Hair loss is a common health condition found in both men and women as they age. Hair loss encompasses medical conditions like:
- Androgenetic alopecia
- Alopecia areata
- Telogen effluvium
- Tinea capitis
Nutrient deficiencies such as iron deficiency, biotin deficiency, and zinc deficiency may also manifest as hair loss.
Zinc deficiency is an important yet preventable cause of hair loss. Restoring serum zinc levels via oral zinc supplementation results in inhibition of the catagen phase of the healthy hair growth cycle and hair restoration.
One can achieve normal zinc levels by consuming zinc-rich foods, fortified foods, and oral zinc supplements. Accurate dosage and duration for zinc therapy are imperative for the treatment of hair loss.
Zinc may inhibit the conversion of testosterone to dihydrotestosterone by suppressing the activity of 5-alpha reductase. The deficiency of zinc disrupts the hair growth cycle and results in hair loss.
For you to get a better overview of zinc, we included some background information. To skip to the answer, click here.
What is zinc and why do we need it?
The human body requires carbohydrates, fats, and proteins as well as an adequate amount of water for optimal functioning. Proteins and carbohydrates are used for building numerous structural and metabolic substances whereas carbohydrates and fats predominantly serve as fuel.
For carrying out normal metabolic reactions, the body also requires micronutrients, vitamins, and minerals, to regulate and modulate these processes. Zinc is the second most abundant mineral in the body, the first being iron.
Despite being a trace mineral, zinc is essential for the catalytic activity of hundreds of enzymes and is also involved in the processes of gene expression and protein synthesis.
Zinc plays a crucial role in the following physiological mechanisms.
- Optimal function of the immune system
- Cell division and growth
- Metabolism of carbohydrates
- Wound healing process
- Promotes insulin action
- Normal olfactory (smell) and gustatory (taste) sense
- Cofactor of vitamin D functions
- Help in the transportation of vitamin A
The adequate concentration of zinc is important for the developmental processes occurring in the fetal, neonatal, infantile, and childhood phases of an individual. Research reveals that zinc is also involved in the sequestration of copper and modulates the serosal transfer of copper in the gut lumen.
What happens when you have a zinc deficiency?
Lack of zinc has increased prevalence in developing countries, owing to malnutrition, while mild to moderate cases may also emerge in developed regions. The human body is incapable of synthesizing zinc, hence, the only source of nutrition is food and supplements.
According to the FDA, the average dietary intake of zinc is 3mg/day in children, 8mg/day in adult females, 11mg/day in adult males, and higher quantities for women who are either pregnant or lactating.
Zinc deficiency is an interplay between malnutrition and chronic illnesses predominant in developing and developed countries respectively. Nutritional causes include the consumption of phytates and oxalates that suppress zinc absorption as well as reduced intake of meat.
On the contrary, chronic illnesses involve multiple organs and systems including gastrointestinal, metabolic, hepatic, hematologic, renal, and immune-related disorders.
Approximately 17,3% of the world population is susceptible to developing zinc deficiency. Zinc deficiency may be congenital or acquired. The congenital form of zinc deficiency is marked by intestinal abnormalities that lead to impaired intestinal absorption of zinc, for instance, acrodermatitis enteropathica.
Acquired zinc deficiency arises when an individual does not consume sufficient dietary zinc, is unable to absorb zinc, is subjected to excessive loss of zinc, or dietary zinc does not fulfill increased metabolic demand. Certain medications and luminal contents impair absorption while physiological states such as pregnancy and lactation tend to increase the metabolic demand.
Lastly, excess zinc loss occurs in the presence of diarrhea, hemodialysis, and burns.
Clinical manifestations of zinc deficiency
The clinical manifestations of zinc deficiency are mentioned as follows. The amount and severity of these clinical features reflect the importance of zinc as it mediates myriads of biochemical pathways in the body.
- Bullous pustular dermatitis
- Thinning hair
- Psychological abnormalities
- Weight loss
- Cell-mediated immunity dysfunction
- Hypogonadism in males
- Neurosensory disorders
- Impaired healing of ulcers
- Growth retardation
- Rough skin
- Poor appetite
- Mental lethargy
- Delayed wound healing
- Reduced testosterone levels
- Reduced lead body mass
- Reduced dark adaptation
- Delayed sexual maturity
Acrodermatitis enteropathica is a rare zinc deficiency condition that has both inherited and acquired forms. Acrodermatitis enteropathica is characterized by the classic triad of the following conditions.
Similar clinical features are observed in biotinidase deficiency, a condition called pseudo-acrodermatitis enteropathica.
What happens when you take too much zinc?
Various environmental, occupational, dietary, and physiological factors are responsible for causing zinc toxicity. These factors are mentioned below.
- Zinc inhalation from occupational sources
- Excessive consumption of the zinc supplement
- Ingestion of coins/pennies by individuals suffering from PICA
- Denaturing creams
- Erroneous preparation of total parenteral nutrition
Excessive exposure to zinc occurs via respiratory, parenteral, dermal, and gastrointestinal routes that are mentioned above. The severity of zinc toxicity is determined by the duration and magnitude of excessive zinc exposure. Clinical features of zinc toxicity are as follows.
- Hematemesis in excessive consumption of zinc
- Renal injury includes asymptomatic hematuria, interstitial nephritis, and acute tubular necrosis
- Liver necrosis
- Acute respiratory distress syndrome (ARDS) in excessive zinc inhalation
- Metal fume fever syndrome is characterized by irritation and cellular damage to the respiratory tract
- Bone marrow abnormalities include sideroblastic anemia and granulocytopenia
- Neurologic impairment
Zinc levels in the blood are inversely proportional to the concentration of copper in the blood. Not only does zinc toxicity gives rise to the above-mentioned health complications but also manifests as copper deficiency.
Why does hair loss happen?
Hair loss is a distressing event in an individual's life that is a manifestation of numerous underlying endocrine, psychological, and pathological mechanisms. Following are the common conditions that are associated with female pattern hair loss and hair loss.
Commonly known as male pattern baldness, androgenetic alopecia is the most prevalent form of hair loss in both men and women. This is a genetic hair loss disorder characterized by increased sensitivity of hair follicles to androgens. While men experience thinning of hair at the temple, front, and vertex of the scalp, women tend to suffer from diffuse hair thinning without frontal hair loss.
Alopecia areata is an acute autoimmune hair loss disorder characterized by patchy alopecia. Alopecia areata can occur in any of the three patterns.
- Patchy alopecia is referred to as circumscribed patches of hair loss found on any part of the body.
- Alopecia totalis is the total loss of scalp hair.
- Alopecia universalis is the total loss of body hair.
Tinea capitis is a fungal infection of hair follicles and hair shafts that is more prevalent among children. The pathogen responsible for causing tinea capitis in the majority of the cases is the dermatophytes, and Trichophyton tonsurans. People suffering from tinea capitis often present with a patchy alopecia pattern of hair loss.
This is a sudden, non-scarring, and non-inflammatory form of hair loss. Physiological and/or emotional stressors cause a relatively large amount of hair to enter into the telogen phase of the hair cycle prematurely, followed by hair shedding.
The stressors include certain medications (anticoagulants, anticonvulsants, etc.), pregnancy, malnutrition, fever, surgery, and infections. This is a self-limiting hair loss condition and resolves upon elimination of the stressor.
This is an example of impulse-control disorder (ICD), characterized by conscious or unconscious pulling, twisting, and twirling of hair. Trichotillomania is characterized by frontoparietal patchy alopecia with an increased risk of infection and permanent scarring of the scalp.
What's the science behind zinc for hair loss?
For some, alopecia may be a sign of zinc deficiency. The association between zinc and hair physiology is further strengthened by the fact that zinc supplementation results in improved hair growth.
Research studies show that zinc deficiency has a significant association with the onset of telogen effluvium. The deficiency of zinc and other trace elements disrupt the normal hair cycle.
This also accelerates hair regression and causes excessive hair loss. Karashima et al. conducted a case series comprising patients suffering from telogen effluvium with concomitant zinc deficiency. These patients also present with patchy alopecia.
Oral zinc supplementation with polaprezinc cured or improved hair loss in the patients included in the case series.
Does taking zinc help hair growth?
Zinc is a key regulator of enzymes that catalyze the biochemical pathways involved in the synthesis of proteins and nucleic acids. This is an essential process for rapidly dividing hair follicle cells and components that form the extracellular matrix of the hair.
Zinc also contributes to the production of collagen and elastin proteins as it regulates the activity of the involved enzymes. Zinc serves as a cofactor for metalloenzymes, thus, playing an important role in infections and other pathological processes involving hair follicles.
Zinc suppresses the activity of apoptosis-related endonucleases. Inhibition of the activity of this enzyme leads to inhibition of the catagen phase of the hair cycle. Owing to this action of zinc, the hair follicles do not progress into the telogen phase prematurely, therefore, improving hair growth.
Zinc is also a key component of the hedgehog signaling pathway that mediates the transcription of the genome for protein synthesis. Zinc plays an integral role in the immunomodulation of the hair follicles by regulating the innate and adaptive immune mechanisms.
Zinc deficiency manifests as dysregulation of the immune system and reduced immune tolerance. This predisposes the hair follicles to infections and increased the risk of autoimmune conditions including telogen effluvium. More importantly, zinc inhibits 5-alpha reductase and reduces the levels of dihydrotestosterone, restoring the normal physiology of the hair growth cycle.
Even though hair loss is an established sign of zinc deficiency, similar hair loss conditions may arise in the background of zinc toxicity. Excess zinc disrupts the anagen phase of the hair cycle and retards the re-growth of hair. This reflects that precise dosage and treatment duration of hair loss with zinc supplementation is imperative for desired outcomes.
How much zinc for hair loss and hair growth?
Zinc supplementation for hair loss disorders is a debatable topic. Different zinc oral supplementation have different effects on hair growth. Park et al. conducted a study to assess the effect of oral zinc gluconate on hair regrowth in patients suffering from alopecia areata.
Park et al. administered oral zinc gluconate supplementation of 50 mg/T/day to alopecia areata patients and recorded hair regrowth to assess the therapeutic effects of oral zinc gluconate. The patients were categorized into positive and negative response groups based on the serum zinc level in these individuals.
Improvement in serum zinc levels in these patients has a direct association with improved hair growth in patients belonging to the positive response growth. Serum zinc levels did not increase significantly in individuals that belong to the negative response group.
It also helps to take a supplement rich in hair vitamins that help in hair loss treatment and combat hair fall.
Natural and artificial sources of zinc
Following individuals are at an increased risk of developing a zinc deficiency state, thus, requiring adequate zinc supplementation.
- Pregnant women
- Lactating women
Dietary diversification strategies are a long-term approach to improving zinc levels in an individual. These dietary modification strategies include the following.
- Agricultural intervention includes processing to reduce zinc absorption inhibitors such as phytates.
- Promotion of animal-based foods that are rich in zinc. These include red meat, liver, milk, and cheese.
Zinc supplements are available as adjuvant therapy to overcome zinc deficiencies. Zinc sulfate, zinc gluconate, zinc pyrithione, and zinc acetate are widely used as supplements as they are absorbed more readily. Food fortification is another cost-effective and sustainable technique to restore zinc serum levels.
Zinc oxide and zinc sulfate are commonly used in food fortification. Bio-fortification is a modified form of food fortification that involves the genetic engineering of plants to reduce the levels of zinc inhibitors and increase the levels of zinc absorption enhancers.
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