Hair grows about 1cm per month, and each hair has a lifespan of about 2 to 4 years on the scalp. On average, a person loses about 50 to 100 hairs per day. As time passes, hair loss increases, not only affecting appearance but also potentially reflecting certain health conditions.
Five zang and six fu-organs are the "benefactors" of hair
The five zang and six fu-organs are the source of qi and blood for the entire body. All tissues in the body rely on the nourishment from the five zang and six fu-organs, and hair is no exception. To have healthy and dense hair, one must consider the strength of the functions of the five zang and six fu-organs. Otherwise, even if hair is transplanted, it will quickly fall out due to insufficient qi and blood nourishment. For example, starving refugees rarely have lush hair; similarly, women are more prone to hair loss during menstruation, and if menstrual flow is excessive, hair loss will increase.Traditional Chinese medicine (TCM) believes that "hair is the surplus of blood," meaning hair is closely related to the abundance of "blood." It also holds that "the splendor of the kidneys is in the hair," indicating a strong connection between hair and "kidney qi." Kidney qi governs the growth, development, and flourishing of hair, while blood supplies the necessary nutrients for hair. The two complement each other. "The liver stores blood," and "hair is the surplus of blood." Only when there is an excess of blood can it be stored; if liver blood is insufficient, hair will not receive enough nourishment and will begin to fall out.
Aging, gradual blockage and poor circulation of the pathways, which hinders the distribution of qi and blood to the scalp, is also a key factor in hair loss.
Types of Hair Loss
Hair loss can be categorized by appearance into the following types:- Pattern Type: There is a fixed pattern of hair loss, such as male-pattern baldness, which is the most common type of hair loss in both men and women. Men often start losing hair from the front and sides of the forehead, with a 10% incidence rate starting at age 20, increasing with age. Women typically start losing hair from the top of the head, often after childbirth, around 40-50 years old, or after menopause.
- Localized Type: Hair loss occurs in specific areas, such as alopecia areata (spot baldness), often caused by stress, intense emotions, dermatitis, infections, or autoimmune diseases.
- Diffuse Type: Hair loss occurs across the entire scalp, such as telogen effluvium. Normally, hair follicles go through growth, regression, and resting phases before falling out and re-entering the growth phase. However, life stress, malnutrition, or major illnesses can cause a large number of hair follicles to prematurely enter the resting phase, leading to short-term, widespread, and significant hair loss.
Modern Medical Discoveries
Modern medicine has found that higher concentrations of dihydrotestosterone (DHT) in the scalp and hair follicles are key to male and female pattern baldness, with genetics also playing a significant role. Testosterone in both men and women is converted into the more potent dihydrotestosterone (DHT) by the enzyme "5α-reductase," an upgraded version of male hormones. During puberty, DHT is responsible for promoting the development of sexual characteristics (such as the prostate, penis, pubic hair, and beard), but in adults, it may lead to conditions like prostate enlargement, scalp and hair follicle atrophy, and accelerated hair loss. Women also have small amounts of male hormones, and men have small amounts of female hormones. Research has found that pattern baldness is also related to the ratio of sex hormones in the body: in women, the ratio of male to female hormones increases, meaning either estrogen decreases or male hormones increase; in men, it is the opposite, with the ratio of male to female hormones decreasing, meaning either estrogen increases or male hormones decrease. In other words, when women become less feminine or men become less masculine, hair loss is more likely. In TCM, this is seen as a manifestation of "insufficient kidney qi."Modern medicine still cannot explain why the concentration of DHT in the scalp and hair follicles increases, why DHT promotes the growth of beard, body hair, pubic hair, and underarm hair, but inhibits the growth of hair on the top and forehead. TCM, however, has an explanation. TCM has found that the liver is closely connected to the top of the head. Patients with insufficient liver blood are prone to dull pain and tenderness on the top of the head, while excessive liver yang can cause distending pain on the top of the head. If the hair on the top of the head turns white but the back of the head remains black, it is a sign of insufficient liver blood. Insufficient liver blood cannot nourish the hair, and the areas it governs will naturally fall out first.
How to treat it?
Modern medicine treatments for hair loss are only addressing the symptoms:- Taking medication that inhibits 5α-reductase to reduce DHT production: Many patients do stop hair loss and even grow new hair, but after stopping the medication, the hair gradually falls back to its original state, indicating that it only treats the symptoms. DHT is a useful hormone in the body, and inhibiting its production can cause side effects, commonly including reduced libido, erectile dysfunction, decreased ejaculate volume, anxiety, insomnia, and some patients may still experience symptoms even after stopping the medication.
- Hair growth tonic: Stimulates scalp blood vessel dilation, improving local scalp blood circulation. However, it does not improve overall blood circulation, nor does it consider the five zang and six fu-organs. If there is a deficiency, it cannot supply sufficient qi and blood to the hair, making the improved circulation channels futile.
- Hair transplantation: A surgical procedure that takes hair follicles from the back of the head and "plants" them in areas with hair loss. However, if the systemic imbalance and qi-blood circulation are not improved, the newly transplanted hair will not receive enough qi and blood nourishment and will quickly fall out, akin to planting new trees on barren land, which is also futile.
- Qi-blood deficiency: Qi and blood are a dichotomy. "Qi" includes the concepts of oxygen, function, and kinetic energy, while "blood" includes the concept of nutrition. The five zang and six fu-organs are the source of qi and blood. If the digestive system's function is poor, with spleen qi deficiency, leading to insufficient nutrient absorption and qi-blood generation, then spleen qi is tonified. If there is insufficient propulsion and qi movement in the heart and lungs, then heart and lung qi is tonified, and the heart and lungs are strengthened. Severe hair loss due to significant qi-blood loss postpartum requires major tonification of qi and blood. Hair loss due to excessive menstrual blood leading to blood deficiency requires not only tonifying blood but also regulating menstruation. Diffuse hair loss is commonly seen in qi-blood deficiency pattern.
- Yin deficiency: "Yin" refers to the various essential substances required for the construction, operation, and metabolism of human tissues. If the body is overworked and lacks rest, these essential substances will be quickly depleted, leading to a "yin deficiency" pathology, such as excessive overtime, prolonged late nights, excessive sexual activity, or overuse of the brain. Hair that does not receive enough essential substances will not easily grow and will easily fall out. Ghost hair loss is commonly seen in yin deficiency pattern.
- Kidney qi deficiency: Kidney qi governs the growth, development, and maintenance of human tissues. If kidney qi is insufficient, new hair will be difficult to grow, and half-grown hair will easily fall out. Causes of kidney qi deficiency include congenital inheritance, excessive labor, excessive sexual activity, or chronic illness. Kidney qi deficiency is treated by tonifying kidney qi. Male pattern baldness is commonly seen in kidney qi deficiency pattern.
- Qi-blood stasis obstruction: Hair growth and maintenance require the supply of qi and blood. If there is stasis in the circulation channels, qi and blood will not smoothly reach the hair follicles, leading to difficulty in growing new hair and easy loss of old hair. Signs of qi-blood stasis are treated with invigorating blood and resolving stasis methods.
Research shows that the number of childbirths, sleep, high stress, smoking, not wearing hats, lack of sun protection, and lack of exercise are all related to hair loss. Excessive weight loss leading to malnutrition or the use of unsuitable hair products can also cause abnormal hair loss.
Maintaining good dietary and lifestyle habits, avoiding late nights, overwork, and moderating sexual activity are the secrets to maintaining a head of beautiful hair.
It's rare for the author to have time to take photos during consultations. Below are some recent treatment cases:
Acupoint tuina (massage)
Local acupoints: Jiaosun (TE20), Yuzhen (BL9), Baihui (DU20), Fengchi (GB20).Different acupoints can be matched according to different patterns (pattern = systemic imbalance or pathological state of the human body).
| Hair loss pattern | Selected acupoints |
|---|---|
| Qi and blood deficiency | Zusanli (ST36), Hegu (LI4), Sanyinjiao (SP6) |
| Kidney qi deficiency | Taixi (KI3), Fuliu (KI7), Shenshu (BL23) |
| Qi and blood stasis obstruction | Taichong (LV3), Jianshi (PC5), Sanyinjiao (SP6) |
Each treatment session: Press each acupoint for 3-5 seconds, release for 3-5 seconds, repeat for 3-5 minutes before moving to the next acupoint. Perform one session in the morning, noon, and evening.
Acupoint tuina (massage) method: Use a tuina stick of moderate hardness or your own fingers to tuina the relevant acupoints in sequence. Press until you feel a slight soreness, but do not use excessive force. If you feel pain upon lightly touching the acupoint, it indicates that it has been injured, and you should avoid pressing it again for the time being.
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