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Sometimes you notice a few extra hairs in your brush. Other times it’s a clump of strands going down the drain in the shower. But whenever you start to notice hair loss, it can feel like a punch to the gut. “If you are experiencing hair loss, you are not alone,” says Elizabeth Bahar Houshmand, MD, FAAD, Founder of Houshmand Dermatology and Wellness. “So many people feel embarrassed to discuss their hair loss but it can have such a significant impact on self-esteem and wellness, both physically and mentally. There are effective treatments.”
Meet the Expert
- Dr. Elizabeth Houshmand is a double board-certified dermatologist specializing in cutaneous laser surgery and the dermatologic care of patients with a special interest in cosmetic dermatology, general dermatology, acne, hyperpigmentation, and hair loss.
- Dr. Craig Ziering is a board-certified dermatologist, a pioneer in the field of advanced hair restoration and transplantation, and a world-renowned hair restoration and transplant surgeon. He is the founder of Ziering Medical.
The first step in treating hair loss is finding out the cause of it. Though there are plenty of potential triggers, creatine is a controversial one. Keep reading to find out what creatine is, the potential role it plays in hair loss, other causes of hair loss, and how to prevent and treat it.
What Is Creatine?
“Creatine is an organic acid that helps supply energy to cells, particularly to muscle cells,” explains Dr. Craig Ziering, board-certified dermatologist and founder of Ziering Medical. “Creatine is used for energy. It increases the body’s ability to produce energy rapidly, exists naturally in our bodies, and helps fuel our muscles. Creatine is thought to improve strength, increase lean muscle mass, and help the muscles recover more quickly during exercise.”
About half of the body’s supply of creatine comes from diet and about half is produced in the liver, kidneys and then delivered to the skeletal muscles for use, explains Dr. Houshmand. “About 95% of creatine is stored in the skeletal muscle of your body and is used during physical activity,” she says. “Small amounts are also found in your heart, brain and other tissues.”
Creatine is also found in foods like red meat, seafood, and milk, explains Dr. Houshmand. In a diet that includes meat, most people consume one to two grams per day of creatine. Vegetarians and vegans may have lower amounts of creatine in their bodies due to lower intake. Creatine supplements or as part of smoothies are common. Creatine creates a quick burst of energy and strength, which improves performance in athletes.
Can Creatine Cause Hair Loss?
“This is a difficult one to answer,” Dr. Houshmand says. “There are no scientific studies that have found that creatine does cause hair loss. The study that is often referenced is from 2009.”
In this study, a small group of 20 male rugby players were looked at. Some of the patients had higher levels of DHT, a testosterone metabolite. A spike in DHT can cause hair loss for some men, but those in this study group didn’t specifically report that. During the study, the rugby players used a creatine supplement regimen involving seven days of creatinine-loading during which a higher level of the supplement was given, followed by a maintenance period of lower levels of creatine. The researchers found that levels of DHT increased during the loading period and stayed over baseline during the maintenance period, while testosterone levels didn’t change.
“It’s important to note here that the researchers didn’t assess hair loss in the study participants,” Dr. Houshmand says. “Therefore, we can only observe the effect on hormone levels here. That’s why I say it’s difficult to answer this based on this single study. So, this evidence is anecdotal. Overall, more research is needed into creatine’s effect on DHT levels. Further research should also be performed to assess whether increases in DHT due to creatine supplementation are sufficient to promote hair loss.”
A spike in DHT causes hair loss for some men, but those in this group study didn’t specifically report it. “No scientific study has ever conclusively found that creatine does cause hair loss and researchers are pretty clear about creatine being a fairly safe product to take,” Dr. Ziering says.
Other Potential Causes of Hair Loss
“Everyone experiences hair shedding, and it happens to each of us every day,” Dr. Ziering says. “Most people lose 50 to 100 hairs per day as part of this natural cycle. This usually isn't noticeable because new hair is growing in at the same time. Hair loss occurs when new hair doesn't replace the hair that has fallen out.”
There are multiple causes of hair loss. “The most common is multifactorial, including genetics, aging, hormonal fluctuation, stress, and various medical conditions and medications like thyroid disease and iron deficiency anemia,” Dr. Houshmand says. “Also, how you wear your hair—tight ponytails, braids, and buns—can cause permanent hair loss.” Poor diet can also be a factor.
How You Can Help Prevent Hair Loss
Lifestyle can have a major impact on preventing and treating hair loss. Dr. Ziering outlines a few steps you can take at home to keep your hair as full and healthy as possible:
- Regularly wash your hair with mild shampoo. By washing your hair regularly you are preventing hair loss by keeping hair and scalp clean. Regular washes lowers the risk of infections and dandruff that may lead to hair breakage or loss.
- Take vitamins. Vitamin A encourages healthy production of sebum in the scalp. Vitamin E betters blood circulation in the scalp to help hair follicles remain productive and vitamin B helps hair maintain its healthy color.
- Enrich diet with protein. Eating lean meats, fish, soy or other proteins promotes hair health and in turn helps curb hair loss.
- Scalp massage with essential oils. Those who have been experiencing hair loss should massage the scalp with essential oils for a couple of minutes. It helps your hair follicles remain active.
- Keep yourself hydrated. The hair shaft comprises one quarter water so drink at least four to eight cups of water in a day to stay hydrated and for the growth of healthy hair.
- Reduce alcoholic beverages. If you are experiencing hair loss then reduce your alcohol intake because drinking alcohol reduces hair growth.
- De-stress. Studies in the past have found medical evidence to link stress with hair loss. De-stress yourself; one of the ways to do so is by practicing meditation. Alternative therapies such as meditation and yoga not only reduce stress but restores hormonal balance.
- Avoid constant heating and drying. Don't subject your hair to frequent, constant heating and drying procedures. Heat weakens hair proteins, and constant heating and drying can lead to weakness and fragility that causes hair loss.
- Keep your head sweat free. Men with oily hair experience dandruff during summer due to sweating and the chances of hair fall increases. Using shampoos that contains aloe vera can keep the head cool and prevent dandruff.
When to See a Doctor
Early treatment makes a huge difference, so it’s best to see a dermatologist as soon as you start noticing signs of hair loss, as they can also help you determine the type of hair loss. “Not all hair loss is the same and you can have more than one type,” Dr. Houshmand says. “This way your doctor can help direct your evaluation and treatment customized for you. Alopecia is typically divided into scarring and non-scarring cases. Scarring alopecia is caused by an inflammatory process that leads to scars around the follicles with permanent damage.” If you notice areas of your scalp that are red and itching it is important to visit a board-certified dermatologist right away.
A dermatologist can also offer in-office treatments, such as PRP, platelet rich plasma. Dr. Ziering says other potential procedures to help regrow hair include injections of corticosteroids, hair transplant, and laser therapy. Your doctor will help you determine the best course of treatment.
The Final Takeaway
Hair loss is very common and nothing to be ashamed of. The best course of action is to see a dermatologist immediately to start treatment. “Talk to your doctor if you notice sudden or patchy hair loss or more than usual hair loss when combing or washing your hair,” Dr. Ziering says. “Sudden hair loss can signal an underlying medical condition that requires treatment.”