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There’s a reason autumn is called fall: the trees drop their leaves, after all. For some, it’s more personal than that—their hair starts to shed, too. “Every autumn, patients in our practice complain more and more about hair loss,” reports Dr. Christian Merkel of Munich’s Skin and Laser Center at the Opera.
If you, too, have noticed more hair shedding than usual as the days become shorter, don’t stress: the number of hairs that fall out is often just a harmless part of the natural renewal process—just like the seasons themselves. “Hair grows in a fixed cycle,” says Merkel. “Growth over several years is called the anagen phase. Then the hair enters the catagen phase. Within a few weeks, the hairs detach from the scalp and eventually fall out. In the telogen phase, the roots recover before the cycle begins again.”
We lose around 100 to 200 hairs a day through this cycle, but in the fall, we tend to lose even more. “In evolutionary terms, our hair is part of our coat. Accordingly, there is also a shedding cycle,” says Merkel.
Hair loss in the fall
It is reasonable to assume that seasonal hair loss is anchored in genetics. According to Merkel, however, the exact causes are unclear. “Some scientists assume that more hair is in the growth phase in summer because we need more sun protection,” he says. Because this is no longer as necessary in the autumn, the body can now transfer more hair into the shedding phase.
Of course, the hair that falls out due to the change of seasons will grow back again—we will need them next summer as the sun beats down! However, if you’re experiencing more hair loss than seems normal, it can’t hurt to have it checked out by a doctor. Especially if the hair loss continues beyond the fall.
Reasons for hair loss
“In most cases, hereditary factors (androgenetic alopecia) are responsible for hair loss,” says Dr. Emi Arpa, a dermatologist in Berlin. “In men, this can be seen in the receding hairline and at the back of the head. In women, the hair around the crown of the head thins out.”
Hair loss can also have numerous other causes besides seasonal and genetic factors. “Only a doctor can determine these,” Arpa says. “The hair cycle is generally very sensitive to external circumstances, such as mechanical pressure from headgear and tension from tight braids, but also internal factors.”
According to Arpa, internal factors could include hormonal fluctuations due to birth control, pregnancy, or perimenopause. It can also be from stress: “Our mind and body, including our skin, are inextricably linked,” Arpa says. “Stress influences the blood flow to the scalp through certain hormones and signaling substances.” Blood flow is essential for the supply of nutrients to the hair roots and hair growth.
The best foods for preventing hair loss
“Nutritional deficiencies can also lead to hair loss,” says Arpa. What you eat is therefore crucial for full hair. To that end, the doctor recommends eating foods that are rich in iron, omega-3 fatty acids, zinc, biotin, selenium and vitamin B5 for healthy hair growth. “Proteins and antioxidants also have benefits for the hair,” says the dermatologist. Below, a list of her favorite foods to eat for healthy hair:
- Legume and egg dishes for protein
- Nuts for omega-3 fatty acids and vitamin E
- Oatmeal for iron, zinc, and biotin
- Salmon for omega-3 fatty acids
- Apricots for vitamin B5
- Tomatoes, blueberries, papaya, and pulses for antioxidants
It may be tempting to take a nutritional supplement for hair loss, but Amra advises against doing so without a medical examination first. “If you have no illnesses and eat a balanced diet, you will get all the nutrients, vitamins, and minerals your body needs,” she says. “An excess is unnecessary and won’t suddenly make more hair grow.”
In the case of unexplained hair loss, the expert therefore recommends a blood test as the very first step—one in which the thyroid gland, vitamin balance, iron status, minerals, trace elements, electrolytes, and hormones in the body are examined: “If a deficiency is found, it should be addressed with the appropriate dietary supplements,” she says, noting that vitamins taking as a preventative measure might not be effective.
“Unless you know the cause—for example, that you have certain deficiencies in your dietary intake—it would be better to simply eat a balanced diet to directly counteract this than to take supplements.” It’s also worth noting that some nutrients from supplements are not absorbed at all in the gastrointestinal tract.
The best hair growth treatments
Some doctors offer IV drips, also known as vitamin infusions. With IVs, you can be sure that the nutrients get into the bloodstream. Eveline Urselmann, a doctor of aesthetic medicine and owner of two practices in Hamburg, explains: “We offer various infusions to combat hair loss. We offer ‘predefined’ ones and those that we can customize individually after taking a blood sample.”
Speaking of blood—it not only plays a key role in diagnostics, but also in treatment. A so-called PRP treatment is particularly effective for hair loss.
“PRP is short for platelet-rich plasma, which is extracted from the blood of the person being treated,” explains Uselman. “For the treatment, blood is taken and centrifuged to separate it into three parts: red blood cells, white blood cells, and golden-yellow plasma. Only the plasma is injected into the scalp using fine needles, exactly where the hair is thinning,” she explains.
The growth factors in plasma stimulate the formation of new tiny blood vessels around the hair roots, so that they are better supplied with nutrients again. The plasma also has an anti-inflammatory and antioxidant effect, making perfect conditions for new hair growth.
To be effective, the treatment must be carried out as a cure: Urselmann recommends six sessions at four-week intervals for a treatment period of six months. The effectiveness is scientifically proven, but only against hereditary and circular hair loss. “There are clear studies on this,” she says, adding that “in practice, however, I often observe that patients who have other triggers behind their hair loss, such as stress, nutrient deficiencies, or a severe viral infection like Covid, respond particularly well to the procedure.”
According to the expert, it is also important to refresh the treatment regularly: “At least once every six months—preferably while it is still working and not just when hair starts to fall out again. Prevention is always better than intervention, provided you can afford it financially.”
If your blood work shows that the hair loss is hereditary, all three doctors recommend medication in addition to PRP. “In androgenetic hair loss, the hair follicles atrophy and the blood vessels that supply the hair with nutrients shrink. The drug minoxidil acts precisely at this point, dilating the blood vessels and thus remedying the deficiency in the supply to the hair root by increasing vascular blood flow,” explains Arpa.
Minoxidil can be used by both men and women. It is available as a foam and solution and is applied topically to the scalp. The best-known brand product is, of course, Rogaine; however, the active ingredient is also available from other companies with the same effectiveness for less money.
The anti-hair loss drug finasteride is also approved for men and women in the United States. “It intervenes deeply in the metabolism, inhibiting the so-called 5-alpha-reductase in the cells, which is responsible for converting the sex hormone testosterone into the more active dihydrotestosterone (DHT). In children, this is responsible for the development of the male sex organs, but also for the growth of body hair and hair loss on the head,” explains Arpa.
With finasteride, the list of potential side effects is long. They range from erectile dysfunction in men to breast cancer in women to severe depression in both. Therefore, it should only be prescribed after patients are carefully informed of these side effects.
LED helmets, similar to the popular face masks, are also being celebrated on social media as the latest remedy for hair loss. Merkel explains: “The scalp also benefits from the anti-inflammatory effect of light, which has been proven for use on the face. However, the hair roots lie several millimeters deep in the scalp, so it is questionable whether the light actually reaches them and stimulates hair growth, as the manufacturers promise. There are still no studies on this.” She says you may be better off focusing on another circulation booster that costs nothing at all: scalp massages in the morning and evening, preferably with rosemary oil.
Hair growth products containing caffeine are available in every drugstore and are completely harmless. “Caffeine stimulates blood circulation— however, for it to be effective, it needs to be left on long enough,” says Arpa.
This means that serums and hair tonics with caffeine are more effective than shampoos. “Studies have shown under laboratory conditions that caffeine stimulates and strengthens the hair roots. However, it should also be mentioned that insufficient research has been carried out to determine whether the same result can be achieved under real-life conditions.” In addition to caffeine, the amino acid arginine is also found in numerous hair loss products. It is said to have similar stimulating properties.
