Hair Loss: Information on Causes, Diagnosis & Treatments
Losing hair can occur because of several reasons including a combination of the aging process and heredity. Generally, males and females lose approximately 100 hairs each day as a natural cycle where old hair falls out to allow the growth of new hair. However, there are factors where the normal shedding and regrowth process can be disturbed including changes in hormones, genetic predisposition, medications, medical conditions or a family history of hair loss. Other factors that lead to hair loss include emotional and physical stress.
Traditionally, balding refers to hair loss the developed on the scalp, that is typically caused by hereditary factors in both men and women. This type of hair loss tends to occur gradually and often in predictable patterns as a bald spot, receding hairline or overall thinning. However, there are many other factors that could cause moderate thinning hair loss to total baldness.
Hair Loss Causes
Figuring out the exact cause of hair loss can be challenging. In fact, there are dozens of reasons men and women lose hair. Some of these include:
- Androgenic Alopecia – More than 90% of all hair loss and women is the result of androgenic alopecia because the body ineffectively processes his male hormones (testosterone) producing only tiny amounts of the much-needed hormone.
- Alopecia Areata – This hair loss condition is an autoimmune disorder where the body attacks hair follicles. Medical science considers this to be a genetic problem that can be treated effectively with steroid injections.
- Anemia (low iron levels) – Heavy menstrual periods, cancer, sickle-cell anemia, ulcers and consuming a diet low in iron rich foods can cause hair loss.
- Hypervitaminosis A (excessive levels of vitamin A) – hair loss can occur from elevated levels of vitamin A in the body.
- Anabolic Steroids –
- Exposure to Toxic Chemicals and Heavy Metals – Exposure to dangerous toxins and metals can produce unhealthy hair that eventually falls out and fails to regrow.
- Protein Deficiencies – Men and women who have a protein deficiency can experience hair loss due to a lack of amino assets to regrow hair loss through the natural shedding process.
- Nutritional Deficiency – The deficiency and trace minerals, minerals, vitamins, and essential fatty acids are known to cause hair loss. However, this condition can be remedied by using supplements and taking multivitamins.
- Smoking – Using tobacco products tends to increase the levels of DHT (dihydrotestosterone) that is known to cause significant hair loss in women.
- Excessive Stress – Both emotional and physical stress are leading causes of temporary hair loss. These stress levels can be exacerbated by childbirth, divorce, car accident, disease, extreme dieting, or a loved one's death.
- Psoriasis – Skin conditions including psoriasis cause irritation and redness to the skin, that could lead to compromised hair follicles in the affected area.
- Fungal Infection – Ringworm and other fungal infections can cause significant hair loss of the affected area. However, the problem is easily treated using over-the-counter medications.
- Seborrheic Dermatitis – This non-contagious skin condition is known to cause temporary hair loss because the skin becomes inflamed, oily or scaly. This can usually be treated with anti-dandruff shampoos or shampoo products that contain ketoconazole that contain ingredients that blocked the shrinkage of care follicles caused by dihydrotestosterone.
- Contraception Including Birth Control Pills – Nearly every form of contraception including progestin implants, hormonal injections, vaginal ring, or a patch is known to cause fluctuations in female hormone levels that result in hair loss.
- Giving Birth – Childbirth associated hair loss (telogen effluvium) is a common occurrence that develops within the first five months after giving birth. Typically, pregnant women have thicker hair, more than normal, because of the abundance of hormones flowing in their system. When these hormones decrease, hair will begin falling out for a few weeks.
- PCOS (polycystic ovarian syndrome) – This condition is caused by an imbalance of female hormones where the ovaries produce too much testosterone. This can result in facial hair growth, acne, ovarian cysts, difficulty losing weight, fertility problems, depression, and irregular periods.
- Thyroid Imbalance – An overactive (hyperthyroidism) and under active (hypothyroidism) thyroid can affect the growth of hair and cause associated symptoms including constipation, increased sensitivity to cold, fatigue, unexpected weight gain, dry skin, muscle aches, overall weakness, joint stiffness/swelling, pain, irregular menstrual cycles, depression, slow heart rate, and impaired memory.
- Medications – Numerous medications can cause the patient to lose hair. These include:
- Retinoid drugs containing vitamin A to treat acne
- Antifungal medications
- Breast-cancer medications
- Anticoagulation medications
- Epilepsy medications and other anticonvulsants
- Mood stabilizers
- Cholesterol-lowering medications
- Weight-loss drugs
- Medications to treat Parkinson's disease
- Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Diuretics, ACE inhibitors, beta-blockers and other high blood pressure drugs
- Chemotherapy Treatment – Doctors use chemotherapy and radiation to destroy cancer cells. However, the harsh chemicals used in chemotherapy treatments can disrupt the normal hair growth phases. Typically, the hair will grow back in the months after the chemotherapy has stopped. Sometimes, intense radiation can destroy hair follicles in the treated area.
- Bariatric Surgery – Nearly 4 out of 10 individuals who have undergone bariatric surgical procedures lose an excessive amount of hair post-surgery.
- Systemic Lupus Erythematosus – This autoimmune disease mistakenly attacks hair follicles and other healthy body parts. Lupus is a serious disease that affects approximately 1.5 million American.
- Growing Older – As individuals grow older, they tend to lose more hair when it becomes brittle, shorter, and thinner. This is because some follicles will stop manufacturing new hair growth, causing the scalp to thin out.
Diagnosing Hair Loss
Accurately diagnosing hair loss can be challenging. However, the doctor will usually perform a comprehensive physical examination after taking a medical/personal history and ordering a test to better understand the patient's nutritional status. The doctor might suspect the baldness is a result of the fungal infection and take a hair sample to be analyzed under a microscope in a laboratory setting. Additionally, blood tests can verifier rule out medical illnesses, including thyroid problems and Lupus that might be causing the issue, or an imbalance of sex hormones or iron deficiency.
Treating Hair Loss
The type of treatment the doctor will recommend will be based on the exact cause of hair loss as determined through a diagnosis. The doctor may recommend changing medications if the hair loss is the result of a drug side effect. However, losing hair might stop if it is caused by exposure to chemicals or trauma when using hair straighteners, blow dryers, or chemical dyes to change the hair's color.
If the loss of hair is the result of a medical problem or poor nutrition, the doctor may recommend a healthy diet or provide an effective treatment to improve an underlying medical condition. If hair loss is the result of a fungal infection, the doctor will usually prescribe an oral medication that is applied directly to the affected area. Fungal medicines usually take up to 12 weeks to see complete results. Treating alopecia areata requires a corticosteroid as a topical cream or injection.
If the patient is suffering from pattern baldness, it is likely caused by a hereditary condition in both men and women that can only be treated effectively with Rogaine (minoxidil) in both men and women or Propecia/Proscar (finasteride) in men. Other options include scalp reduction surgery or hair transplant procedures.