They symbolize health and life energy. And you actually notice it by the hair pretty fast, if you do not feel right. They dry out, become brittle, thin and brittle or – in the worst case – fall out. "This can lead to a woman who already has thinning hair, so far that it already gets quite panic at the sight of a few hairs in the brush or on the bathroom floor," Sabine Schwarz from practice (hautzentrum-wien.at). The dermatologist specializes in hair loss. Your most important task: to find out the exact cause of the loss. Because only then can you specifically treat. After all, almost every second woman suffers from the problem at some point in her life. The reasons are hormone changes, nutrient deficiency, diseases or even genetic predisposition. In the interview, the expert explains the various causes of hair loss, which has to do with the problem of stress and which new treatment promises the greatest success. WOMAN: When does one actually talk about hair loss? Black: It is quite normal to lose hair, about 50 to 100 daily. They grow for a while, between three and five years. This is followed by a period of rest in which the root repels the hair. This affects about 20 percent of the hair roots. Every stronger hair loss should be observed. Some have the subjective feeling that they lose a lot more hair than just 100. But as long as the quality and the approximate amount remain the same, you do not have to worry. WOMAN: When do you have to worry? Black: If the hair is getting thinner and finer, you can no longer make a proper hairstyle or the regrowing hair immediately fail again. Then action is announced. The first route leads most to the pharmacy. There are many capsules and tinctures that stimulate the hair roots in the resting phase prematurely to increase growth or the support in the scalp. Often they work very well. But if there is no improvement after two to six months, you should definitely go to the doctor. Because if the hair roots are not stimulated for a long time, they wither away. WOMAN: What can the doctor do? Schwarz: Be sure to go to a specialist, a dermatologist, who deals specifically with the topic. Because the hair is a complex field. First, the doctor clarifies the cause of the hair loss. The head skin is examined with a microscope for fungi or inflammation. In the therapeutic conversation additional illnesses, medication, hormone changes or a family history are clarified. Also, a blood test is essential to discover deficiency symptoms. WOMAN: And what does the treatment look like? Black: It varies depending on the cause. There are three different types of hair loss. With diffuse hair loss, the hair on the whole head evenly less. Reasons for this can be massive vitamin and mineral deficiencies such as selenium, zinc, silica, iron or vitamins B and D. But the use of some medications such as certain blood pressure, antidepressants, cholesterol-lowering drugs, chemotherapy and high heavy metal pollution, thyroid problems or autoimmune diseases may be the cause. It means compensating for deficiencies, changing medications, releasing toxins. If the problem is resolved, the hair will come back, often thicker and denser. Then there is also the circular hair loss, resulting in the round, bald spots. Behind it is the immune system, as helps a cortisone tincture. The third type is the so-called androgenetic effluvium. This is by far the most common reason, about 90 percent. WOMAN: How is that expressed? Black: The hair on the top of the head gets less, the hairline goes back, the vertex becomes lighter. This is due to the hormones and a genetic disposition. The hair roots on the top of the head have hormone receptors, in contrast to those on the back of the head. If the testosterone is too high, they repel the hair. This happens to many women about three to four months after a birth, because then the estrogen level drops sharply. Another reason may be polycystic ovarian syndrome, cysts in the ovaries, which therefore produce too much male hormones. A genetic disposition is especially noticeable from the change, because then the estrogen production decreases. WOMAN: And what can you do about it? Schwarz: There are two concrete therapies. One is capsules and tinctures that stimulate hair growth and promote hair retention in the root. However, they only work as long as they are used. The second is a local hormone therapy. For this, a tincture with estrogen is added, which lowers the testosterone sensitivity of the hair root. This can only be prescribed by the doctor. And the lifestyle plays a big role. WOMAN: What does that have to do with it? Black: Stress affects hormone production, testosterone is elevated. Lifestyle changes help to bring that back into balance. Relaxation therapies often work wonders even on genetically caused hair loss. We have looked at the hair root in isolation for far too long, and the whole human is attached to it. You really have to think holistically about problem solving. WOMAN: Are there any new therapies? Schwarz: We are currently achieving very promising results in mesotherapy with own plasma. This contains stem cells and is injected into the scalp using a syringe with several very short needles. So the roots are stimulated, the hair grows again. I recommend 2-3 sessions in 6-8 weeks, then an annual refresher if needed. Unfortunately, the treatment is not paid by the cashier, and a session costs 300 euros. But they are certainly well invested.