Hair Loss

Loss of hair; Alopecia; Baldness; Scarring alopecia; Non-scarring alopecia

Hair loss is a common condition that can affect both men and women. It can occur gradually, resulting in thinning hair or patchy baldness. While losing approximately 100 hairs per day is normal, excessive hair loss may be a cause for concern. In this article, we will explore the various causes of hair loss and discuss potential treatments. It’s important to note that hair loss can be a result of multiple factors, including heredity, physical or emotional stress, and certain medical conditions.

Heredity: As individuals age, it is common for both men and women to experience hair thinning and a decrease in hair volume. This type of hair loss is often associated with aging, heredity, and hormonal changes, particularly related to testosterone. Male pattern baldness, which can occur after puberty, affects a larger percentage of men than women. By the age of 70, approximately 80% of men show signs of male pattern baldness.

Physical or Emotional Stress: Significant physical or emotional stress can lead to a type of hair loss known as telogen effluvium. During this condition, around half to three-quarters of the scalp hair may shed. Hair tends to fall out in large quantities when shampooing, combing, or simply running hands through the hair. This shedding may not be noticeable until several weeks or months after the stressful event. Typically, hair loss decreases within 6 to 8 months. Telogen effluvium is usually temporary but can become chronic in some cases.

The causes of telogen effluvium include:

High fever or severe infection

Childbirth

Major surgery, illness, or sudden blood loss

Severe emotional stress

Crash diets with insufficient protein

Medications, such as retinoids, birth control pills, beta-blockers, certain antidepressants, and NSAIDs

In some women between the ages of 30 and 60, hair thinning affecting the entire scalp may occur. The hair loss may initially be more severe but gradually slow down or stop. The cause of this type of telogen effluvium is unknown.

Other Causes: Hair loss can also be attributed to various other factors, especially when it follows an unusual pattern. Some of these causes include:

Alopecia areata, characterized by bald patches on the scalp, beard, and eyebrows, with possible eyelash loss

Anemia

Autoimmune conditions like lupus

Burns

Certain infectious diseases, such as syphilis

Excessive shampooing and blow-drying

Hormonal changes

Thyroid disorders

Nervous habits like hair pulling or scalp rubbing

Radiation therapy

Tinea capitis (ringworm of the scalp)

Tumors of the ovaries or adrenal glands

Hairstyles that place excessive tension on the hair follicles

Bacterial infections of the scalp

Home Care: Hair loss associated with menopause or childbirth often resolves within 6 months to 2 years. In cases where hair loss is due to illness, radiation therapy, medication use, or other causes, treatment is generally unnecessary. Hair typically regrows once the underlying condition ends or the therapy is completed. Wearing a wig, hat, or other head covering may be a temporary solution until the hair grows back.

Hair weaves, hair pieces, or changes in hairstyle can help disguise hair loss and are often the least expensive and safest approach. It’s important to avoid suturing (sewing) hairpieces to the scalp to prevent scarring and infection.

When to Seek Medical Attention: Contact a healthcare professional if you experience the following:

Hair loss in an unusual pattern

Rapid hair loss or hair loss at an early age (e.g., teens or twenties)

Pain or itching accompanying hair loss

Abnormal scalp skin, such as redness, scaliness, or other irregularities

Development of acne, facial hair, or irregular menstrual cycles

Female experiencing male pattern baldness

Bald spots on the beard or eyebrows

Weight gain, muscle weakness, intolerance to cold temperatures, or fatigue

Presence of scalp infections

Medical Evaluation: If you seek medical attention for hair loss, your healthcare provider will conduct a thorough medical history and examine your hair and scalp to determine the cause.

During the evaluation, your provider may inquire about:

Hair loss symptoms, including the pattern of hair loss and whether other family members are affected

Hair care practices, such as frequency of shampooing, blow-drying, and use of hair products

Emotional well-being and any physical or emotional stress you may be experiencing

Recent dietary changes

Past illnesses, high fever, or surgeries

While rare, additional tests that may be performed include:

Blood tests to rule out underlying diseases

Microscopic examination of a plucked hair

Scalp skin biopsy

If you are diagnosed with scalp ringworm, your healthcare provider may prescribe antifungal shampoo and oral medication. Creams and lotions may not effectively penetrate the hair follicles to eliminate the fungal infection.

Treatment Options: Based on the cause of hair loss, your provider may recommend different treatment approaches. For instance:

Minoxidil solution applied to the scalp may stimulate hair growth.

Hormones or other medications might be prescribed to reduce hair loss and promote regrowth. Finasteride and dutasteride are drugs commonly used by men to combat hair loss and stimulate new hair growth.

If a vitamin deficiency is identified, your provider may suggest supplements.

Hair transplant surgery may be recommended in certain cases.

In conclusion, hair loss can be distressing, but understanding its causes and seeking appropriate medical advice can help identify effective treatment options. It’s essential to consult with a healthcare professional to determine the underlying cause of hair loss and develop an individualized treatment plan.

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