Environmental factors affecting hair loss

Environmental Factors Affecting Hair Loss in Desert Climates



Chapter 1     Introduction
Chapter 2     Hair Facts
Chapter 3     Hair Science
                             The Structure of the Hair
                             The Phases of Hair Growth
Chapter 4     Universal Causes of Hair Loss
Chapter 5     Environmental Factors Affecting Hair Loss
                             Hair in Desert Climates
                             Desalinated Water
                             Silica in the Air
Chapter 6     Understanding How Water Affects Hair
                             Ground Water
                             Surface Water
                             Countries Using the Largest Quantities of Desalinated Water
                             Understanding the Effects of Distillation on Water
                             Water and the Hydrological Cycle
                             Water Stability
Chapter 7     Summary

Most adults will suffer from hair loss at some point in their lives and few retain a full head of hair into old age.
It is also not commonly realised that women are affected by hair loss as often as men but they rarely lose all their hair.
The causes of hair loss are both clinical and environmental, and the reasons are not always fully understood. Some causes of hair loss we do understand, and there is continuing research into the subject.

Hair is a genuine individual and an individual cannot be summed up in a few figures.
That being said, vital statistics can sometimes be useful.

  •  Hair is the fastest growing tissue in the body, second only to bone marrow
  • The speed at which hair grows is 1cm per month. This corresponds to a daily growth rate in excess of 0.3 mm per day
  •  There are 100,000 hairs on the average adult head
  •  Hair grows faster in the summer, during sleep and between the ages of 16 and 24
  •  Between the ages of 40 and 50 women tend to lose about 20 percent of their hair
  •  Healthy hair is highly elastic and can stretch 20 or 30 percent before snapping
  •   A human hair is stronger than copper wire of the same thickness
  •  Hair has a natural cycle, growing resting and shedding

The Structure of the Hair
Hair consists of three layers:- Cuticle, Cortex and MedullaCuticle

  • This is the outside protective layer of the hair shafts.
  • When the hair shaft becomes damaged the scales no longer lie flat – instead they protrude at acute angles.
  • The hair then becomes porous, brittle and loses its shine.


  • This is mainly composed of the protein Keratin and provides strength and elasticity to the hair shaft.
  • It is also responsible for the colour, pigmentation, shape and texture of hair.


  • This is the innermost core of each hair.
  • It is formed of round cells in a honeycomb formation, which gives the hair its structure.

There are two main parts to the hair system:-
The Root and the Hair Shaft


  • Every single hair has its own Follicle and Papilla.
  • The hair Follicle is in a tiny tubular indentation in the skin, which holds the bulb. When old hair leaves the follicle without depositing new cells, it will not be replaced, and a thinning or balding process begins.
  • The Dermal Papilla is a small clump of tissues at the base of the follicle. It is the entry point for micro blood vessels, which provide nutrients for the growth of hair.
  • The Hair Bulb lies just above the Papilla. The Papilla signals the hair bulb to migrate cells downward into the Papilla, promoting cell division and is responsible for hair growth (cell reproduction).
  • The Sebaceous Gland is attached to each hair follicle and produces an oily substance called Sebum, the hair’s essential lubricant oil. It is also a waste product containing acids and other chemicals that can be damaging to the hair and scalp if a clean healthy scalp is not maintained.


  • The Internal Root Sheath can be divided into three layers the cuticle, Huxley layer and Henle layer. The inner root sheath stops at the level of the sebaceous gland to leave only the hair cortex and surrounding cuticle to protrude above the epidermis.
  • The External Root Sheath is distinct from other epidermal components of the hair follicle being continuous with the epidermis. The “bulge” region in the outer root sheath is the site at which the erector pili muscle is attached.

The Phases of Hair Growth
Hair growth is at its most productive cycle between puberty and the mid-twenties. As we grow more mature the growth cycle gradually slows down.
The cycle passes through 3 distinctive phases and then, in normal circumstances after a short unproductive period repeats over again.
The three phases of the hair growth life cycle:
Anagen or growth phase
Catogen or intermediate phase
Telogen or resting phase
Hair Fallout is perfectly normal. The typical adult loses about 70-100 hairs a day from the scalp and over 50% of scalp hairs must be lost before hair loss is apparent. Hair usually grows back unless certain factors conspire to shut down the hair follicle thus severely affecting healthy hair regeneration.
90% of scalp hairs are growing and 10% are resting at any one time.
There are many factors that can contribute to hair loss. Some are well-known, others less so.
Hair is the fastest growing tissue in the body and second only to bone marrow. Poor diet and nutrition can not only slow the growth rate of the body’s hair, but can actually cause it to fall out.

  • Hair loss can often occur in people who do not follow a sufficiently varied diet, or eat too much junk food.
  • Zinc deficiency is responsible for variety of diseases, degenerative diseases and illnesses including hair loss.
  • Vegetarians, if they neglect to consume sufficient protein, can suffer excessive hair loss, especially when they first switch to a meat-free diet. When vegetarians increase the amount of non-animal protein (soy products, for instance) in their diets, hair loss stops and often reverses itself.
  • Dieters who restrict calories can also experience hair loss. Hair loss in women is often associated with crash dieting.
  • Deficiencies in iron, zinc, B vitamins and vitamin C can all lead to hair loss.
  • Drug users, bulimics, and anorexics frequently experience hair loss in the more serious stages of their condition, and it is because they do not maintain a proper intake of vitamins and nutrients

Male Pattern Baldness
The most common form or hair loss in men is (MPH) or Androgenic Alopecia. Androgenic Alopecia is the most common cause of thinning and premature baldness. This condition is partly genetic and partly hormonal. Genetics play a large role in hair loss. In fact, researchers have actually identified a gene associated with hair loss.
Over 50% of men by age 50 have male pattern hair loss.
Men find this condition very distressing and will often come to their Doctor seeking a solution.  Treatment should start early to prevent further hair loss however in some cases this is not entirely preventable. A lot can be done to prevent further hair loss especially if treatment is started early.

Female Pattern Baldness
Not as well known but just as distressing is female pattern baldness, marked by a moderate loss of hair on the crown of the head or at the hairline. It is rare for women to develop completely bald areas as men often do. Women lose hair for many reasons, including hormonal, anaemia, prolonged emotional stress and thyroid problems.

Scarring Alopecia
Can occur after infectious scalp disorder or, more rarely, they are auto-immune conditions.

Alopecia Areata
An autoimmune disorder, which causes hair to fall out in random patches around the scalp. Cells in the immune system attack the hair follicles and inhibit them from producing hair. Sometimes this occurs very unexpectedly and can cause a burning or tingling sensation. In serious cases the entire body may experience hair loss, including eyebrows and facial hair.

Telogen Effluvium
A form of non-scarring alopecia can occur after such major traumas such as prolonged high fevers, or illnesses or after sudden hormonal changes, particularly in new mothers and during the menopause.

A common scaling skin disease. Most psoriasis sufferers will develop psoriasis of the scalp at some time, and the condition is both distressing and cosmetically disfiguring.

A parasitic skin infection cased by a fungus. It can be disfiguring and often causes hair loss.

Thyroid Disorder
Hair problems including decreased manageability may rarely be one of the first signs of thyroid undersecretion. The hair loss, if any, will be diffuse, and the condition can therefore be confused with several other conditions.

Iron Deficiency
More and more cases of diffuse hair loss in women are attributed to iron deficiency. This is more common among vegetarians and those with eating disorders.

Seborrhoeaic Eczema
An inherited, itchy, inflammatory, scaling scalp condition which can cause much discomfort and embarrassment. The condition is treatable, with much success, but is not wholly curable.

Pityriasis Amiantacea

A heavy scaling condition that can cause patchy hair loss. Prompt treatment can remove scaling and stop progression of associated hair loss.

Contact Dermatitis
A scalp condition affecting areas of the scalp in contact with a chemical irritant. Symptoms can range from a mild scaling and irritation to violent allergic reaction. Trichological treatment is very effective.

A pustular condition mostly affecting young black men. It can lead to permanent hair loss and even to Keloids.

Sebum Build-up
Sebum is an oily waste by-product that consists of fatty acids that are potentially damaging to the hair and scalp because of its acidic nature. Dandruff, scalp irritations and poor hair condition can be the result of sebum problems. When sebum is discharged in above normal amounts, it tends to accumulate in the hair follicles where it attracts bacteria and fungus. If this condition is not rectified it may cause detrimental effects such as the weakening of hair shafts and irritation of particular scalp areas and can cause hair loss.

After the mid-twenties the hair follicles and scalp receive less nourishment. A gradual decline begins, as the hair becomes weaker, thinner, duller and more prone to damage. Both men’s and women’s hair lose about 5% of its thickness from age 20-50 and another 15% from 50-80. But increase in age does not mean having to resign to ever diminishing hair. Boosting nutrients and vitamins can have a dramatic effect on hair loss.

Chemicals and Trauma
Aggressive cleansing agents, mechanical damage (blow drying, perming), excessive use of colouring agents, sprays and styling aids, and polymers that coat the hair and scalp contribute to hair loss. Traction and using excessive heat on the hair can cause hair to break off.


Hair can fall for many reasons. Illnesses and certain drugs can cause hair to fall out. Thyroid imbalance can also be a cause for hair loss.

Stress and emotional strains of living in today’s modern complex world. Such conditions affect the vascular system thus reducing the amount of oxygen and nutrients reaching the hair cells. In effect stress can cause the scalp to tighten. The body shuts down production of hair during periods of stress Exercise is very important to combat stress and scalp massage not only reduces stress but helps the blood flow to the hair follicles and encourages growth. Patients should be actively looking into ways of reducing anxiety.

Drugs and Certain Medications
Some medications are a cause of hair loss. The best known examples are the medications used in cancer chemotherapy. These medications target rapidly growing cells in the body, which means the cancer cells but unfortunately also includes the hair cells as well. Anti-depressants, amphetamines, hormones, anticoagulants and drug prescriptions for heart disease and high blood pressure can affect the hair’s growth cycle in some cases.

Prolonged exposure to the sun dries out the hair and disrupts the cells of the cuticle causing the hair, if untreated, to become brittle and prone to breakage. This is an easily avoidable cause of hair loss.

In desert climates (including the southern United States, Africa, the Middle East and Australia), sunheatdust and the use of desalinated water and air conditioning, all contribute to additional causes for non-clinical hair loss.

Hair in Desert Climates
In desert climates hair loss is a common complaint effecting both men and women from all nationalities and age groups.

Doctors and hairdressers are used to complaints about falling hair. Women panic when they see vast amounts of hair on the shower floor and want to know the cause. Hairdressers report that it is almost the first thing women want to discuss when they sit down in the hairdresser’s chair. Expatriates and particularly Asian women notice an increase in hair loss when moving to the Middle East.

In a study[i] of 61 expatriate men and women in the United Arab Emirates having varied hair types (Afro, Asian, Caucasian), 68% displayed natural hair fall and 32% displayed topical hair fall to hair breakage above the external root sheath and epidermis.
There are special environmental factors in the Gulf that affect hair:-

Desalinated Water
The main source of tap water in many arid countriesis desalinated water. Desalination is the removal of salt from seawater to produce drinking water. Over 70% of the water in the United Arab Emirates is desalinated water[ii].

Whilst desalinated water is considered safe to drink, it causes many problems for hair, scalp and skin. A common complaint in the Arabian Gulf from both men and women is the loss of hair. New arrivals in Arabian Gulf countries frequently complain of unusual hair loss within 3 – 4 months of arrival. Dry skin, hair and scalp, hair loss, brittle hair and split ends are common, mainly due to desalinated water and to the use of chlorine.

General Relative Occurrence of Elements in Desalinated Water[iii]

Moderate to High ppm Sodium Chlorine Calcium Magnesium
Low ppm/ppb Zinc Copper Iron Selenium Fluorine
Low ppm/ppb Phosphorus Potassium Boron Molybdenum Iodine Chromium

How desalinated water affects the hair:

  • Desalinated water dries the hair and makes it brittle and break[iv]
  • Desalinated water can cause harmful scalp build-up[v] that leads to hair breaking off above the external root sheath
  • Chlorine in desalinated water can cause hair to become brittle and break

So what is frequently perceived as hair loss is in fact hair breaking off at the root.

How calcium affects hair[vi]:
Calcium leaves the hair feeling dry and weighted down. It can even cause a perm to appear relaxed

  • Calcium builds up on the scalp causing flaking of the scalp, giving the appearance of dandruff
  • Calcium can choke the hair at the mouth of the follicle causing the hair to break off, then coating the scalp, blocking further new hair growth


What other elements in water effect hair?

  • Chlorine – a harsh oxidiser added to the water to kill bacteria also adversely effects hair. Any build up at the mouth of the follicle may cause the hair to break off, then coating the scalp, and blocking further new hair growth.

Chlorine is not a mineral but an oxidizer. Chlorine is put into drinking water and swimming pools to kill bacteria. In addition to the following effects chlorine has on hair, due to its oxidizing effects, chlorine also oxidizes minerals onto the hair causing worse effects of those minerals.

How chlorine affects hair[vii][viii]:

  • Active chlorine in the hair can cause hair to feel gummy when wet and straw-like when dry.
  • Chlorine can damage the cuticle and proteins of the hair.
  • As an oxidizer, chlorine can cause the air and sun to oxidize hair and worsen the conditions listed above.
  • Chlorine can cause hair to feel dry.
  • Chlorine can cause hair to become brittle.
  • Chlorine can cause hair to lack shine.

How do minerals and chlorine attach to the hair?
The hair, scalp and skin have an electrical charge and that charge is negative. Minerals and oxidisers are charged positive. When a positively charged mineral comes in contact with our hair, scalp, or skin, it attaches on like a magnet.

The hot desert sun dries out and fades the hair and long term exposure will turn the hair brittle and cause it to break off. Without sun protection the scalp can experience sun damage. A desert climate can have special hazards that attribute to the loss of hair and faster ageing. This is especially noticeable in Europeans who do not cover up in the sun and engage in sun bathing. Their skin becomes prematurely lined and thin. Gulf climate ruins the complexion. Women in the Gulf age faster than those of the same age in other parts of the worlds.

Fresh food and vegetables have often travelled thousands of kilometers to reach the Arabian Gulf and their nutritional value will have been depleted. It is generally advisable to take a good quality multivitamin in order to make sure the body gets an optimum supply of vitamins and nutrients.

Silica in the Air
Silica is a sand-like substance found in desert or volcanic areas. It is usually bound to calcium or magnesium and forms very hard, virtually insoluble deposits.

How silica affects hair:
Silica causes many of the same effects on the hair as calcium[ix].

  • Silica causes hair to feel dry
  • Silica weighs hair down
  • Silica can cause dandruff-like symptoms of flaking
  • Build up of silica can choke the hair follicle causing hair to fall out

Air-conditioned atmosphere is very drying and this takes away the moisture from the hair, which is extremely damaging.  The hair is also constantly exposed to extremes; hot conditions outdoors and very cool air indoors.

The water used to wash hair, scalp, and skin comes from one of two sources:

  • Ground Water
  • Surface Water

Ground Water
If the water comes from the ground, it is either from a well or from the local treatment plant that derives the water from wells pumping water from the ground. The source of ground water is from rain passing through aquifers, which are layers of minerals. The acidity (pH below 7) of the rain increases the dissolving effect of minerals. These dissolved solids are found in the water when pumped above the ground and used to bathe.

Surface Water
If the water comes from a treatment plant, which derives the water from a surface source, the water is coming from either a river or a lake or the sea (desalinated water source). Surface water usually contains fewer minerals because the water has not filtered down through the mineral layers. However, increasing populations are polluting the water causing additional bacteria growth. As a result, the treatment plants must add more chlorine to kill bacteria and then add lime (a calcium compound) to help control the chlorine levels.
The principal methods used[x] for desalination include distillation (or evaporation), electro dialysis, freezing, ion exchange, and reverse osmosisDistillation is the most common desalination method used in the Gulf countries.

Countries using the largest quantities of desalinated water and treated wastewater[xi]

Country Use of non conventional sources of water
desalinated water
as % of total withdr. as % of withdrawal of country treated wastewater
as % of total withdr. as % of withdrawal of country total non- conventional 10m³/yr as % of total withdr. as % of withdrawal of country
Saudi Arabia 714 41.3 4.20 217 18.1 1.28 931 31.8 5.48
United Arab Emirates 385 22.3 18.26 108 9.0 5.12 493 16.8 23.38
Kuwait 231 13.4 42.94 52 4.3 9.67 283 9.7 52.61
Syria 370 30.8 2.57 370 12.6 2.57
Egypt 25 1.5 0.05 200 16.7 0.36 225 7.7 0.41
Other 24 countries 372 21.5 0.09 253 21.1 0.06 625 21.4 0.15
Total Near East 727 100.0 0.34 1 200 100.0 0.23 2 927 100.0 0.57

The total use of desalinated water in the Near East is estimated at 1,727 million m³/year. In absolute terms, three countries, Saudi Arabia, the United Arab Emirates and Kuwait, are by far the largest users of desalinated water with 77% of the total for the region, with Saudi Arabia alone accounting for 41% .

Understanding the effects of distillation on water
Distillation consists of boiling the water and then allowing the steam to condense. This is a fairly natural process, as it is what occurs during evaporation. All solid matter is left behind, except chemicals that volatilise at a lower temperature than the water. Some distillers have methods to capture these substances to prevent them from remaining in the water. Distillation is probably the best treatment of water to remove pathogens, metals, chemicals and heavy water molecules. Evaporating the water does not significantly damage the spin, moment, weight and some other subtle qualities of the water.

In the Middle East and North Africa, it has become fairly common for dual-purpose facilities to produce both electricity and water, termed Cogeneration. The main advantage being that a combined facility can consume less fuel than would be needed by two separate facilities.
Distillation, however, produces more acid water. It also creates “hungry” water. If it is devoid of minerals, the water tends to pick up whatever minerals it touches. Also, distilled water lacks nutrient minerals. Many people today are deficient in trace elements. Distilled water will tend to attract many minerals to itself and some will be excreted with the urine. There should however be no mineral deficiencies provided a healthy diet is followed. However, sodium can be detected in most water supplies, sometimes in surprisingly high concentrations. In cities such as Jeddah, Saudi Arabia, that depend entirely on desalinated seawater the salinity of the drinking water is quite noticeable to the visitor.

Distilled water is water which has been heated to the boiling point (212 degrees Fahrenheit or 100 degrees Centigrade) and converted to steam. The steam is then cooled and condensed back into liquid form as pure water. Distillation kills biological contaminants such as bacteria, parasites, cysts, and viruses, and removes organic and inorganic chemicals, heavy metals, volatile gases, and other contaminants. The water produced is pure and contains no solids, minerals, or trace elements. Steam distillation is the only water purification method that removes virtually all contaminants.

Zoltan P. Rona MD MSc[xii] observed the health effects of drinking different types of water for over 19 years and claimed that “drinking distilled water on a regular, daily basis is potentially dangerous.” Dr. Masaru Emoto[xiii], Doctor of Alternative Medicine and Japanese water researcher also performed extensive research on distilled water by studying the crystallization processes and found that “water that had been distilled, polluted or passed through consumption had lost its inner order. This leads to the realization that natural healthy water carries an ‘inner order’ defining its nature and properties.”

The problem is that both Distillation and Reverse-Osmosis cannot distinguish between harmful impurities such as lead and copper and dissolved minerals like Calcium and Magnesium. It is only in the past few years that researchers have found more evidence that natural dissolved minerals are essential to health and their absence may lead to certain health problems.

Some of the water concerns[xiv] raised by WHO researchers and scientists include:

  1. When used for cooking, soft water was found to cause substantial losses of all essential elements from food (vegetables, meat, cereals). Such losses may reach up to 60 % for magnesium and calcium or even more for some other microelements (e.g., copper 66 %, manganese 70 %, cobalt 86 %).
  2. Possible increased dietary intake of toxic metalsLow-mineral water is unstable and therefore, highly aggressive to materials with which it comes into contact. Such water readily dissolves metals and organic substances from pipes, coatings, storage tanks hose lines and fittings and can be tough on hair.

To appreciate water’s role in these health problems we need to understand water and its natural cycle.

Water and the Hydrological Cycle[xv]
Apart from rainwater (created by a distillation process) and ice, pure water cannot be found nature outside of laboratory conditions. In the natural cycle, rainwater falls to the ground and penetrates the soil collecting minerals as it makes its way down to the water table or aquifer.

After many years, sometimes thousands, water makes its way back up through natural fissures in the earth, collecting yet more minerals on its way back up. It then reappears on the surface as a natural spring.

This is why most spring water is considered healthy and ideal to drink – its natural cycle is complete.

Water Stability[xvi]
Water also has “calcium saturation index”, known as the Langelier Index[xvii] that shows how stable water is in relation to the chemicals and minerals in its immediate environment. Water naturally seeks balance or neutral index.

  • If water has a strongly positive reading (hard water – lots of minerals) it will tend to precipitate dissolved minerals. E.g., hard water (strongly positive index) deposits scale in pipes or hot water heaters.

Water with a strongly negative reading (soft water – no minerals) is aggressive and prone to dissolve minerals and metals from its immediate environment.

The same pure de-mineralised water that leaches minerals from concrete pipes is the same water that is leaching minerals from the hair and bones.

It is estimated that more than 7,500 desalination plants are in operation worldwide[xviii], of which 60% are located in the Middle East. Desalinated water at the moment serves the needs of about 100 million people worldwide.

Studies show that pure demineralised (desalinated) water causes an extra loss of sodium, chloride, potassium, magnesium and calcium ions from the body. Minerals in hard water stop it from leaching minerals out of the bones and they give it important ‘structural’ information. Studies also show that elements within desalinated water cause a range of damage to the hair shaft leading to hair breakage and excessive hair shedding.

If the diet consists of adequate whole foods and is high in fruits and vegetables, the impact will be less. Because minerals found in water are well absorbed and highly bio-available, even in minute quantities, they assist the body by providing basic building blocks of life.

The conclusion is that the extensive use of desalinated water can result in topical hair loss conditions unassociated with universal causes.

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[i] Donnelly HA., Carpenter A., Topical hair loss (UAE), 2005
[ii] Joseph A. Cotruvo B.Sc., Ph.D. Environmental Health Sciences at NSF International. World Health Organization Geneva, 2004
[iii] Joseph A. Cotruvo B.Sc., Ph.D. WHO Expert Workshop Report ‘Nutrients in Drinking Water’ Dec. 2005
[iv] Stroud JD. Hair-shaft anomalies. Dermatol Clin. 1987 Jul;5(3):581-94.
[v] Characterization of the cysteine-rich calcium-binding S100A3 protein from human hair cuticles. Kizawa. K., Biochem & Biophys Res Comm, Vol. 299, Issue 5, 20 December 2002
[vi] Feldmeyer L. et.al. Clinical variation in X-linked dominant chondrodysplasia punctata British Journal of Dermatology 154 (4) 766-769
[vii] Stroud JD. Hair-shaft anomalies. Dermatol Clin. 1987 Jul;5(3):581-94.
[viii] Pierard GE. [Structure and pathogenic interpretation. Acquired dystrophies of the hair]. Ann Dermatol Syphiligr (Paris). 1975;102(2):137-43.
[ix]Stroud JD. Hair-shaft anomalies. Dermatol Clin. 1987 Jul;5(3):581-94.
[x] World Health Organization Geneva, 2004 (In the Middle East, most desalted water is produced by distillation, which imitates the hydrological cycle. This means the salt water is heated so water vapour will form. This vapour eventually condenses when it is collected and cooled)
[xi] FAO (Food & Agriculture Organisation of the United Nations) Aquastat Report 2007
[xii] Dr. Zoltan P. Rona is a graduate of McGill University Medical School (1977) and has a Master’s Degree in Biochemistry and Clinical Nutrition from the University of Bridgeport in Connecticut (1985). He is the author of the Canadian bestsellers, “The Joy of Health” and “Return to the Joy of Health”. He is a consultant on nutritional medicine to the Motherisk Program of the Department of Pharmacology of the Toronto Hospital for Sick Children.
[xiii] Masaru Emoto is a graduate of Yokohama Municipal University, Doctor of Alternative Medicine from the Open International University for Alternative Medicine, President Emeritus of the International Water for Life Foundation.
[xiv] Water Technology News – April 2006
[xv] PhysicalGeography.com
[xvi] B. Oram, Wilkes University, Wilkes-Barr, PA
[xvii] Langelier Index – An index reflecting the equilibrium pH of a water with respect to calcium and alkalinity; used in stabilizing water to control both corrosion and scale deposition.
[xviii] World Health Organization Geneva, 2004

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