Ask An Expert: Anabel Kingsley, Trichologist

Trichologist Anabel Kingsley shares her expertise on menopausal hair loss and gives her top product recommendations

Brand President and Consultant Trichologist at Philip Kingsley, Anabel Kingsley is a world authority on scalp health and hair. With clinics in London and New York and an award-winning range of hair care products, she understands exactly how to care for midlife hair.

For Anabel, hair is the family business. In the 1950s, her father, the late Philip Kingsley, founded his namesake clinic and tended to the locks of clients such as Audrey Hepburn, who famously inspired the brand’s signature Elasticizer Deep-Conditioning Treatment. The product has since become a favourite among celebrities and industry-experts alike, from Cate Blanchett and Kate Winslet to Tricho-Derm Dr Sharon Wong.  

In 2016, following the death of her father, Anabel, by then an experienced Consultant Trichologist, took the reins at the brand and now leads its Trichological Clinics. She is well-versed in matters of female hair loss, both from a professional perspective but also a personal one. Having contracted ulcerative colitis in her twenties, from time to time her hair falls out, so she knows intimately the emotional distress that can occur from hair loss. 

Alongside her work at Philip Kingsley, Anabel has contributed articles on hair and scalp health to publications ranging from Harper’s Bazaar to Huffington Post. She has also lent her expertise to the leading cancer charity Look Good Feel Better, contributing to their Guide to Managing Hair Loss during and after cancer treatment.

Here, Anabel explains the changes your hair goes through during the menopause, recommends products and shares her suggestions on ways to keep your hair healthy and strong.

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What are the hormonal changes affecting hair in the perimenopause and menopause years?

Menopause causes oestrogen levels to decrease. Oestrogen is a hair-friendly hormone, helping to keep your hair in its anagen (growth) phase for longer. During menopause, oestrogen levels drop, meaning the anagen (growth) phase can become shorter. As the hormonal balance is disrupted by less oestrogen protection, hair follicles can become more sensitive to the male hormone (dihydrotestosterone) which starts to shrink the follicle. Subsequently each hair produced from the shrinking follicle is finer than the last.

What are the most common symptoms?

Hair can break more easily. This is because the new hairs that your follicles produce become gradually finer, and finer hair is naturally more fragile. Therefore, it is increasingly important when reaching menopause that women seek products to strengthen and protect the hair against mechanical or chemical damage that can cause further weakening. 

If you have a genetic predisposition for hair loss you are more prone to hair thinning, this is because the drop in oestrogen levels around menopause means that you have a higher ratio of testosterone in your body, allowing it to have a stronger negative affect on your hair follicles. In women whose hair follicles are sensitive to DHT (dihydrotestosterone), hair thinning during menopause is often more pronounced.

READ MORE: What are the 34 symptoms of menopause?

Is this a time of life when a woman should review the products she is using on her hair and scalp?

The best treatments for menopausal hair thinning address the hormonal sensitivity that is present in the hair follicles. This usually involves a combination of hair follicle stimulants such as minoxidil and methyl nicotinate, stress management (stress can raise androgen levels in your body) and scalp drops containing hormones. 

At the Philip Kingsley Trichological Clinic in Mayfair London, their expert Trichologists formulate prescription-only scalp drops, containing a combination of anti-androgenic hormones, as well as a follicle stimulant. In most cases, Philip Kingsley’s clients using these drops will see an improvement in their hair density within 3-6 months.

Do symptoms improve as women move from perimenopause into menopause, or are the hormonal changes permanent?

Fortunately, as the hair cells adapt to the hormonal changes, the shedding decreases and normalises and the condition of the hair improves.  However, the natural process of ageing can bring about a very gradual permanent change in hair diameter and hair density.

What are the key product ingredients to help with symptoms, and how does each ingredient work?

Ingredients that can help to optimize the scalp environment to encourage and support healthy hair growth are:

  • Menthol: a stimulant
  • Piroctone Olamine: an antimicrobial that helps to clear flaking and itching
  • Methyl nicotinate: a vasodilator that can also help to aid in the effectiveness of other ingredients
  • A combination of Zinc Sulphate, Vitamin B6 and Azelaic Acid: Combined in topical drops they can help to block the conversion of testosterone to the more damaging dihydrotestosterone. (Tricho 7 stimulating Scalp Drops – these also contain piroctone olamine and methyl nicotinate)
  • Betaine salicylate or salicylic acid: exfoliants that can be formulated into scalp masks to gently remove dead-skin cells

READ MORE: Rosie Green’s favourite products for thinning hair

Do you have any favourite products that you recommend to perimenopausal women?

Our hair tends to become dryer as we get older. This can cause it to break and fray, so using light, moisturizing products is very important. My Clinic Clients love our Tricho Pro Protein Spray – a thickening spray enriched with plant proteins. It immediately adds bulk to your mid-lengths and ends, and also hydrates and strengthens.

Don’t underestimate the impact that a good volumising product can have. They can immediately camouflage hair thinning and boost your morale and confidence. Many of my clients use our Maximizer Root Boosting Spray. Many also use hair fibers. Toppik and Nanogen are good brands.

Finer hair is more fragile, and therefore prone to breakage. Use a weekly pre-shampoo conditioning treatment to add elasticity and strength to your hair. I love our Elasticizer, originally formulated for Audrey Hepburn. Because it’s a pre-shampoo treatment, it will not weigh your hair down. You leave it on your strands for long enough to penetrate (20 minutes to an hour) and then shampoo away any excess residue.

How should you change your hair care routine in the perimenopausal years?

Remember scalp health is vital to the health of the hair, making exfoliating scalp masks a beneficial part of any hair and scalp care routine. Scalp exfoliators gently remove dead skin cells – and this is important, as a flaky scalp is known to worsen hair shedding in certain individuals. Depending on what is in the mask, they may also moisturize and soothe the scalp to prevent itching and irritation.

Got a perimenopause or menopause question?

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What is your own hair care routine and the products you use?

A good rule of thumb is to care for your hair and scalp in a similar way to the skin on your face. You take them to the same places and they are subject to the same environmental assaults i.e. wind, UV rays, dirt and pollutants. ‘Scalp’ is really the operative word here. Being the environment from which hair grows, it is here where the optimization of strands begins.

I cleanse and moisturize frequently (daily if possible) with a shampoo and conditioner formulated for my hair texture and its unique needs. If you do not shampoo regularly, excess oils, sweat, bacteria, flakes and dirt simply sit and build-up on the scalp – and this can adversely impact hair follicle function. Shampooing also helps to return moisture to strands and aids in light reflection. I use a scalp toner post-shampoo to tone and hydrate the scalp. Applying an exfoliating scalp mask once a week to soothe the scalp and gently lift away dead skin cells.

READ MORE: What is The Difference Between Perimenopause And Menopause?

I also use an intensive pre-shampoo conditioning treatment once a week to improve the elasticity, strength, moisture content and shine of strands. If your hair is very damaged or dry, use this twice weekly. 

Every two weeks, I use a detoxifying hair and scalp treatment, our newly-launched anti-oxidant rich detoxifying Vitamin C Jelly. It removes impurities, pollution and hard water mineral build-up for weightless, radiant, bouncy hair. It also gives your scalp a thorough cleanse and helps to counteract free radical damage. Vitamin C Jelly’s acidic nature means it can dissolve away any accumulation of residue both on and below the hair’s cuticle.

Can HRT help with perimenopausal hair loss or hair thinning symptoms?

Certain HRTs can help prevent or improve hair density changes. Others have no impact, or can actually be detrimental. Speak to your doctor about any hair loss concerns you have so they can point you in the right direction.

Are there any supplements that can help with the symptoms?

I recommend our PK4 Soya Protein Boost. These contain all essential amino acids (proteins your body cannot make on its own) needed for hair growth.

READ MORE: 10 of the best menopause supplements

Any lifestyle/diet changes that can help with perimenopausal hair changes?

Your hair depends on what you eat in order to grow. So the backbone of any good hair care regime is a healthy, balanced and varied diet. One reason for this is that hair is non-essential tissue – so your body will never prioritise its nutritional requirements. Ironically, hair cells are also the second fastest growing cells the body produces. In other words, they’re very needy! This means that even tiny deficiencies can cause hair loss, long before they impact your general health.

To ensure that your hair is getting the nutrients it needs, eat a fresh, varied diet rich in protein, vitamin B12, zinc, iron, and complex carbohydrates. Also, don’t leave long periods (more than 4 hours) between meals or snacks. Proteins are the building blocks of your hair, so it’s especially important to get enough on a daily basis.

As told to Alex Peters

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