Hair Loss: Common Causes And Treatment
T. GRANT PHILLIPS, MD W. PAUL SLOMIANY, MD and ROBERT ALLISON, DO, Washington Health Systems Family Medicine Residency, Washington, Pennsylvania
Am Fam Physician. 2017 Sep 15 96:371-378.
Patient information: See related handout on hair loss.
Patients with hair loss will often consult their family physician first. Hair loss is not life threatening, but it is distressing and significantly affects the patient’s quality of life. The pattern of hair loss may be obvious, such as the bald patches that occur in alopecia areata, or more subtle, such as the diffuse hair loss that occurs in telogen effluvium. As with most conditions, the physician should begin the evaluation with a detailed history and physical examination. It is helpful to determine whether the hair loss is nonscarring , which is reversible, or scarring , which is permanent. Scarring alopecia is rare and has various etiologies, including autoimmune diseases such as discoid lupus erythematosus. If the follicular orifices are absent, the alopecia is probably scarring these patients should be referred to a dermatologist. This article will discuss approaches to nonscarring causes of alopecia.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Topical minoxidil is safe and effective for the treatment of androgenetic alopecia in women.
SORT: KEY RECOMMENDATIONS FOR PRACTICE
Topical minoxidil is safe and effective for the treatment of androgenetic alopecia in women.
What Specific Treatments Are There For Hair Loss In Women
Female hair loss treatments include
- minoxidil ,
- hair extensions, and
- weaves.
- Minoxidil is available over the counter and available in 2%, 4%, and 5% concentrations. It may be something of a nuisance to apply twice daily, but it has been shown to help conserve hair and may even grow some.
- Minoxidil tends to grow very fine small hairs wherever it is applied. It is important to avoid running the liquid onto the face or neck where it can also grow hair.
- It is marketed for women at the 2% concentration but may be used in higher strengths as directed by a doctor.
Approach To The Patient With Nonscarring Alopecia
The history and physical examination are often sufficient to determine a specific etiology for hair loss. It is convenient to divide the various causes into focal and diffuse etiologies, and proceed accordingly. Patchy hair loss is often due to alopecia areata, tinea capitis, and trichotillomania. Diffuse hair loss is commonly due to telogen or anagen effluvium. Androgenetic alopecia may be diffuse or in a specific pattern, and may progress to complete baldness.
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What Vitamins Cause Hair Loss
People often complain about the hair loss problem. They waste their time looking for the remedy desperately. Many factors lead to hair loss. A genetic, stressful environment, habits are the primary reasons for the shedding of the hairs. Besides them, vitamins also play a role in hair loss. Some minerals, iron, zinc, B12, D vitamins are the origin of the hair loss problem for some people. In the deficiency of vitamins, there may some difficulties in hair care thus, vitamins for hair loss are significant.
Heres How The Hair Growth Cycle Works:
Ok, its science-y but very cool, basically each hair follicle on our scalp undergoes three stages of a life cycle, explains Dr Wong.
AnagenThis is the active growing phase, which can last between 2-7 years during which the hair becomes longer and thicker.
CatagenAfter anagen, the hair follicle moves into the short transitional phase called catagen when the hair fibre stops growing, followed by the resting phase telogen which lasts around 3 months.
TelogenDuring telogen the old hair is gradually pushed up towards the skin surface before it is then shed naturally and replaced with a new emerging anagen hair.
On a typical head of hair each follicle is at a different stage at different times so you probably wont notice it happening. Very cool. This cycle continues repeatedly throughout our lifetime and each hair follicle is cycling independently of neighbouring follicles meaning that human hair growth is asynchronised, says Dr Wong.
Its important to note that hair loss is a very common problem for women much more so that people realise. “Research shows that at least 1 in 3 women will suffer from hair loss or reduced hair volume at some point in their lifetime,” says Anabel Kingsley. So, if you are losing strands, it’s important not to freak out, your mane willrecover. In the meantime, here’s everything you need to know…
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What Vitamin Deficiency Causes Hair Loss
Vitamin B12: B12 provides carrying oxygen for hair follicles. If it is got enough, then it leaves negative effects on the human body. B12 deficiency gives rise to hair loss to a large extent. You have a hair loss problem dependent on B12 deficiency, and you also feel tired or in depression. Maybe you experience forgetfulness, and you are susceptible to illnesses.
Omega 3: Omega 3 is forgotten by many, yet it is really useful for hair growth. Besides keeping the memory strong, it helps hair look bright. Omega 3 exists in fish oil. Thanks to it, people benefit from its nutritious trait. It makes thicker and brighter existing hair. If you have a hair loss problem, it also minimizes the shed of the hairs. At first, there may be inflammation in the hair follicles, which leads to hair loss. Omega 3 can solve this problem.
What Medications Can Cause Hair Loss 46 Known Drugs
Losing your hair or dealing with baldness can be incredibly frustrating.
As you age, it’s also not altogether unexpected: a majority of men will deal with hair loss sometime in their life due to natural causes, but it can be delayed — and hair restored — with proper hair loss treatment.
But medications for other conditions can also cause hair loss, and certain drugs can contribute not only to hair loss but excessive hair growth and changes in color and texture as well.
There’s good news though, as these changes in your hair are typically reversible once you stop taking the drug thats causing them. Here’s what you should know about medications and hair loss.
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What Are The Symptoms Of Alopecia Areata
Alopecia areata mostly affects hair, but in sometimes it can cause changes to the nails. People with the disease are usually healthy and have no other symptoms.
Hair Changes
Alopecia areata typically begins with sudden loss of round or oval patches of hair on the scalp, but any part of the body may be affected, such as the beard area in men, or the eyebrows or eyelashes.
After a bare patch develops, several possible things may happen:
- The hair grows back within a few months. It may look white or gray at first but may regain its natural color over time.
- More bare patches develop. Sometimes hair grows back in the first patch while new bare patches form.
- Small patches join to form larger ones.
- In rare cases, all body hair is lost.
In most cases, the hair regrows, but more hair loss may follow.
Nail Changes
Nail changes such as ridges and pits occur in some people, especially those who have hair loss over more parts of their body.
Pcos Can Be A Trigger
Polycystic ovary syndrome is a condition in women in which the body manufactures more androgens, or male hormones, than it normally should. It is a potential cause of hormonal hair loss in women. Women who suffer from this condition may grow facial hair and extra body hair. One of the other symptoms of this condition is thinning of hair on the head. Women affected with PCOS may also experience weight gain, acne, menstrual irregularities, ovulation problems, depression, and infertility. Hair thinning may be the only outward sign that a woman is suffering from this condition.
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Beware Of Big Promises
There are numerous devices and products that are marketed as effective hair loss treatments, but many of them do not work. Beware of all of the false advertising associated with these products. If a cure for hair loss in women sounds too good to be true, it probably is. Before-and-after pictures may have been doctored to be misleading. How do you know if a hair loss treatment really works? Ask your dermatologist about any treatment you are considering. Look on the FDA and Federal Trade Commission websites to search for approved medical devices and drugs.
The Thyroid Disease Connection
The thyroid is a butterfly-shaped gland that rests in the front base of the neck. It secretes thyroid hormones that are used by every cell in the body. There’s a connection between hair loss in women and thyroid disease. Imbalances in thyroid hormone levels are a common reason for hair loss in women. Too much thyroid hormone and too little thyroid hormone may both trigger hair loss. Other symptoms of hyperthyroidism include weight loss, rapid heart rate, inability to fall asleep or stay asleep, and anxiety. In addition to hair loss, hypothyroidism may be associated with weight gain, fatigue, feeling cold, slow heart rate, and constipation. Luckily, thyroid hormone imbalances are easily detectable with blood tests. Treatment helps alleviate symptoms, including hair loss.
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What Are The Common Causes Of Hair Loss In Women
What causes hair loss?
- Hair style: Your style of hair can cause hair loss when your hair is arranged in ways that pull on your roots, like tight ponytails, braids, or corn rows. This type of hair loss is called traction alopecia. If hair follicles are damaged, the loss can be permanent.
- Vitamin deficiency.
- Over processed scalp hair .
What causes anagen effluvium hair loss?
- Toxic substances, including chemotherapy, radiation therapy and some medications. These cause sudden hair loss that can occur anywhere on your body. It happens to hair in the growth stage. Sometimes, this type of hair loss can be permanent if your hair follicles are damaged.
What causes telogen effluvium hair loss?
- Extreme physical stress or shock to your body: This causes temporary hair loss. This category includes events like losing a lot of weight, surgery, anemia, illness and having a baby.
- Extreme emotional stress: mental illness, the death of a loved one, etc.
- An abnormal thyroid.
- Medications and supplements: blood pressure medicines, gout medicines and high doses of Vitamin A.
- Hormone changes caused by pregnancy, menopause or birth control pills.
What causes FPHL ?
- Genes: Your familys genes can cause thinning of hair along the top of your head.
- Aging: Hormone changes as you age can cause balding.
- Menopause: This type of hair loss often gets worse when estrogen is lost during menopause.
There are also some conditions that affect hair loss:
Female Pattern Hair Loss
In women, hair slowly thins all over the scalp, but the hairline usually doesnt recede. Many women experience this type of hair loss as a natural part of aging, although hair loss may begin any time after puberty. Female pattern hair loss can cause hair to thin dramatically, but only rarely does it lead to baldness.
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What Causes Hair Loss
First, your doctor or dermatologist 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 treatment.
Hormonal changes can cause temporary hair loss. Examples include:
- 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
- a high fever
People with trichotillomania have a need 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 also lead to thinning hair.
How To Diagnose Drug Induced Hair Loss
If you think that you may be experiencing hair loss as a result of a medication, you should speak with a healthcare professional, particularly the doctor that prescribed the suspect medication. Some of the early signs of excessive hair loss include an increased amount of hair on your pillow, more hair on your brush, and more hair in the shower drain.
Whenever a doctor is attempting to diagnose drug induced alopecia, they will take a complete medical history in order to account for the new medications, changes to doses, and family history of hair loss.
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You’ve Been Super Stressed Or Ill
Stress or illness can cause hair lossit’s a process known as telogen effluvium, or the excessive shedding of hair induced by stress, Michelle Henry, MD, a dermatologist based in New York, previously told Health.
“Our bodies perceive mental stress the same way it perceives physical stress, and any dramatic stressor on the body can cause hair growth to become arrested,” Dr. Henry said. “And when hair growth is arrested, it sheds.” Specifically, when the body is stressed it released the hormone cortisol, which can then affect the hair follicle and result in shedding or hair loss. That shedding typically occurs at least three months following a stressful event, Angelo Landriscina, MD, a Washington, DC-based dermatologist, previously told Health.
Of course, preventing stress is the easiest way to help prevent stress-induced hair lossbut that’s not always an easy thing to do. If you experience hair loss of any kind, it’s wise to check in with your dermatologist. Should they determine that your hair loss is stress-related, your derm may recommend a treatment called minoxidil, a vasodilator that improves circulation around the hair bulb at the base of the hair follicle, to help grow hair back that you’ve lost. Also important: having patience and allowing time for hair growth.
How Can I Prevent Hair Loss
There are things you can do to prevent further hair loss. Dont 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 youre eating a balanced diet that includes adequate amounts of iron and protein.
Certain beauty regimens can worsen or cause hair loss.
If youre 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 include:
- blow dryers
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