mayfair is now her clinic. “Covid-19 has 100% impacted people’s hair: 6-12 weeks after any sort of fever or illness hair usually sheds. It’s called ‘post-febrile alopecia’. While our hair is hugely important to us psychologically, it is a dispensable tissue as physically we can survive without it.
“This means that when we are unwell our body diverts attention away from hair cell production and towards maintaining essential systems that keep us upright and breathing. Stress also commonly causes hair loss as it can impact our general health. For instance, it can disrupt our gut microbiome and our ability to absorb nutrients. Stress can also mess with our hormone levels and scalp health – both of which can result in hair shedding.
During lockdown, Kingsley’s clinics had to shut down but they did provide virtual consultations. In my opinion virtual consultation is better than no consultation, but this is such an emotional topic, I found it best to sit with a person willing to put their hands on your head. The more stressed we are, the more Covid there is, the more hair there isn’t.
How I felt when my hair fell out
I was beyond devastated. I was Madam Hair. I wrote about hair in my column about what celebrities reveal in their various hair decisions. Hair is the psychology of the soul and mine was dropping out.
Years before I had gone on a safari where the open topped Jeep had got stuck in sand and we had to pass a mother and four teenage lions and their kill. My friend, referencing my love of cats, said, “I can see the headline now, ‘She loved cats then one ate her!’”
Now I had a less fun headline, “She loved hair then she went bald.”
It turns out my hair loss was largely due to hormones and stress – it was called non-scarring alopecia. Of course, at the time you don’t know if it’s temporary or not.
The rise of the scalp massage
In LA they are all over hair loss. I went to a salon called Blow Me Away. They took pictures of the scalp on a computer so you could see hair growth or loss. Then you receive a 45-minute head massage with various pro hair oils. Apparently in Japan head-massage places are like nail bars, everywhere.
The scalp treatment is the new facial. Facials, although loved by many are a thing or the old normal. Many people don’t want to be touched around their eyes and mouth due to Covid. But if you’re going to get your hair washed, which you would anyway, you may as well have a healthy scalp.
Centred’s Laura Tudor speaks about hair loss
Laura Tudor founded Centred, a boutique scalp and haircare brand. She not only suffered hair loss herself, she is married to Josh Wood’s top stylist Kieran Tudor. She lost over a third of her hair. (I had a Centred scalp treatment and it was glorious.)
How long did it take for Laura’s hair to grow back? “I would say it took around a year to 18 months to grow my hair back. It was a really slow process, but it made me really look after the hair that I had left. It was exciting to see the tiny regrowth hairs, which I started to see from about 3 months after taking supplements and really looking after my scalp and hair.”
What were her initial fears and feelings? “I was so afraid that it wasn’t going to stop. I think overall I lost about a third of my hair over a period of three months. I had small patches and I remember standing in a lift and I could see my scalp — my hair was that thin. I think our hair, whether we have it or not, makes up so much of our identity. When it’s falling out and it is totally out of your control, it can be quite a scary time.
“It’s normal to lose about 100 hairs a day and that changes depending on what time of year it is. But this was different, my hair was coming out every-time I ran my fingers through it, which shouldn’t happen.”
Was it a cruel irony to be married to a super stylist? Having seen them together and having been blessed with the healing hands of Kieran, I think they’re quite a team.
“I felt so lucky that I was able to ask Kieran what was going on and hear his expert advice. He really helped advise and work with me to find the right ingredients and products that could help undo all the damage that had been done. As soon as I started to talk about hair loss to my friends, I was so surprised that so many people had been through similar experiences. That’s when I knew I could do something to help. I think hair loss and scalp concerns are very much still taboo topics, and are hidden away. But in fact there are simple everyday things that we can do to help prevent these issues that can actually not only improve your hair but your overall health and wellbeing.”
Supplements that help with hair loss
One of the first supplements she used was Lion’s Mane. “Lion’s Mane was one of the first natural medicines I started to take when I was going through a very stressful time.” It’s said to improve cognitive health, help nerve growth regeneration in the brain and help clarity and focus. “I still take it every day, it helps me keep on my A game.
“In terms of hair specific supplements – your hair is the last part of your body to receive nutrients, but the first part of your body to be withheld from. This means that when the body is going through stress, it actually diverts nutrients to the more vital processes and parts of the body. On the flip side, if you are consistently taking a supplement, you are making sure that the body has the support it needs even during stressful times to grow strong, long healthy hair.”
I saw a demonstration by Chris Appleton of how to get Arianna Grande’s fierce ponytail — he invented it — and said, “If you pull hair into a ponytail tightly you might see some scalp. You can colour with Color Wow’s Powder. I had used this for root touch up and now I was applying it to my head but not feeling very grande.
I was longing for long healthy hair that was synonymous with a healthy, sharp mind.
“Historically, I think there has been fear about talking about female hair loss, about women’s hormonal problems, about women’s aging,” Dr. Sophie says. “Very few people talk about hair loss. When someone is a new mother, if they start complaining about their hair, the perception is that there is some degree of vanity versus they should just be delighted they’ve got a new baby. Things are improving and opening up. People are starting to talk about hair.”
Kingsley acknowledges that she sees a lot of weeping women. More recently, Kingsley has experienced hair loss herself due to hormonal changes and knows full well how hair impacts the way we feel about ourselves.
“It affects our mood, confidence and self-esteem more so than any other part of us,” she says. “Women I see often tell me they don’t feel like themselves anymore, or that they have lost a part of their identity when they are losing their hair. Hair loss can be psychologically debilitating. I have seen it affect work performance, social life and relationships.”
When you have your hair washed at Kingsley’s clinic, it’s under iconic pictures of the Rolling Stones and various other 60’s types. Even in that swinging decade, hair didn’t always swing and blood tests were demanded.
Finally getting a diagnosis
I had a blood test. I had both androgenic alopecia and telogen effluvium. Androgenic alopecia is where hair follicles on your scalp are genetically predisposed to be sensitive to normal levels of androgens (male hormones). This causes follicles to gradually miniaturize and produce slightly finer hairs with each passing growth cycle. To treat this, I was prescribed Kingsley Clinic scalp drops containing minoxidil (a stimulant that helps to keep hairs in their anagen or growth phase and the active ingredient in Rogaine) and anti-androgens (which helps to protect hair follicles from the impact of male hormones).
“We also help people to manage rarer hair loss conditions, like autoimmune and scarring alopecia.”
For me, her products really helped. “There is no ‘one size fits all’ as everyone’s hair loss story is individual — and what works for you may not work for a friend. It’s why we take a holistic approach at our Clinic, looking into every possible factor that might be affecting someone’s hair i.e. health, diet, lifestyle, hormones and genetics.”
What is telogen effluvium (TE) hair loss?
“TE is a reactive hair loss, caused by an internal disruption,” says Kingsley. For me, this was due to my thyroid condition, not eating properly, and stress.
I took their Gelatine Protein Supplement, Tricho Complex multi vitamin & mineral supplement and was asked to improve my diet. “I also asked you get in touch with your doctor to adjust your thyroid medication dosage – your blood tests showed your thyroid was in a critical state,” she says.
What hair I had was also broken off and brittle.
“Breakage is also something to be aware of. Often times, women who are losing their hair also have fragile hair – and it’s important to address this as breakage can further thin-out your mid-lengths and ends. I recommended our Elasticizer pre-shampoo conditioning treatment once to twice a week.”
Pay attention to your scalp
“Your scalp is your hair’s support system; it is the bedrock of your hair follicles,” says Kingsley. “If your scalp isn’t in good condition it can impact the integrity of newly growing hairs. A flaky scalp can also cause hair loss. Also, any topicals you apply to your scalp to treat a hair loss condition penetrate a clean scalp most effectively.
“Remember that your scalp is simply skin and needs similar care to the skin on your face. i.e. frequent cleansing and toning. In terms of scalp conditioners – you shouldn’t apply conditioner to your scalp.” Only the ends.
A hair loss checklist for you
Laura Tudor’s research showed that 40% of women had visible hair loss by the time they reached 40. It’s a cruel taboo which Mark Smith feels he hit upon by mistake.
He felt that he shouldn’t be seeing hair loss even though he is a hair stylist, in the same way he had been taught growing up not to look into a woman’s handbag and he didn’t know how to confront it either. Then he realised, “You have got to arm yourself with knowledge so you can steer people in the right direction. I would say have a blood test. If you haven’t had any stress in your life and nothing has changed it’s always worth a blood test to see if there is something you are missing out on. It’s not always stress related. It can happen if you become depleted in certain vitamins and minerals. Also, there are things that you might be doing wrong when you are washing or styling your hair. Using a sharp or aggressive brush or combing or washing hair too much, using too much heat, obsessively washing hair and tonging it. The Viviscal really helps and I had a client with long, very fine hair, she took it and it made it amazingly thick.
“Many clients have been concerned about their hair and have wanted help. It does depend on how much hair you have to lose. If someone has got a real lot of hair it’s not going to make a difference, but if you’ve got fine hair like you, it can be devastating. We should have been be open, we are part of people’s mental health.”
Absolutely.
