Hair loss, also known as alopecia, is a condition characterized by the loss of hair from the scalp or the entire body. It can occur in both men and women at some time in their lives. It is normal to lose between 50-100 hairs a day, out of approximately 100,000 hairs in your scalp. Once the old hairs are shed, they’re replaced with new hair. This is a part of the normal hair growth circle. Hair loss occurs when this cycle of hair growth is disrupted or when the hair follicle is destroyed and replaced with scar tissue.
What Causes Hair Loss?
The causes of hair loss can range from the simple and temporary, like a vitamin deficiency, to the more complex, like an underlying health condition. Here are some reasons why you might be seeing less hair on your scalp.
The most common cause of hair loss is hereditary male or female-pattern baldness. About 80 million people in the US have hereditary thinning or baldness. If you have a family history of baldness, you may have this type of hair loss. Pattern baldness is more common in men and can begin as early as puberty. This type of hair loss may involve both hair thinning and miniaturization.
Poor nutrition, such as protein, zinc, or iron deficiency, can cause you to experience hair loss. Because when these nutrients are not present in the body, it will increases the shedding of hair and slows the hair growth. Massive hair shedding can occur two to three months later. Hair can then be pulled out from the roots easily. Fortunately, this condition can be reversed by consuming adequate amounts of those nutrients. Find out the best foods to eat for healthy hair and scalp.
Hormonal changes due to pregnancy, menopause and thyroid problems, can also cause hair loss. The good news is that this kind of hair loss is temporary and resolves itself after the body has regained its equilibrium.
Prescription drugs that used treat cancer, arthritis, depression, as well as high blood pressure may cause temporary hair shedding in some people. Just like the hormone conditions, your hair should grow back once you stop taking any medication that causes hair loss.
Alopecia areata is an autoimmune disease where a person’s immune system attacks the body, in this case, the hair follicles. This causes smooth, round patches of hair loss on the scalp and other areas of the body. When the same process causes total loss of hair from the scalp, it is known as alopecia totalis.
Alopecia areata is an unpredictable disease. In some people, hair grows back but falls out again later. In others, hair grows back and remains. Each case is unique. Even if someone loses all of his or her hair, there is a chance that it will grow back.
Traction alopecia is a type of hair loss that is caused by a constant pulling on the hair. It is most commonly seen in women who wear weaves, tight braids and hair extensions. The good news about traction alopecia is that it is preventable in its earliest stages. The best prevention against traction alopecia is to avoid styles that place strain on the hair and scalp.
Symptoms of Hair Loss
The symptoms of hair loss vary depending on what causing it. It can be sudden or occur gradually. It may also only affect your scalp or your whole body.
Some types of hair loss are temporary while others like male or female pattern baldness are progressive and permanent. Some common symptoms of hair loss include:
- Thinning of hair
This is the most common symptom of hair loss. The hair thinning process may not accompany heavy hair fall but it is a slow pattern process where you would eventually lose hair more than normal hair loss. This happens gradually. You may not even be aware of it until you suddenly wake up one morning and realize that your hair is thinner than it was a few months ago.
- Patchy bald spots
Some people may experience smooth, coin-sized bald spots, usually on the scalp, but it may also occurs in eyebrows, beards or the genital area. In some cases, it may cause discomfort or itchiness before the hair falls out.
- Sudden hair loosening
Any physical or emotional stress can result in clumps of hair loosening and falling out when you comb, wash or even just gently tug your hair. This type of hair loss usually causes overall hair thinning and not bald patches.
- Scaly patches on the scalp
If you notice patches of scaling that spread over the scalp, you may have ringworm, a common fungal skin infection. Other ringworm symptoms include broken hair, itching, swelling, and redness.
- Full-body hair loss
Some invasive medical treatments like radiation or chemotherapy can result in the loss of hair all over your body. Hair usually grows back once you stop the treatments.
Diagnosis of Hair loss
To diagnose hair loss, a dermatologist will give you a physical exam, laboratory evaluation and ask about your medical history. The dermatologist also will carefully look at your scalp and hair. During an exam, the dermatologist may pull on your hair to get the necessary evidence.
Sometimes, the dermatologist may perform a scalp biopsy (removing a small piece of the scalp) to examine the hair roots. This can help determine whether an infection is causing hair loss or not. Occasionally, a blood test is necessary.
Treatment Options for Hair Loss
Treatment for hair loss will depend on the cause. Once the cause has been determined, the doctor will be able to recommend the right treatment for you. The main goals of hair loss treatment are to stop the progression of hair thinning and promote hair growth.
If you’re in the early stages of hair loss or have noticed signs of damage in your hair or scalp, you may be advised to make changes to your diet. Sometimes, biotin supplements will be prescribed to help strengthen your hair and stop hair loss.
In more severe cases, your doctor will prescribe specific medications for hair loss. Currently, there are two medications approved by the Food and Drug Administration (FDA) to treat hair loss.
- Minoxidil (Rogaine). Minoxidil is a topical treatment that is applied directly to the scalp and works by promoting hair growth and thickness. It may be used by men and women. It needs to be used twice daily for at least three to six months before you’ll notice anything.
The main side effect of minoxidil is possible irritation to the scalp. If you have a history of heart disease, consult with your doctor before starting this medication. You can buy minoxidil over the counter in lower concentration formulas, but a doctor can prescribe higher concentrations that may be more effective.
- Finasteride (Propecia). Finasteride is a prescription drug available only to men. It works by preventing testosterone being converted into dihydrotestosterone (DHT), a hormone which causes hair to fall out. Many men taking finasteride experience a slowing of hair loss, and some may show some new hair growth. You need to keep taking it to retain benefits.
It usually takes three to six months of continuously using finasteride before any effect is seen. The balding process usually resumes within 6 to 12 months if treatment is stopped.
Side effects for finasteride are uncommon. These include a loss of sex drive or erectile dysfunction (the inability to get or maintain an erection).
If your hair loss is caused by inflammation in your body, a dermatologist may inject a medicine called a corticosteroid into your scalp. This can help stop the inflammation that happens when a person has alopecia areata.
The injections are repeated every few weeks. Alopecia may return when the injections are stopped. Side effects of corticosteroid injections include pain at the injection site and thinning of your skin (atrophy).
You may also want to consider hair loss surgery if you have male-pattern or female-pattern baldness. However, surgery is sometimes suitable for a range of alopecia conditions. The success of hair loss surgery depends on the skill of the surgeon, as complications can arise.
Surgery for hair loss should only be considered after trying less invasive treatments. Surgical procedures to treat baldness are expensive and can be painful. Possible risks include infection and scarring.