Hair loss, also known as alopecia, is a common concern that can affect anyone, impacting not just the scalp but sometimes the entire body. It can be a temporary setback or a more permanent change, stemming from various factors like heredity, hormonal shifts, medical conditions, or simply the natural process of aging. While hair loss can happen to anyone, it’s often more noticeable and prevalent in men.
The term “baldness” usually refers to significant hair loss specifically from the scalp. The most frequent culprit behind baldness is hereditary hair loss associated with aging. How individuals cope with hair loss varies greatly. Some choose to embrace it, letting nature take its course without intervention. Others might prefer to conceal it using different hairstyles, makeup, hats, or scarves. Alternatively, there are various treatments available for those who wish to prevent further hair loss or encourage regrowth.
If you’re considering treatment for hair loss, it’s crucial to first understand what’s causing it. Consulting with your doctor is a vital first step to explore the reasons behind your hair loss and discuss suitable treatment options tailored to your situation.
Symptoms of Hair Loss: Recognizing the Signs
Hair loss presents itself in many forms, influenced by the underlying cause. It can appear suddenly or gradually, affecting just your scalp or extending to the entire body. Recognizing the patterns and symptoms is the first step in understanding why you might be experiencing excessive hair loss.
Gradual Thinning on Top of the Head
This is perhaps the most widespread type of hair loss, becoming more common as people age.
In men, this often manifests as male-pattern baldness, where the hairline progressively recedes from the forehead, forming an “M” shape. Thinning may also occur at the crown of the head.
Female-pattern baldness, on the other hand, typically involves a broadening of the hair part and overall thinning of the hair, especially on the top-central portion of the scalp. Interestingly, a receding hairline, known as frontal fibrosing alopecia, is also increasingly observed in older women.
Circular or Patchy Bald Spots
Some people experience hair loss in distinct circular or patchy bald spots. This can occur on the scalp, beard area, or even eyebrows.
This type of hair loss, known as alopecia areata, often starts suddenly and can be characterized by one or more circular bald patches that may even overlap. Before the hair falls out, some individuals might notice itching or pain in the affected area.
Sudden Loosening of Hair
Experiencing a physical or emotional shock can sometimes lead to a sudden shedding of hair. This type of hair loss can be quite dramatic, with handfuls of hair coming out during combing, washing, or even with gentle touch. While alarming, this type of hair loss is usually temporary and results in overall hair thinning rather than bald patches.
Full-Body Hair Loss
Certain medical conditions and treatments can cause hair loss all over the body. A well-known example is chemotherapy for cancer treatment. This can lead to the loss of hair across the entire body. However, in most cases, hair will regrow once the treatment is completed.
Patches of Scaling That Spread Over the Scalp
Scaly patches spreading across the scalp are a key indicator of ringworm, a fungal infection. This condition can cause hair loss, often accompanied by broken hair, redness, swelling, and sometimes even oozing from the scalp.
Traction Alopecia from Hairstyling
Certain hairstyles that repeatedly pull on the hair, such as tight pigtails, braids, cornrows, or the use of tight hair rollers, can lead to traction alopecia. This type of hair loss is caused by the constant tension on the hair follicles.
Frontal Fibrosing Alopecia and Receding Hairline
Frontal fibrosing alopecia is characterized by a receding hairline, primarily affecting older women. The exact cause remains unknown, but early treatment is important to potentially prevent significant and permanent baldness in the affected area.
When to Consult a Doctor About Hair Loss
It’s important to know when hair loss warrants a visit to the doctor. If you are bothered or distressed by persistent hair loss, either in yourself or your child, and are considering treatment, seeking medical advice is recommended. For women noticing a receding hairline (frontal fibrosing alopecia), early consultation with a doctor is particularly crucial to discuss potential treatments to minimize permanent hair loss.
Furthermore, you should consult your doctor if you experience sudden or patchy hair loss, or if you observe more hair loss than usual when combing or washing your or your child’s hair. Sudden hair loss can sometimes be a symptom of an underlying medical condition that requires diagnosis and treatment.
Unpacking the Causes: Why Are You Losing Hair?
It’s normal to lose between 50 to 100 hairs each day. This amount of shedding is usually unnoticeable because new hair growth keeps pace with the loss. Hair loss becomes apparent when this balance is disrupted – when new hair growth doesn’t replace the hair that has fallen out. Several factors can contribute to this imbalance, leading to excessive hair loss:
-
Family History (Heredity): The most common cause of significant hair loss is a hereditary condition, often occurring with aging. This is known as androgenic alopecia, encompassing male-pattern baldness and female-pattern baldness. It follows predictable patterns: receding hairline and bald spots in men, and overall thinning at the crown in women.
-
Hormonal Changes and Medical Conditions: Various conditions can trigger temporary or permanent hair loss. These include hormonal fluctuations during pregnancy, childbirth, menopause, and thyroid problems. Medical conditions like alopecia areata (an autoimmune condition causing patchy hair loss), scalp infections such as ringworm, and trichotillomania (a hair-pulling disorder) are also significant causes.
-
Medications and Supplements: Hair loss can be a side effect of certain medications. Drugs used for treating conditions like cancer, arthritis, depression, heart problems, gout, and high blood pressure are among those that can contribute to hair loss.
-
Radiation Therapy to the Head: Radiation treatment to the head can result in hair loss. In some cases, the hair may not grow back to its original density or texture.
-
A Very Stressful Event: Experiencing a significant physical or emotional shock can lead to a noticeable thinning of hair. This type of hair loss often becomes apparent several months after the stressful event and is typically temporary.
-
Hairstyles and Treatments: As mentioned earlier, hairstyles that put excessive tension on the hair can cause traction alopecia. Additionally, harsh hair treatments such as hot-oil treatments and permanents can damage hair follicles and lead to hair loss. If scarring occurs as a result of these treatments, the hair loss can be permanent.
Risk Factors That Increase Hair Loss
Several factors can elevate your risk of experiencing hair loss:
- Family history of baldness: Having a family history of balding, from either your mother’s or father’s side of the family, increases your predisposition.
- Age: The likelihood of hair loss increases as you age.
- Significant weight loss: Experiencing substantial weight loss can sometimes trigger hair loss.
- Certain medical conditions: Conditions like diabetes and lupus are associated with an increased risk of hair loss.
- Stress: High levels of stress can contribute to hair loss.
- Poor nutrition: Nutritional deficiencies can also play a role in hair health and loss.
Prevention Strategies for Hair Loss
While most baldness due to genetics (male-pattern and female-pattern baldness) isn’t preventable, you can take steps to prevent other types of hair loss:
- Be Gentle with Your Hair: Use a detangler when washing your hair and avoid harsh pulling when brushing or combing, especially when your hair is wet and more vulnerable. A wide-toothed comb can be gentler and help prevent hair from being pulled out. Limit the use of harsh treatments like hot rollers, curling irons, hot-oil treatments, and permanents. Also, reduce tension from hairstyles that use rubber bands, barrettes, and tight braids.
- Review Medications and Supplements: Discuss with your doctor any medications and supplements you are taking, as some may have hair loss as a side effect. Your doctor might be able to suggest alternatives.
- Protect Your Hair from UV Light: Shield your hair from excessive sunlight and other sources of ultraviolet light, as overexposure can damage hair.
- Stop Smoking: Studies have indicated a link between smoking and baldness, particularly in men. Quitting smoking is beneficial for overall health and may help reduce hair loss.
- Consider a Cooling Cap During Chemotherapy: If you are undergoing chemotherapy, ask your doctor about cooling caps. These caps can help reduce hair loss during chemotherapy treatments by cooling the scalp and reducing blood flow to hair follicles.
By understanding the potential causes and risk factors, and by taking preventive measures where possible, you can be proactive in managing your hair health. If you are concerned about excessive hair loss, consulting with a healthcare professional is always the best course of action to determine the cause and explore appropriate solutions.
References
- AskMayoExpert. Alopecia. Mayo Clinic; 2019.
- Malki L, et al. Variant PAD13 in central centrifugal cicatricial alopecia. New England Journal of Medicine. 2019; doi:10.1056/NEJMoa1816614.
- Briggs JK. Hair loss. Triage Protocols for Aging Adults. Waloters Kluwer; 2019.
- Warner KJ. Allscripts EPSi. Mayo Clinic, Nov. 25, 2019.
- Office of Patient Education. Hair replacement surgery. Mayo Clinic; 2017.
- Hair loss. American Academy of Dermatology. https://www.aad.org/public/diseases/hair-loss/treatment/causes/fall-out. Accessed Jan. 31, 2020.
- Hair loss. American Cancer Society. https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/hair-loss.html. Accessed Jan. 2, 2020.
- Van Zuuren EJ, et al. Interventions for female pattern hair loss. JAMA Dermatology. 2017; doi:10.1001/jamadermatol.2016.5790.
- Shapiro J, et al. Evaluation and diagnosis of hair loss. https://www.uptodate.com/contents/search. Accessed Jan. 2, 2020.
- Shapiro J, et al. Alopecia areata: Clinical manifestations and diagnosis. https://www.uptodate.com/contents/search. Accessed Jan. 2, 2020.
- Hereditary hair loss. Mayo Clinic Health Letter. 2016;4:1.
- Cold caps and scalp cooling systems. https://www.breastcancer.org/tips/hair_skin_nails/cold-caps. Accessed Jan. 31, 2020.
- Mirmirati P. Age-related hair changes in men: Mechanisms and management of alopecia and graying. Maturitas. 2015; doi.10.1016/j.maturitas.2014.10.008.
- Chemotherapy and you: Support for people with cancer. National Cancer Institute. https://www.cancer.gov/publications/patient-education/chemotherapy-and-you.pdf. Accessed Feb. 3, 2020.
- Shapiro J. Lichen planopilaris. https://www.uptodate.com/contents/search. Accessed March 26, 2020.
- Gibson LE (expert opinion). Mayo Clinic. March 26, 2020.
