Hair Loss in Singapore: Vitamin Shower Heads, Anti-Pollution Shampoo & Supplements

The other day, one of my friends turned to me with the question what to do about hair loss, as she experienced her hair had increasingly been getting thinner over the past few weeks. Mysterious hair loss in the tropics, happening to otherwise healthy women, is a classic “oh, didn’t you know?!”-story among expat women in Singapore. Rumor has it, that this has to do with the water. But does it?

Categorical experiences like these (the source is always ‘a friend of a friend’) are fervently shared as the unequivocal truth within our expat clans. The plotting tone used to pass this cautionary wisdom to Singapore-newbies is like a tribal rite to demonstrate  a courageous seniority; some respect please, for those of us who have stoutheartedly been withstanding the thug life of the tropics. Surviving the lawless slums of J-Burg is a piece of cake compared to the challenges expat women in Singapore face on a daily basis. Like, another favorite, the sudden and almost inevitable occurrence of “yellow-fever” that trample our Western men, preferably exemplified by the account of how someone’s neighbor’s friend’s tennis partner’s husband has left his dedicated wife for a dainty and docile Filipina half her age.

I must say I was flattered that my friend consulted me, of all people, confirming my position as beauty expert within our clan. Nice. I wish my advice could have been as easy as a miracle shampoo, but this case actually isn’t so easy. As I didn’t have an answer for her straight away, I promised to dive into the topic and see what I could find out, i.e. whether the much feared hair loss in the tropics is another suggestive tell-tale of expat wives or a genuine concern living Singapore.

What causes hair loss?

According to dermatologists worldwide, common causes of hair loss are aging, stress, hormonal change, diet, physical trauma (hairstyles like braiding but also tight pony tails), skin diseases, fungal infections, drug intake, systematic disease, medical treatment and damage by hair treatment (like bleaching and relaxing). Water composition isn’t mentioned specifically, but could however be underlying some of above mentioned causes like physical trauma.

So how does this relate to living Singapore? 

To start with, I think we can safely rule out aging, hormonal change, drug intake, systematic disease, medical treatment and hair treatment to be the cause of increased hair loss among expats living in Singapore. Stress, diet, physical trauma and fungal infections might be worth investigating in more detail...

Hair Loss Cause 1: Stress?

Do we experience more stress living in Singapore and is this the cause for hair loss? Moving to the other side of the world can cause some tension, especially when it’s one’s first time living abroad. And settling-in at a new place does take some time, even for the most experienced expats.

Amsterdam to Singapore (2015): Oh the stress of realizing you have to open a bottle of wine with a hammer + nail, because all your stuff is still somewhere in a container in the middle of the ocean...

The hair follicles in our scalp are either in a growing (80-90%) or resting (10-20%) phase. According to the Dermatological Society of Singapore, “physical or emotional stress can cause a proportion of these follicles to enter the resting phase prematurely and in synchrony. Following it’s normal course of about 3 months, the hairs are then shed simultaneously. Fairly large quantities of hair may be shed daily and this development takes place 2 to 3 months after the causative event.”

However, like many other women, my friend suffering from hair loss isn't new to Singapore anymore, in fact she has lived her for over 2 years now. Neither did she experience any stress-inducing major life changes recently, nor does she find life in Singapore particularly stressful. A quick round among my expat friends reveals the same; life in safe, meek Singapore is actually far less stressful for most of us, especially those (which are in fact many) who had a demanding job back home but aren't working in Singapore at the moment.

Expats in Singapore be like...

Of course it can be stressful from time to time, having to talk the unbearable Singlish with yet another taxi uncle, to endure the horrible durian stench, the 'be afraid of, well, everything' campaigns and not being able to find your favorite cheese in the supermarket, but come on ladies...first world problems, lah. So what else could be the cause?

Hair Loss Cause 2: Diet?

What comes to mind right away about our diet in Singapore, are the high levels of the commonly used seasoning ‘monosodium glutamate’ (MSG, E621, Ve-Tsin, Yeast Extract - and a lot of other sneaky names!). Mind you, MSG is not just used in local dishes at hawker centers but can be found in a lot of sauces, condiments, canned food and salty snacks in supermarkets. Even 'Western' products.

Over the years, MSG has been blamed for many nasty side effects (the so called “Chinese Restaurant Syndrome”), such as headache, sweating, numbness, tingling or burning in the face, neck and other areas, nausea, insomnia and...hair loss. Although researchers haven’t been able to find definitive evidence of a link between MSG and these symptoms (The Straits Times speaks of a food myth when it comes to MSG and hair loss), they did conclude there was enough scientific evidence to that a small percentage of the population may respond badly to large doses of MSG, usually within an hour of exposure and with side effects not lasting any longer than 4-5 hours. Even though it doesn't seem the direct cause of hair loss, it's worth avoiding MSG for more than enough other reasons. Read more here.

Apart from what to avoid, is there anything our diets in Singapore could be short of? I personally eat less freshly baked bread and less fresh vegetables in Singapore than I would in Europe, because of the exorbitant prices as well as the lack of variety and quality. Listing "8 Dermatologists' tips for healthier hair" in The Huffington Post, Roopal V. Kundu MD, Associate Professor of Dermatology at Northwestern University’s Feinberg School of Medicine, stretches the importance of iron and protein for hair health. 

Other vitamins and nutrients to watch are vitamins B12, B9, and biotin (great in terms of hair strength and preventing breakage). If your diet doesn’t suffice (like when you’re a vegan or vegetarian), supplements are the to-go solution. There are lots of supplements available, especially marketed for healthy hair, skin and/or nails; which one to pick?

A quick round of research unveils that most all-round "Skin, Hair & Nails" supplements are mostly limited to Biotin and Vitamin C, whereas "Hair Growth / Anti Hair Loss" supplements seem more complete. So do check the exact nutritional contents before you buy a supplement! My personal pick would be RidgeCrest Herbals' Hair ReVive capsules, containing not only the nutrients we need for healthy hair (like B12 and biotin), but even the 'active' form of B12 (methylcobalamin - better absorbed and retained in higher amounts within your tissues, i.e. more effective) as opposed to the 'standard', synthetic form that is found in most supplements.

RidgeCrest Herbals' Hair ReVive, 120 capsules
Price: 51,25 SGD
Available online through iHerb

Hair Loss Cause 3: Environmental Factors?

The sun is Singapore is scorching hot and the air is horrendously humid. Yet when we're indoors, in the car or in public transportation, we're exposed to lots of dry air from blazing aircons. And then there's the yearly haze, the 'citylife' setting of Singapore and not to forget the high chlorine levels in tap water we use for showering. Could one or more of these factors be contributing to hair loss in the tropics?

A.) City Life & Pollution

It's becoming widely understood that pollution can do major damage to your skin, but most people don't realize that the same also goes for your scalp and hair. On Shape.com, Susanna Romano, partner and stylist at Salon AKS in New York City, explains that "particulate matter (minuscule bits of soot, dust, and other grime), smoke, and gaseous pollutants can all settle on both the hair and scalp, causing irritation and damage". As a result, problems ranging from dryness to breakage to an itchy scalp arise.

Researchers from the school of medicine at Queen Mary, University of London, found that men (women were not included in the study) living in polluted areas are more likely to go bald than those who enjoy a cleaner atmosphere. Pollution from the environment can get into the bloodstream and cause damage to the hair and follicles. Especially the fumes from car exhausts are a major factor in built up areas. Yikes.

The question that arises in order to regard pollution as a possible cause of increased hair loss in Singapore, is whether the air quality in Singapore is so much worse compared to countries we've been living in before. A recent WHO air quality model confirms that 92% of the world’s population lives in places where air quality levels exceed WHO limits. And that citizens in Africa, Asia and the Middle East are exposed to much higher levels of air pollutants that those in living other parts of the world. It's therefore safe to say that if you moved from to Singapore from the Nordics, Australia or the US, you do find yourself in worse air quality than you did before.

Now what to do? As with skincare, several hair care brands offer a specialized care against the degenerating effects of pollution. I've personally been a big fan of Aveda for many years now, for their amazing botanically-based products and large emphasize on environmental responsibility. I would recommend any of their products to anyone anytime, but now that they have special pramāsana™ purifying scalp system- "treat your scalp like skin - because it is", in case of hair loss, I would definitely try these products.

You apply the purifying scalp cleanser before you shampoo to remove buildup from pollution, sweat, styling products and more. Like a detox for your scalp, it deeply, yet gently cleanses and purifies the scalp to help instantly balance sebum levels, while it exfoliates and removes pollution – creating a clean scalp foundation for beautiful hair. In addition to the scalp cleanser, there is protective scalp concentrate and an exfoliating scalp brush, making up the pramāsana™ purifying scalp system.

Aveda Pramāsana™ Purifying Scalp Cleanser, 150ml - 60 SGD
Aveda Pramāsana™ Protective Scalp Concentrate, 75ml - 83 SGD
Aveda Pramāsana™ Exfoliating Scalp Brush - 46 SGD

Available at Aveda Boutiques in Ngee Ann City, Capitol Piazza, Tang's Orchard and Changi Terminal 2 at The Shilla.

Another brand that I would recommend would be Shu Uemura. Their Urban Moisture Collection for normal to dry hair adds intense nourishment and hydration while offering protection against urban aggressors, such as dust, pollution, and hard water. Hair is left soft and supple with a natural glow.

Shue Uemura Urban Moisture Hydro-nourishing Shampoo, 300ml  - around 70 SGD
Shue Uemura Urban Moisture Hydro-nourishing Conditioner, 250ml - around 82 SGD
Shue Uemura Urban Moisture Hydro-nourishing Deep Treatment Masque, 200ml - around 95 SGD
Shue Uemura Urban Moisture Hydro-nourishing Double Serum, 100ml - around 55 SGD

Available sparsely in Singapore, as far as I could find at Next Hair Salon in ION Orchard and at The Shoppes at Marina Bay Sands, #B1-149. There are quite a lot of Shu Uemura cosmetics stores in SG, but these don't sell the Art of Hair line unfortunately.

Anyway, now that we're talking about water anyway, how about the tap water in Singapore? On expat fora, (the chlorine levels in) the Singaporean tap water is blamed for our hair loss...

B.) Chlorine Levels in Tap Water

As said, among expat women, the common claim is that hair loss experienced in Singapore is due to ‘something’ in the Singaporean water. On expat forums, shower filters with Vitamin C are recommended as the go-to solution. These shower heads, like the popular SONAKI  Vitamin C Shower Head With Water Filter (available through a.o. Lazada, between 20-80 SGD), promote better skin and hair by reducing exposure to chlorine:

“Vitamin C has been widely used in commercial applications for neutralizing chlorine and chloramines in tap water and has been recognized as playing an important role in the appearance of firm and youthful-looking skin.”

Sonaki Vitamin C Shower Head

Sounds plausible, but does exposure to chlorine lead to hair loss indeed? Chlorine does a great job of eliminating germs and bacteria, but it does take its toll on our hair as well. Whereas some research claims that chlorine, as a corrosive agent, eats away not only the germs in water but the living tissue in hair follicles as well, other research suggest that chlorine makes hair appear coarse and damaged, but doesn't lead to higher rates of hair loss. Do note that research on this topic mostly relates to chlorine in swimming pools.

Another important question is whether the Singaporean water is richer in chlorine than water in other countries, which would explain our exposure to higher levels of chlorine than we're used to. Singapore’s National Water Agency states that “Singapore’s tap water is well within the World Health Organisation drinking water guidelines, and is suitable for drinking without any further filtration".

But what about exposure to skin and hair? I personally wash my hair more often in Singapore than I did back home in Europe because of the amounts I sweat here, which makes my scalp more itchy. According to Blondal, a company producing water filtration systems, “the World Health Organization (WHO) recommends a chlorine level of 0.2 ppm (Points Per Million) for drinkable water. The water in Singapore contains an average of 3.0 ppm which is 15 times higher than WHO recommends". However, a company selling water filters in Singapore might not be the most objective source. According to a somewhat more objective source, the Straits Times, in 2016, “chlorine levels in all the waterworks in Singapore ranged from 2.04 to 2.98mg per litre, well within the WHO’s limits of 5mg per litre.”

Still, this is a higher chlorine level than found in many expats’ countries of origin; In Western Australia, normal chlorine concentrations in scheme drinking water supplies usually range from 0.5 to 1.5 milligrams per litre. And in Europe, various alternative disinfectants for drinking water disinfection are used instead of chlorine, however the practice is not homogeneous. France, for example, mainly uses ozone. Italy and Germany use ozone or chlorine dioxide as primary oxidant and disinfectant. In most southern European countries (e.g., Italy, Spain, and Greece) and the United Kingdom (UK), chlorine is added for residual disinfection. The UK is one of few European countries that use chloramines for residual disinfection in the distribution network and for the lowering of DBPs (Spain also uses chloramines for disinfection occasionally). The Netherlands and Germany don’t use chlorine or chloramine at all.

It would be highly interesting to check whether expat women who previously lived in countries with low or non-existent levels of chlorine and chloramine (like the Netherlands and Germany) suffer from more hair loss while living Singapore versus women who’ve been exposed to tap water with chlorine and chloramine on a more or less daily basis before.

As said, one of the solutions to get rid of chlorine in tap water could be the use of a (Vitamin C) shower head filter, for which I've heard raving results. However, if you have a rain shower, like my friend, a shower head like this won't be possible. A DIY solution could be worth a try by using a 1,5 L bottle of mineral water to rinse the tap water out of your hair at the end of your shower. Imagine showering with Evian, that would confirm all preconceptions about us spoiled expat women...well, we'd be in good company because Serena Williams apparently has a unique ability to tell the difference between the feel of regular bathwater and Evian water.

No hair loss for Serena Williams! (Photo: Business Wire)

Evian or not, do be sure to use ‘spring’ water, as this must have come out of the ground ready to drink, instead of water with a label that simply says ‘bottled water’. The latter can come straight from the mains, in facts around a third of bottled water sold in supermarkets is nothing more than re-processed tap water.

C.) Humidity

In the tropics, we all curse humidity because of our the frizz it causes, but might there be a correlation with hair loss as well? Some rounds of research learn that in India, there is actually a condition called Monsoon Hair, which is the direct effect of humidity. Even global brand Dove pays attention to it locally:

"Let the melody of monsoon play on your mind, not it’s menace on your hair. This high-on-humidity weather is the main reason behind hair fall. Hair’s chemical structure makes it unusually sensitive to airborne hydrogen. In this weather, your hair absorbs hydrogen, forming bonds, and swells until the smooth cuticle erupts to make them frizzy. But, you can take care of your hair by doing some simple and small everyday things, which we otherwise ignore." 

How? Well, by using Dove products of course. A closer look upon an Dove India ad campaign however unveils that the hair fall experienced in the monsoon season is due to mere breakage of the hair:

Another Indian source, on men's grooming, mentions the following about monsoon hair: "monsoon humidity leaves hair worn out, lifeless and brittle; as a result, men lose clumps of hair during this season. Another reason that adds to the issue is the presence of environmental pollutants in rainwater that culminates in fungal infection on scalp that weakens roots and causes hair fall". Fungal infections, now that's an interesting lead! 

Fungi are single celled or multinucleate organisms that decompose and absorb the organic material in which they grow, like our scalp. They include yeasts, mushrooms, molds, smuts, rusts and mildews, and thrive best under moist condition. Humidity directly wets the hair, but heath and humidity also cause us to sweat more, which wets our scalp and hair indirectly as well. We all know that feeling of wet patches of sweat, especially in the hairline in our neck; upon arrival in Singapore, I was convinced I could never ever get used to sweaty hair sticking behind my ears and in my neck, but I've mastered the art of ignorance toward tropical sweat after more than 2 years. 

Interestingly enough, according to the greatly informative US website www.hairlossrevolution.com, in most cases fungal infections do not directly cause hair loss: it is the itching and irritation that may tend to force you to scratch you hair. Hair infection by fungal agents is known as trichomycosis and diagnosis should involve a dermatologist, as it's difficult to confirm a particular infection by just physical inspection. Treatment often involves special shampoos containing zinc pyrithione and selenium sulfide. In addition, it's advised to remove any yeasty foods like bread, alcohol and mushrooms from your diet. Apart from diet, there are quite some other DIY solutions that might help getting rid of the infection, like applying tea tree oil to the scalp. 

D.) Sun and Aircon

Sun and Aircon make your hair dry and brittle, causing it to break. It can therefore SEEM like you're losing a lot of here, where in fact it's 'just' breaking off. It can therefore be regarded as more of a physical trauma to the hair than a cause for hair loss from the roots... 

Hair Loss Cause 4: Physical Trauma?

Ehhh I’m guilty of this one myself, inflicting physical trauma i.e. breakage and damage to my tresses. Due to increased sweating caused by the humid tropical weather, I wash and straighten my hair more often than I would back in Europe. We all know straightening irons make our hair brittle an break off easily, yet I still prefer smooth, sleek and shiny hair over a frizzy bunch of hay on my head.

What to do? Dry your hair completely before using a flat iron; if your hair is still wet, the heat from the iron can make the water in your hair boil, damaging your hair. Furthermore, never skip the use of a heat protecting product. I've tried tons of different products over the years (I have been using a flat iron since 2004...) and absolutely love Redken's Heat Protection line, in particular "Fabricate 03" as is it doesn't make my hair heavy.

Can't live without: Redken's Heat Protection line

In addition, treat your tresses with a nourishing, restoring mask at least once a week. My favorite: Kerastase Masque Elixir Ultime (200ml, 73,80 SGD - available at selected hair salons only).

Read my full review of this and other favorite hair masks here!

That leaves us to hairstyles in which the hair is braided, twisted or tied tightly, which are another problem causing trauma to the hair. They do not only break the hair but also put a great deal of strain on the hair follicle. Under prolonged strain, hairs become detached and the follicle may not recover, with permanent hair loss at the affected sites. So best to avoid these do's while living in Singapore.

Conclusion?

In conclusion, there are various factors that could contribute to the often heard of expat problem of increased hair loss in Singapore; from air pollution to fungal infections due to humidity. It's hard to say what exactly causes hair loss in Singapore, as this probably differs per person and might be caused by a delicate interplay between factors as well. On the bright side, there are quite some feasible remedies to try to see what works for you. And in case you find the miracle solution, do keep me posted. Good luck!