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 Causes Hair Loss In Women
According to experts, the average human scalp has about 100,000 hair follicles. At any given time, each of your hair follicles is in a different phase of this cycle: Anagen phase , Catagen phase, Telogen phase , and Exogen phase . Thus, seeing some hairs in your brush or in a bath is perfectly normal and doesnt mean you are experiencing a hair loss.
However, if you find more lost hairs than usual, spot thinning edges, or your scalp becomes more noticeable, it is worth analyzing the possible causes and taking action to stop and reverse hair shedding.
Who Gets Hair Loss
As all our hair follicles are formed during fetal growth, it is inevitable that we will notice hair loss of some kind in later life.
Hair loss occurs in:
- Children and adults
- People with any colour or type of hair.
Hair loss can be an isolated problem or associated with another disease or condition. It can be temporary or permanent, depending on the cause.
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Can I Prevent Abnormal Hair Loss
Most types of hair loss cant be prevented. However, there are a few things you can do that may help keep your hair healthy and strong for longer, including to avoid:
- tight hairstyles, such as braids, buns or ponytails
- twisting, rubbing or pulling your hair
- hair lotions that are heavily perfumed
- excessive heat treatments
- undue exposure to ultra-violet light from the sun or sunbeds, which expose you to higher levels of UV radiation than the sun.
Other useful actions to take involve stopping smoking. as well as having a balanced diet. This should include eggs, berries, avocados and nuts all are thought to help healthy hair grow, along with Vitamins A and C, biotin and, in some cases, vitamin B12.
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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What Questions Might Your Healthcare Provider Ask To Diagnose And Categorize Your Hair Loss
Your healthcare provider might ask about your habits:
- What kinds of hair products do you use?
- What kinds of hair styles do you wear?
- What types of food do you eat ?
- Do you have a habit of pulling your hair out ?
They might ask about your history:
- Has anyone in your immediate family experienced hair loss?
- Is there anything stressful going on in your life?
- What medications and supplements do you take every day?
- Has hair loss ever happened to you before?
- What foods are in your diet?
And, they might ask about your observations:
- How long have you been losing hair?
- Have you been shedding more?
- Have you noticed hair loss in places other than your scalp, like your eyebrows? Leg and arm hair?
- Does anything worsen your hair loss?
- Does anything improve your hair loss?
- Have you noticed hair loss occasionally or has it been going on continuously?
- Have you noticed if your hair growth has changed?
- Has your hair been breaking more often?
Autoimmune Diseases That Affect Hair
Alopecia areata is often associated with an autoimmune disease, so it’s thought that some forms of hair loss can be caused by one of these medical conditions or is at least somehow related to it. Diabetes and lupus are two autoimmune diseases that can result in hair loss. This type of hair loss may not always be reversible it may sometimes be permanent. But medications and hair restoration surgeries may help compensate for any hair loss.
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Hair Loss Due To Medications
Hair loss is a side effect of a number of medications taken for common health problems. Blood-thinning medications, oral contraceptives, drugs for depression, NSAIDs, and beta and calcium channel blockers can all lead to thinning hair or baldness. Too much vitamin A and vitamin A-based drugs called retinoids can cause hair loss as well. Some chemotherapy drugs used to treat cancer are known to cause total hair loss as they work to destroy cancer cells. Just as hair usually grows back after chemo, it should also grow back once you stop taking any medication that causes hair loss.
What Causes Hair Loss
Did you know that it is normal to lose 50 to 100 strands of hair every day? When you consider that at any given moment we have between 100,000 and 150,000 strands of hair on our heads, you can imagine that 50-100 strands might not be missed.
But sometimes we lose more hair than that perhaps 200 or more strands a day. That amount of hair loss can be noticeable and can even be a sign of an underlying medical condition.
What causes hair loss, or alopecia? What can you do about it?
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Sudden Hair Loss: The Basics
- Sudden hair loss can occur for a variety of reasons, including illnesses that cause fever, severe stress and even certain medications.
- If youve recently lost weight due to a crash diet or dont get enough of certain essential nutrients, you may experience sudden hair shedding.
- Although most types of sudden hair loss are reversible, its important to seek out expert help to get an accurate diagnosis and learn about the best treatment options.
- Your healthcare provider may recommend several treatments for hair loss, including the hair regrowth medication minoxidil.
- Our Complete Hair Growth Kit includes numerous science-backed products to help you regrow hair, decrease shedding and improve your hairs strength.
What Are The Signs Of Diffuse Hair Loss
Diffuse hair loss can affect anyone. You may experience:
- Excessive Shedding: Losing 50-150 strands of hair is normal. However, if you are experiencing hair loss in clumps, consult a doctor immediately.
- Hairline Recession: Hair thinning in the central part of the scalp, widening of the hair parting, and hair loss from the frontal part without any apparent cause are signs of diffuse hair loss triggered by telogen effluvium .
If you notice these signs and symptoms, consult a doctor immediately for a proper diagnosis. They may run a few tests to confirm diffuse hair loss and the underlying reason.
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Infections That Cause Hair Loss
A number of infections and illnesses can lead to hair loss. An infection that causes a high fever, a fungal skin infection, and bacterial infections like syphilis can all be responsible for balding or thinning hair. Treating the underlying infection can restore hair growth and prevent future hair loss. So your first step is to seek medical attention for the primary health problem.
What About Pregnancy Hair Loss
Pregnancy may cause many changes in the scalp hair. As the hormones fluctuate during pregnancy, a large number of women feel their hair thickens and becomes fuller. This may be related to change in the number of hairs cycling in the growth phase of hair growth, but the exact reason is unknown. Quite often, there may be a loss of hair after delivery or a few months later which will eventually normalize.
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If You Have Hair Loss Start Here
Treating your hair loss starts with addressing the underlying cause. So if you have signs of hair loss, see a board-certified dermatologist as soon as possible. They can help you pinpoint the problem and address the issue. No matter what the reason, the sooner you get treatment for hair loss, the better the result will be.
Since the hair is an extension of your body, living a healthy lifestyle can also help. Some measures you can take are:
Eating a balanced diet
Avoiding traumatic hair care
Seeing your primary care provider regularly for preventative medical care
Topical solution or foam is the first-choice medication for most types of hair loss. For hereditary hair loss, your dermatologist may recommend pills like or . Other treatment options include cosmetic and surgical procedures at a dermatologists office. Some of these treatments are still experimental, but they show promise. Alternatively, many women cover thin areas with topical products, scalp tattooing, or wigs.
No matter what your age, the good news is that most causes of hair loss are treatable. Addressing the root cause early is key to stopping the process and regrowing hair.
Lack Of B Vitamins Can Cause Hair Loss
Lacking certain vitamins and minerals may also lead to thinning hair or hair loss in women. Some dermatologists believe that not eating enough red meat or following a vegetarian diet may affect hair loss.
Red meat and other animal foods are rich in iron, a mineral that supports hair and body growth. Women are already prone to iron deficiency due to blood loss during menstruation, so not taking in enough iron in the diet may lead to deficiency.
Eating disorders, like anorexia nervosa, may also lead to vitamin deficiencies and thinning hair. In particular, deficiencies thought to affect hair include those in zinc, amino acid L-lysine, B-6, and B-12.
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Symptoms Of Excessive Hair Loss
For most people, excessive hair loss is gradual, which means it happens over a long period of time. This is especially true of male-pattern baldness. Hair loss is considered excessive when it results in bald spots or hair that is noticeably thinning. In some cases, hair can fall out suddenly. This is typically caused by sudden or prolonged stress, either physical or emotional.
What Are Causes And Risk Factors For Hair Loss
Because there are many types of hair loss, finding the cause can be challenging. This review will cover the most common causes of hair loss occurring on normal unscarred scalp skin. The medical term for hair loss is alopecia.
Most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation , and hormonal changes like those in pregnancy, puberty, and menopause may cause hair loss.
Several health conditions, including thyroid disease, iron deficiency anemia, and secondary syphilis, can cause hair loss. While thyroid blood tests and other lab tests, including a complete blood count , on people who have ordinary hair loss are usually normal, it is important to exclude treatable causes of hair loss.
Patchy hair loss
Some conditions produce small areas of hair loss, while others affect large areas of the scalp. Common causes of patchy hair loss are
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What Are Some Tips For Dealing With Hair Loss In Women
There are some things you can do on your own. You might check with your stylist or try some of these:
- Coloring your hair adds volume to the strands, making your hair seem fuller.
- Massaging your head, like when you are washing your hair, can stimulate blood flow to the scalp and hair follicles.
- Getting your hair cut shorter, and having layers added, can make your hair seem fuller.
- Using the right kind of shampoo can also help. Look for a shampoo that adds volume without using sulfate detergents.
- Using the right kind of product at the right time can also help. There are products that add volume that you add while your hair is still wet. However, using too much product can add weight.
Living With Hair Loss
Losing your hair can be devastating. Many people consider a thick head of hair a symbol of youth and vitality. So losing it no matter how young you are can make you feel old. It can make you feel less attractive. It can lower your overall self-esteem.
Remember that it is okay to feel what youre feeling. It is also okay to seek out a strategy for stopping or even reversing hair loss. Wanting hair doesnt mean that you are vain. You should not feel guilty about doing something about your hair loss.
If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement.
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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.
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