Dr Sergio Ibáñez, a trichology specialist at Juaneda Hospitales, shares key insights in this interview on how to protect hair health and address hair problems at both early stages — when it’s still possible to prevent significant baldness — and more advanced phases. Prevention, consulting a specialist at the first signs, good nutrition, and hair care are essential to maintaining hair health throughout life.

Q: What causes hair loss?
A: Hair loss primarily has a genetic component, though other factors can influence it. Naturally, between 50 and 100 hairs fall out daily as part of the normal hair cycle. Losing more than 100 hairs a day may indicate a health problem. Hair follows a cycle consisting of three phases: growth (anagen), rest (catagen), and shedding (telogen). Disruption of this cycle triggers different forms of alopecia.

Q: What is the most common type of alopecia?
A: The most common type is androgenetic alopecia, also known as common baldness. It is characterised by the progressive thinning and weakening of hair, leading to eventual hair loss. This condition affects both men and women, though with different patterns.

Q: What triggers or causes baldness?
A: Androgenetic alopecia has a genetic and hormonal origin. It is linked to the sensitivity of hair follicles to dihydrotestosterone (DHT), a hormone derived from testosterone. However, other factors may also contribute to hair loss. Scalp conditions such as seborrhoeic dermatitis, psoriasis, eczema, and infections can have an impact, along with external factors like stress, nutritional deficiencies, restrictive diets, and hormonal changes, including post-partum effects. Not all hair loss is androgenetic alopecia, so it is essential to assess each case individually. At Juaneda Hospitales, we are committed to personalised medicine, which enables us to identify the specific cause of hair loss and tailor treatments accordingly.

Q: When should one consult a doctor?
A: The best time to consult a trichologist is as soon as abnormal hair loss is detected. You shouldn't wait until baldness has progressed and the scalp becomes visible. At the first sign of reduced hair density, seeking a specialist's advice is crucial. Raising awareness about early alopecia treatment is fundamental, as an early diagnosis and proper treatment can make a significant difference. While hair transplants are often viewed as the only solution, some treatments can prevent the need for this procedure. At Juaneda Hospitales, we emphasise the importance of personalising every treatment plan.

Q: How many types of baldness exist, and what characterises them?
A: Androgenetic alopecia is the most common hair condition seen at our trichology clinic in both men and women. However, other relevant conditions include telogen effluvium, which is often linked to seasonal changes, post-partum, or chronic stress, and can cause significant hair loss. There's also alopecia areata, which presents as small, circular patches of hair loss. Additionally, a classification based on the hair follicle unit distinguishes between scarring and non-scarring alopecia.

Q: What is the difference between scarring and non-scarring alopecia?
A: Scarring alopecia involves the irreversible destruction of hair follicles due to disease. In non-scarring alopecia, the hair follicle can recover with treatment and produce hair again. Early diagnosis and treatment are essential in cases of scarring alopecia to prevent follicle destruction and disease progression. The most common scarring alopecia we encounter is frontal fibrosing alopecia, which is characterised by receding hairlines, eyebrow loss, and thinning sideburns.

Q: What external factors contribute to alopecia?
A: External factors can aggravate different types of alopecia and controlling these can help mitigate the problem. Stress is one of the most significant contributors. Physical factors, such as excessive use of hair straighteners, and chemical factors, including harmful shampoos and beauty products, can also play a role. Environmental pollution and highly restrictive diets, which cause nutritional deficiencies, are other contributors.

Q: What role does diet play in hair health?
A: Nutritional deficiencies, often linked to restrictive diets or underlying illnesses, are significant factors in exacerbating hair loss. Achieving a proper nutrient balance can aid in recovering some hair lost to conditions like telogen effluvium. Maintaining a balanced diet and avoiding tobacco and alcohol consumption are essential, as both are harmful not only to overall health but also to hair care.

Q: Do you have any advice on sun exposure?
A: During summer, when sun exposure increases, it's important to protect the hair just as we protect the skin, using specific sunscreens. Solar radiation can weaken hair, making it more fragile and prone to damage. Inappropriate sun exposure requires special attention during this time of year. Additionally, other thermal factors, such as excessive use of straighteners or hairdryers, can harm hair. We recommend using products designed to protect hair from heat and opting for gentle, non-aggressive formulations.

Q: What treatments are available to address hair loss issues?
A: At the Juaneda Hospitales trichology clinic, we offer a wide range of options, from medical procedures to hair restoration treatments, all aimed at achieving natural results tailored to each patient’s specific needs. Our goal is to ensure that every person leaves with a smile, feeling satisfied with the outcomes and their appearance. We strive to make each individual feel unique and offer them a bespoke and exclusive service.