Hair Loss: Causes and Treatments
People who notice hair falling out, thinning, or appearing in large amounts on their comb or brush should consult a dermatologist. With correct diagnosis, many people with hair loss can be helped.
A Water’s Edge Dermatology practitioner will evaluate a patient’s hair-loss problem to find the cause so they can determine if the problem will resolve on its own or whether medical treatment is needed.
Normal Hair Growth
When a hair is shed, a new hair from the same follicle replaces it and the growing cycle starts again. Scalp hair grows about one-half inch per month, but as people age their rate of hair growth slows. Most hair shedding is due to the normal hair cycle, and losing 50 to 100 hairs per day is expected and is no cause for alarm.
Hair Loss in Women
Hair loss is a common problem for women, which can be distressing. Hereditary hair loss is a medical condition that affects about 30 million American women. In quality-of-life studies, women with hair loss reported a higher incidence of feelings that interfered with their daily lives — including a significant loss of self-esteem, being introverted, feeling less attractive, and tense feelings in public places.
Hair Loss in Men
Hereditary hair loss is a medical condition that affects about 50 million American men. Hair loss can be inherited from either the mother’s or father’s side of the family. A man has a 50 percent chance of experiencing hair loss by his 50th birthday. This hereditary condition, clinically termed androgenetic alopecia, is characterized by a receding hairline, as well as a loss of hair on top of the scalp.
Causes of Excessive Hair Loss
Excess hair loss can have many different causes. If hair loss begins suddenly, illness, nutrition, medication, or pregnancy might be the cause. The cause also could be a genetic syndrome or hormone-related disorder. The pattern of hair thinning (localized or diffused) can determine the reason for hair loss.
Hair will regrow spontaneously in some forms of hair loss. Other forms can be treated successfully by a dermatologist. For the several forms of hair loss for which there is no cure at present, there is research in progress that holds promise for the future. Talk to your Water’s Edge Dermatology practitioner about the best options for you.
Improper Chemical Treatments
Many men and women use chemical treatments on their hair, including dyes, tints, bleaches, straighteners, and permanent waves. These treatments rarely damage hair if they are done correctly. However, the hair can become weak and break if any of these chemicals are used too often. If hair becomes brittle from chemical treatments, it is best to stop until the hair grows out.
Hereditary Thinning or Balding
Also known as androgenetic alopecia, this is the most common cause of hair loss and can be inherited from either the mother’s or father’s side of the family. Women with this trait develop thinning hair, but do not become completely bald. Hereditary hair loss can start in one’s teens, 20s, or 30s. While there is no cure, medical treatments are available that may help some people, including:
- Minoxodil, a lotion usually applied to the scalp twice a day, which can be used by men and women
- Finasteride, an oral prescription medication used by men only that blocks the formation of the active male hormone in the hair follicle
The cause of alopecia areata is unknown, but it is thought to be an autoimmune condition (the body makes antibodies to its own hair) that may affect children or adults of any age. The affected persons are generally in excellent health.
This type of hair loss usually causes totally smooth, round patches about the size of a coin or larger. Although rare, it can result in complete loss of scalp and body hair. In most cases the hair regrows; however, dermatologists treat many people with this condition in order to make hair regrow faster.
Treatment may include:
- Cortisone injections in the scalp where the hair loss occurred
- Topical medications
- A special kind of light treatment
- Oral medications
Illness, stress, and other factors can cause too many hairs to enter the resting (telogen) phase of the hair growth cycle, causing an increase in the amount of hair shed (effluvium), usually without bald patches. In many cases, telogen effluvium typically resolves in a few months on its own.
Causes of telogen effluvium include:
- High Fever, Severe Infection, Severe Flu
- Major Surgery/Chronic Illness
- Thyroid Disease
- Inadequate Protein in Diet
- Low Serum Iron
- Birth Control Pills
- Cancer Treatments
Tinea Capitis (Scalp Ringworm)
Caused by a fungal infection, tinea capitis is characterized by patches of scaling that can spread and result in broken hair, redness, swelling, and even oozing on the scalp. This contagious disease is most common in children, and oral medication will cure it.
Trichotillomania (Hair Pulling)
Children, and sometimes adults, will twist or pull their hair, brows, or lashes until they come out. This is often just a bad habit that improves when the harmful effects of that habit are explained. Sometimes hair pulling can be a coping response to unpleasant stresses and occasionally is a sign of a serious psychological problem.
Cicatricial (Scarring) Alopecia
This rare disorder can cause patchy hair loss and associated itching and/or pain. Inflammation around the hair follicle causes damage, scarring, and permanent hair loss in the affected area. The cause or trigger of cicatricial alopecia is unknown. Treatment focuses on stopping the spread of inflammation.
Diagnosing the Cause of Hair Loss
To properly diagnose the cause of hair loss, a dermatologist will ask the patient for a detailed history. This includes medications, allergies, family history, and diet, and for women, their record of menstruation, pregnancy, and menopause.
A thorough examination of the hair also will take place. This typically involves a detailed inspection of the hair and scalp. Hair distribution over the rest of the body also will be assessed to see if there is too little or too much hair in other areas. Scalp biopsies can be used to make or confirm a diagnosis of hair loss and can be essential in guiding therapy.
Hair Loss Treatments
- Topical minoxidil has been shown to help in the regrowth of hair or to help slow hair loss.
- Topical or injectable cortisone medications have been shown to accelerate regrowth of hair for certain conditions.
- Hair transplantation is another treatment option that offers a permanent form of hair replacement using dermatologic surgery to move some existing scalp hair to bald or thinning areas.
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