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Hair Loss

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Hair Loss

Are you seeing bald patches or lots of hair thinning on your scalp? You may be experiencing hair loss.

Everyone loses some hair during their lifetime. There are many causes of hair loss, from stress and childbirth to diseases and medical treatments. Most causes of hair loss can be diagnosed and treated by one of our dermatologists.

Causes

Who experiences hair loss?

Millions of people experience hair loss. Some people can see hair regrow without treatment, while others require therapy to achieve regrowth. Sometimes, hair will not regrow no matter what treatment option is available. To find out what is possible, you should see one of our dermatologists.

What causes hair loss?

The reasons for hair loss are many. When hair loss begins suddenly, the cause may be due to stress, illness, diet, medicine, or childbirth. Gradual hair loss that becomes more noticeable with each passing year may be a sign of hereditary hair loss. Certain hair care practices also can cause noticeable hair loss.

The following describes some of the many causes of hair loss:

Disease

  • Underlying medical condition: Hair loss can be the first sign of a disease. Thyroid disease and anemia may cause hair loss. By treating the disease, hair loss often can be stopped or reversed.
  • Illness: A major surgery, high fever, severe infection, or even the flu can cause hair loss. This type of hair loss is called a telogen effluvium and usually resolves without treatment.
  • Some cancer treatments: Radiation therapy and chemotherapy can cause hair loss. This hair loss is often temporary, but it can cause great distress.
  • Ringworm of the scalp: This disease is contagious and common in children. It may cause balding if not appropriately treated.
  • Trichotillomania: People with this medical disorder repeatedly pull out their own hair on their scalp or body.

Hair disorders

  • Hereditary thinning or baldness (also called androgenetic alopecia): This is the most common cause of hair loss. It affects about 80 million men and women in the United States.
  • Alopecia areata: Researchers believe that this is an autoimmune disease (meaning the body attacks itself). This causes smooth, round patches of hair loss on the scalp and other areas of the body.
  • Cicatricial (scarring) alopecia: This rare disease develops in otherwise healthy people but destroys their hair follicles. Scar tissue forms where the follicles once were, so the hair cannot regrow.
  • Central centrifugal cicatricial (scarring) alopecia: This type of hair loss occurs most often in women of African descent. It begins in the center of the scalp. As it progresses, the hair loss radiates out from the center of the scalp, making it smooth and shiny.

Dieting and poor nutrition

  • Weight loss: Some people who lose more than 15 pounds in a short period of time may experience hair loss. This hair loss is common, and the hair regrows without help.
  • Vitamin A: Too much vitamin A through vitamin supplements or medicines can cause hair loss.
  • Protein: When the body does not get enough protein, it can ration the protein it does get by shutting down hair growth. Eating more protein (e.g., meats, eggs, and fish) will stop the hair loss.
  • Iron: Not getting enough iron can lead to hair loss.
  • Eating disorder: Anorexia (not eating enough) and bulimia (vomiting after eating) can cause hair loss.

Medicine

Some prescription medicines can cause hair loss. These include:

  • Medicines that treat arthritis, depression, gout, heart problems, and high blood pressure.
  • High-dose vitamin A.
  • Blood thinners.
  • Birth control pills: Some women who take the pill see hair loss.
  • Anabolic steroids (steroids taken to build muscle and improve athletic performance) may cause hair loss.

Hormones and stress

  • Giving birth: Some women have noticeable hair loss after giving birth. Falling estrogen levels cause this type of hair loss. The hair loss is temporary, and women see their hair regrow in a few months.
  • Menopause: Hair loss is common during menopause and is often temporary.
  • Stress: Experiencing a traumatic event (e.g., death of a loved one or divorce) can cause hair loss.

Hair care & hairstyles

Years of wearing hair in a style that pulls on the hair such as a ponytail, cornrows, or braids can cause a type of hair loss known as traction alopecia. Your hairstyle and even some of the products you use on your hair can cause hair loss.

  • Bleaching products or improper use of dyes, gels and hair sprays
  • Blow dryers, flat irons, and other devices
  • Hairpins, clips, and rubber bands
  • Too much shampooing, combing or brushing.
  • Rubbing wet hair dry with a towel.
  • Brushing or combing wet hair.

Treatment

How do dermatologists diagnose hair loss?

A dermatologist acts like a detective to find the cause of hair loss. Your dermatologist may begin by asking questions, such as whether the hair loss happened suddenly or gradually or what medicines you take, to eliminate causes.

It is important to give the dermatologist accurate information, especially regarding allergies and diet. Women may also be asked about their menstrual cycle, pregnancies, or menopause.

The dermatologist will also carefully examine your scalp and hair and possible pull on it during the exam. A small piece of the scalp may need to be tested under the microscope by a scalp biopsy. At times, a blood test may be necessary to look for underlying thyroid disease, anemia, or autoimmune problems. Because so many things can cause hair loss, it can take time to find the cause. You may need to make a few appointments to determine a proper diagnosis.

How do dermatologists treat hair loss?

Dermatologists recommend treating hair loss early before the loss is extensive. Treatment is more difficult when a person has already lost a great deal of hair.

One or more of the following treatments may be part of your treatment plan.

Treatment available without a prescription:

  • Minoxidil: This medicine is applied to the scalp and can prevent hairs from getting thinner and stimulate new growth. It is the only hair regrowth product approved for men and women from the U.S. Food and Drug Administration (FDA), and it may be combined with another hair loss treatment.
  • Laser devices: Brushes, combs, and other hand-held devices that emit laser light might stimulate hair growth and make hair appear more youthful. The long-term effectiveness and safety for these devices are not known at this time.

Prescription medicine:

  • Finasteride: This medicine is FDA approved to treat men with hair loss. In pill form, it helps slow hair loss in about 88% of men and stimulates hair regrowth in about 66% of men. It works by stopping the production of a male hormone, dihydrotestosterone(DHT), in the body.
  • Corticosteroid: A dermatologist may inject a medicine called a corticosteroid into your scalp if your hair loss is caused by inflammation in your body, known as alopecia areata.

The type of procedure that your dermatologist will recommend depends on the amount of hair loss. To achieve the best results, a dermatologist may use one or more of the following procedures:

  • Hair transplantation: Skin on the scalp that has good hair growth is removed and transplanted to areas of the scalp that need hair.
  • Scalp reduction: Bald scalp is surgically removed and hair-bearing scalp is brought closer together to reduce balding. Scalp reduction surgery can be performed alone or in conjunction with a hair transplant.
  • Scalp expansion: Devices are inserted under the scalp for about 3 to 4 weeks to stretch the skin. This procedure may be performed before a scalp reduction to make the scalp laxer. It also can be performed solely to stretch hair-bearing areas, which reduces balding.
  • Scalp flaps: A hair-bearing segment of scalp is surgically moved and placed where hair is needed.

Outcome

Your dermatologist can tell you what treatment options are available, and if they are needed, once the cause of your hair loss is determined. In some cases, changing your habits and routine alone will stop the hair loss, allowing your hair to regrow. In other cases, treatment can help restore hair.

Tips

According to the American Academy of Dermatology, some dermatologists often offer their patients the following tips to prevent further hair loss:

  • Practice good hair care to avoid further damage to the hair.
  • Do not stop taking a medicine that your doctor prescribed; if you think a medicine may be causing hair loss, talk with the doctor who prescribed the medicine about possible side effects.
  • Remember that your hair loss may be temporary. Common triggers such as stress, illness, and childbirth can cause temporary loss of hair, and require no treatment.

Concerned About Hair Loss?

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