Blackmores Institute

Common types of hair loss include:<ul><li>Androgenetic alopecia: female and male pattern hair loss</li><li>Alopecia areata: an autoimmune disease</li><li>Telogen effluvium: temporary hair loss5</li></ul>In addition to signalling potential underlying health issues, hair loss can drastically impact one’s self-esteem, mental health and quality of life.4 With the growing prevalence in both children and adults, the need for safe and effective hair loss treatments continues to rise.4 An area of significant interest is the essential role of adequate nutrition and targeted supplementation to support overall scalp and hair health.6<h3>Understanding hair</h3>Hair is comprised of 95% of the protein, keratin, as well as keratin-associated proteins.7 Composed of 3 layers, the cuticle, the cortex and the medulla,8 each strand of hair consists of the root beneath the skin and the visible shaft above.9 At the root (or bulb), new cells, keratinocytes and melanocytes, form and grow upward, pushing the hair out.9 The root sits inside the follicle, surrounded by connective tissue and skin, and is connected to a sebaceous gland, muscle and nerves.9 The hair bulb is nourished by the hair papilla, supplying essential nutrients and oxygen.9 (See Figure 1.)<img src="https://images.contentstack.io/v3/assets/blt948bd74310fc0ad0/blt472150450ee03015/69f296f0709daf05cc2ab50b/bi-figure1-structure-of-hair.jpg" alt="bi-figure1-structure-of-hair.jpg" class="embedded-asset" />Figure 1. Structure of hair9 <h3>The hair cycle</h3>The hair cycle is composed of four primary phases:10<ul><li>Anagen phase (growth): 85-95% of total hairs, lasts for two to six years.</li><li>Catagen phase (transition): shortest hair growth phase, only lasting a few weeks.</li><li>Telogen phase (resting): hair is fully formed but no longer actively growing, lasts for approximately 100 days.</li><li>Exogen phase (shedding): old hair is shed and makes way for new hair growth.</li></ul><h3>The science behind hair loss</h3>Mechanisms driving hair loss may include:2<ul><li>Miniaturisation of the follicle: the hair follicle gradually shrinks, producing progressively shorter, finer, and thinner hairs.</li><li>Shortened hair growth cycle: the anagen phase is shortened, while the telogen phase is prolonged, increasing the time between shedding a hair and the start of a new hair's growth.</li></ul>Several factors can trigger the transition from anagen to telogen and ultimately hair loss, such as inflammation, hormonal changes, stress, nutritional deficiencies, poor sleep quality, and medications that inhibit cellular division. On the other hand, increased nourishment, direct stimulation of hair follicles, and the presence of growth factors encourage the shift from telogen to anagen, promoting hair growth.2 (See Figure 2.)Skin and hair follicles are also recognised sites of microbial colonisation, with research indicating a possible link between scalp and hair follicle microbiomes, and the pathogenesis of hair loss.11<img src="https://images.contentstack.io/v3/assets/blt948bd74310fc0ad0/blt07880c95bbb3cb96/69f296f09df29a5ccfc1c3a6/bi-figure2-schematic-of-the-hair-growth-cycle.jpg" alt="bi-figure2-schematic-of-the-hair-growth-cycle.jpg" class="embedded-asset" />Figure 2. Factors influencing the transition between anagen and telogen phases of hair growth.2<h3>Supportive complementary medicines</h3>A balanced, nutrient-rich diet or targeted supplementation is crucial for healthy hair, as evidence indicates that certain nutritional deficiencies, such as biotin, nicotinamide and zinc are associated with hair loss.12Additionally, as hair is composed almost entirely of protein, namely keratin, adequate intake of a variety of amino acids to support keratin synthesis is critical.13 Further supporting keratin metabolism and proliferation is milliacin, the main active ingredient in millet.14 Keranat™ is a patented active ingredient containing millet seed extract which is encapsulated by polar lipids and common wheat extract to enhance absorption.14 A 2020 randomised, double-blind, placebo-controlled study conducted in 65 women with telogen effluvium found that supplementation with milliacin encapsulated within polar lipids resulted in a significant reduction in hair loss/thinning within 12 weeks compared to placebo, and an overall increase in hair health, shine and scalp hydration.14<table><tbody><tr><th>Ingredient</th><th>Benefit / Action</th></tr><tr><td>Biotin (vitamin B7)</td><td>Required to produce keratin,15 support scalp health,16 and support normal hair pigmentation.17</td></tr><tr><td>Keranat™</td><td>Stimulates keratin production, promotes cell proliferation in hair bulb, reduces hair loss/thinning, and decreases scalp dryness.14</td></tr><tr><td>Nicotinamide (vitamin B3)</td><td>Improves blood circulation, promotes nutrients to the hair follicle,18 and reduces oxidative stress.19</td></tr><tr><td>Zinc</td><td>Supports hair growth and thickness, helps regulate the hair cycle,17 required for protein synthesis (including keratin and collagen),20 and reduces inflammation.21</td></tr></tbody></table><h3>Conclusion</h3>Although it is natural to shed some hair each day, hair loss can be cause for concern. Maintaining healthy hair is not just about appearance, it can signal underlying health issues and contribute to overall health and vitality. As there are many different causes for hair loss, individual assessment is important to identify appropriate treatment. However, ensuring an adequate intake of nutrients, especially protein, biotin, nicotinamide and zinc, provides foundational support for optimising scalp and hair health. <h3> References </h3><ol><li>Better Health Channel. 2023. Hair. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/hair</li><li>Natarelli N, Gahoonia N, Sivamani RK. Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss. Journal of Clinical Medicine. 2023 Jan 23;12(3):893.</li><li>Harvard Health Publishing. Hair Loss - Harvard Health. Harvard Health. Harvard Health; 2018. Available from: https://www.health.harvard.edu/a_to_z/hair-loss-a-to-z</li><li>Liu D, Xu Q, Meng X, Liu X, Liu J. Status of research on the development and regeneration of hair follicles. International Journal of Medical Sciences. 2024 Jan 1;21(1):80–94. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10750333/</li><li>Health Direct. 2022. Alopecia (Hair loss). https://www.healthdirect.gov.au/alopecia</li><li>Almohanna HM, Ahmed AA, Tsatalis JP, Tosti A. The Role of Vitamins and Minerals in Hair Loss: A Review. Dermatology and therapy. 2019;9(1):51–70. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30547302</li><li>Piccolo M, Ferraro MG, Maione F, Maisto M, Stornaiuolo M, Tenore GC, et al. Induction of Hair Keratins Expression by an Annurca Apple-Based Nutraceutical Formulation in Human Follicular Cells. Nutrients. 2019;11(12):3041. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6950555/</li><li>Yang FC, Zhang Y, Rheinstädter MC. The structure of people’s hair. PeerJ. 2014 Oct 14;2:e619. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4201279/</li><li>Biga LM, Dawson S, Harwell A, Hopkins R, Kaufmann J, LeMaster M, et al. 5.2 Accessory Structures of the Skin. open.oregonstate.education. OpenStax/Oregon State University; 2019. Available from: https://open.oregonstate.education/aandp/chapter/5-2-accessory-structures-of-the-skin/</li><li>Martel JL, Miao JH, Badri T, Fakoya AO. Anatomy, Hair Follicle. Nih.gov. StatPearls Publishing; 2024. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470321</li><li>Constantinou A, Kanti V, Polak-Witka K, Blume-Peytavi U, Spyrou GM, Vogt A. The Potential Relevance of the Microbiome to Hair Physiology and Regeneration: The Emerging Role of Metagenomics. Biomedicines. 2021 Feb 26;9(3):236.</li><li>Gokce N, Basgoz N, Kenanoglu S, Akalin H, Ozkul Y, Ergoren MC, et al. An overview of the genetic aspects of hair loss and its connection with nutrition. Journal of preventive medicine and hygiene. 2022;63(2 Suppl 3):E228–38. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9710406/</li><li>Trueb R. “Let food be thy medicine”: Value of nutritional treatment for hair loss. International Journal of Trichology. 2021;13(6):1.</li><li>Keophiphath M, Courbière C, Manzato L, Lamour I, Gaillard E. Miliacin encapsulated by polar lipids stimulates cell proliferation in hair bulb and improves telogen effluvium in women. J Cosmet Dermatol. 2020;19(2):485-493.</li><li>Patel DP, Swink SM, Castelo-Soccio L. A Review of the Use of Biotin for Hair Loss. Skin Appendage Disorders. 2017;3(3):166–9. Available from: https://www.karger.com/Article/FullText/462981</li><li>Saxena R, Mittal P, Clavaud C, Dhakan DB, Hegde P, Veeranagaiah MM, et al. Comparison of Healthy and Dandruff Scalp Microbiome Reveals the Role of Commensals in Scalp Health. Frontiers in Cellular and Infection Microbiology. 2018 Oct 4;8. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180232/</li><li>Trüeb, RM. Nutrition for Healthy Hair : Guide to Understanding and Proper Practice. 1st ed. 2020. Cham, Switzerland: Springer, 2020</li><li>Xu C, Dai J, Ai H, Du W, Ji H. β-Nicotinamide Mononucleotide Promotes Cell Proliferation and Hair Growth by Reducing Oxidative Stress. Molecules. 2024 Feb 8 [cited 2024 Dec 1];29(4):798. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10893548/</li><li>Choi YH, Shin JY, Kim J, Kang NG, Lee S. Niacinamide Down-Regulates the Expression of DKK-1 and Protects Cells from Oxidative Stress in Cultured Human Dermal Papilla Cells. Clinical, Cosmetic and Investigational Dermatology. 2021 Oct;Volume 14:1519–28.</li><li>Lassi ZS, Kurji J, Oliveira CS de, Moin A, Bhutta ZA. Zinc supplementation for the promotion of growth and prevention of infections in infants less than six months of age. Cochrane Database of Systematic Reviews. 2020 Apr 8. https://pubmed.ncbi.nlm.nih.gov/32266964/</li><li>Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. The Journal of Physiological Sciences. 2017 Sep 30;68(1):19–31.</li></ol>

Hair is in a constant cycle of growth, rest and renewal.1 Losing approximately 100-150 hairs per day is normal, however, excessive shedding can raise concern.2 Ranging from mild thinning to total baldness, hair loss can affect a single area or several areas over the head and body.3 Hair loss has evolved into a chronic problem, affecting a substantial portion of the population, with incidence continuing to rise.4

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