What Is Hair Loss?
Academy of Dermatology (AAD) notes that 80 million men and women in America
have hereditary hair loss (alopecia). It can affect just the hair on your scalp
or your entire body. Although it’s more prevalent in older adults, excessive
hair loss can occur in children as well.
According to Kids Health, it’s
normal to lose between 50 and 100 hairs a day. With about 100,000 hairs on your
head, that small loss isn’t noticeable. New hair normally replaces the lost
hair, but this doesn’t always happen. Hair loss can develop gradually over
years or happen abruptly. Hair loss can be permanent or temporary.
It’s impossible to count
the amount of hair lost on a given day. You may be losing more hair than is
normal if you notice a large amount of hair in the drain after washing your
hair or clumps of hair in your brush. You might also notice thinning patches of
hair or baldness.
If you notice that you’re losing more hair than usual, you should
discuss the problem with your doctor. They can determine the underlying cause
of your hair loss and suggest appropriate treatment plans.
What Causes Hair Loss?
First, your doctor or dermatologist (a doctor who specializes in
skin problems) will try to determine the underlying cause of your hair loss.
The most common cause of hair loss is hereditary male- or female-pattern
baldness. If you have a family history of baldness, you may have this type of
hair loss. Certain sex hormones can trigger hereditary hair loss. It may begin
as early as puberty.
In some cases, hair loss may occur with a simple halt in the
cycle of hair growth. Major illnesses, surgeries, or traumatic events can
trigger hair loss. However, your hair will usually start growing back without
Hormonal changes associated with pregnancy, childbirth,
discontinuing the use of birth control pills, and menopause can cause temporary
Medical conditions that can cause hair loss include thyroid
disease, alopecia areata (an autoimmune disease that attacks hair follicles),
and scalp infections like ringworm. Diseases that cause scarring, such as
lichen planus and some types of lupus, can result in permanent hair loss
because of the scarring.
Hair loss can also be due to medications used to treat cancer,
high blood pressure, arthritis, depression, and heart problems.
A physical or emotional shock may trigger noticeable hair loss.
Examples of this type of shock include a death in the family, extreme weight
loss, or a high fever. People with trichotillomania (hair-pulling disorder)
have a compulsion to pull out their hair, usually from their head, eyebrows, or
eyelashes. Traction hair loss can be due to hairstyles that put pressure on the
follicles by pulling the hair back very tightly.
A diet lacking in protein,
iron, and other nutrients can lead to thinning hair.
How Is Hair Loss Diagnosed?
Persistent hair loss often
indicates an underlying health issue. Your doctor or dermatologist can
determine the cause of your hair loss based on a physical examination and your
health history. In some cases, simple dietary changes can help, along with
switching prescription medications.
If your dermatologist
suspects an autoimmune or skin disease, they might take a biopsy of the skin on
your scalp. This will involve carefully removing a small section of skin for
laboratory testing. It’s important to keep in mind that hair growth is a
complex process, so it may take time to determine the exact cause of your hair
What Are the Treatment Options for Hair
Medications will likely be the first course of treatment for hair
loss. Over-the-counter medications generally consist of topical creams and gels
that you apply directly to the scalp. The most common products contain an
ingredient called minoxidil
(Rogaine). According to the AAD, your
doctor may recommend minoxidil in conjunction with other hair loss treatments.
Side effects of minoxidil include scalp irritation and hair growth in adjacent
areas, such as your forehead or face.
Prescription medications may also treat hair loss. Doctors
prescribe the oral medication finasteride (Propecia) for male-pattern baldness. You take this
medication daily to slow hair loss. Some men experience new hair growth when
taking finasteride. Rare side effects of this medication include diminished sex
drive and impaired sexual function. There may be a link between use of
finasteride and a fast-growing type of prostate cancer.
Doctor also prescribe corticosteroids
Individuals with alopecia areata can use this to reduce inflammation and
suppress the immune system. Corticosteroids mimic the hormones made by your
adrenal glands. A high amount of corticosteroid in the body reduces
inflammation and suppresses the immune system.
You should monitor side
effects from these medications carefully. Possible side effects include:
- glaucoma, a collection of eye diseases that can result
in optic nerve damage and vision loss
- fluid retention and swelling in the lower legs
- higher blood pressure
- high blood sugar
There is evidence that corticosteroid use may also put you at
higher risk for the following conditions:
- calcium loss from bones, which may lead to
- thin skin and easy bruising
- sore throat
Sometimes, medications aren’t enough to stop hair loss. There are
surgical procedures to treat baldness.
Hair Transplant Surgery
Hair transplant surgery involves moving small plugs of skin, each
with a few hairs, to bald parts of your scalp. This works well for people with
inherited baldness since they typically lose hair on the top of the head.
Because that type of hair loss is progressive, you would need multiple
surgeries over time.
In a scalp reduction, a surgeon removes part of your scalp that
lacks hair. The surgeon then closes the area with a piece of your scalp that
has hair. Another option is a flap, in which your surgeon folds scalp that has
hair over a bald patch. This is a type of scalp reduction.Tissue expansion can
also cover bald spots. It requires two surgeries. In the first surgery, a
surgeon places a tissue expander under a part of the scalp that has hair and is
next to the bald spot. After several weeks, the expander causes the growth of
new skin cells. In the second surgery, your surgeon removes the expander and places
the new skin with hair over the bald spot.
These surgical remedies for baldness tend to be expensive, and they
carry risks. These include:
- patchy hair growth
- wide scars
Your graft might also not take, meaning that you would need to
repeat the surgery.
How Can I Prevent Hair Loss?
There are things you can
do to prevent further hair loss. Don’t wear tight hairstyles like braids,
ponytails, or buns that put too much pressure on your hair. Over time, those
styles permanently damage your hair follicles. Try not to pull, twist, or rub your
hair. Make sure you have a balanced diet, and that you’re getting adequate
amounts of iron and protein.
Certain beauty regimens can actually worsen or cause hair loss.
If you’re currently losing hair, use a gentle baby shampoo to wash your hair.
Unless you have extremely oily hair, consider washing your hair only every
other day. Always pat the hair dry and avoid rubbing your hair.
Styling products and tools are also common culprits in hair loss.
Examples of products or tools that can affect hair loss are blow dryers, heated
combs, hair straighteners, coloring products, bleaching agents, perms, and relaxers.
If you decide to style your hair with heated tools, only do so
when your hair is damp or dry. Also, use the lowest settings possible.
What Is the Long-Term Outlook?
You can stop or even reverse hair loss with aggressive treatment,
especially if it’s due to an underlying medical condition. Hereditary hair loss
may be more difficult to treat, but certain procedures such as hair transplants
can help reduce the appearance of baldness. Talk to your doctor to explore all
your options to lessen the effects of hair loss.