HAIR LOSS

Everything You Need to Know About Hair Loss

Overview

Hair loss can affect just your scalp or your entire body. It can be the result of heredity, hormonal changes, medical conditions or medications. Anyone can experience hair loss, but it’s more common in men.

Baldness typically refers to excessive hair loss from your scalp. Hereditary hair loss with age is the most common cause of baldness. Some people prefer to let their hair loss run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still, others choose one of the treatments available to prevent further hair loss and to restore growth.

Before pursuing hair loss treatment, talk with your doctor about the cause of your hair loss and treatment options.

Hair grows everywhere on the human skin except on the palms of our hands and the soles of our feet, but many hairs are so fine they’re virtually invisible. Hair is made up of a protein called keratin that is produced in hair follicles in the outer layer of skin. As follicles produce new hair cells, old cells are being pushed out through the surface of the skin at the rate of about six inches a year. The hair you can see is actually a string of dead keratin cells. The average adult head has about 100,000 to 150,000 hairs and loses up to 100 of them a day; finding a few stray hairs on your hairbrush is not necessarily cause for alarm.

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At any one time, about 90% of the hair on a person’s scalp is growing. Each follicle has its own life cycle that can be influenced by age, disease, and a wide variety of other factors. This life cycle is divided into three phases:

Anagen

Active hair growth that lasts between two to six years

Catagen

Transitional hair growth that lasts two to three weeks

Telogen

Resting phase that lasts about two to three months; at the end of the resting phase the hair is shed and a new hair replaces it and the growing cycle starts again.

As people age, their rate of hair growth slows.

There are many types of hair loss, also called alopecia:

There are many types of hair loss, also called alopecia:

Involutional alopecia

This is a natural condition in which the hair gradually thins with age. More hair follicles go into the resting phase, and the remaining hairs become shorter and fewer in number.

Androgenic alopecia

This is a genetic condition that can affect both men and women. Men with this condition, called male pattern baldness, can begin suffering hair loss as early as their teens or early 20s. It’s characterized by a receding hairline and gradual disappearance of hair from the crown and frontal scalp. Women with this condition, called female pattern baldness, don’t experience noticeable thinning until their 40s or later. Women experience a general thinning over the entire scalp, with the most extensive hair loss at the crown.

Alopecia areata

This often starts suddenly and causes patchy hair loss in children and young adults. This condition may result in complete baldness (alopecia totalis). But in about 90% of people with the condition, the hair returns within a few years.

Alopecia universalis

This causes all body hair to fall out, including the eyebrows, eyelashes, and pubic hair.

Trichotillomania

This is seen most frequently in children, is a psychological disorder in which a person pulls out one’s own hair.

Telogen effluvium

This is temporary hair thinning over the scalp that occurs because of changes in the growth cycle of hair. A large number of hairs enter the resting phase at the same time, causing hair shedding and subsequent thinning.

Scarring alopecias

This results in a permanent loss of hair. Inflammatory skin conditions (cellulitis, folliculitis, acne), and other skin disorders (such as some forms of lupus and lichen planus) often result in scars that destroy the ability of the hair to regenerate. Hot combs and hair too tightly woven and pulled can also result in permanent hair loss.

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Symptoms

Hair loss can appear in many different ways, depending on what’s causing it. It can come on suddenly or gradually and affect just your scalp or your whole body. Some types of hair loss are temporary, and others are permanent.

Signs and symptoms of hair loss may include:

Gradual thinning on top of the head

This is the most common type of hair loss, affecting both men and women as they age. In men, hair often begins to recede from the forehead in a line that resembles the letter M. Women typically retain the hairline on the forehead but have a broadening of the part in their hair.

Circular or patchy bald spots

Some people experience smooth, coin-sized bald spots. This type of hair loss usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, your skin may become itchy or painful before the hair falls out.

Sudden loosening of hair

A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging. This type of hair loss usually causes overall hair thinning and not bald patches.

Full-body hair loss

Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back.
Patches of scaling that spread over the scalp. This is a sign of ringworm. It may be accompanied by broken hair, redness, swelling and, at times, oozing.

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Causes Hair Loss

People typically lose about 100 hairs a day. This usually doesn’t cause noticeable thinning of scalp hair because new hair is growing in at the same time. Hair loss occurs when this cycle of hair growth and shedding is disrupted or when the hair follicle is destroyed and replaced with scar tissue.

Hair loss is typically related to one or more of the following factors:

Family history (heredity)

The most common cause of hair loss is a hereditary condition called male-pattern baldness or female-pattern baldness. It usually occurs gradually with aging and in predictable patterns — a receding hairline and bald spots in men and thinning hair in women.

Hormonal changes and medical conditions

A variety of conditions can cause permanent or temporary hair loss, including hormonal changes due to pregnancy, childbirth, menopause and thyroid problems. Medical conditions include alopecia areata (al-o-PEE-she-uh ar-e-A-tuh), which causes patchy hair loss, scalp infections such as ringworm and a hair-pulling disorder called trichotillomania (trik-o-til-o-MAY-nee-uh).

Medications and supplements

Hair loss can be a side effect of certain drugs, such as those used for cancer, arthritis, depression, heart problems, gout, and high blood pressure.

Radiation therapy to the head

The hair may not grow back the same as it was before.

A very stressful event

Many people experience a general thinning of hair several months after a physical or emotional shock. This type of hair loss is temporary.

Certain hairstyles and treatments

Excessive hairstyling or hairstyles that pull your hair tight, such as pigtails or cornrows, can cause a type of hair loss called traction alopecia. Hot oil hair treatments and permanents can cause inflammation of hair follicles that leads to hair loss. If scarring occurs, hair loss could be permanent.

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Risk factors

A number of factors can increase your risk of hair loss, including:

  • A family history of balding, in either of your parent’s families
  • Age
  • Significant weight loss
  • Certain medical conditions, such as diabetes and lupus
  • Stress

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Prevention

Most baldness is caused by genetics (male-pattern baldness and female-pattern baldness). This type of hair loss is not preventable.

These tips may help you avoid preventable types of hair loss:

  • Avoid tight hairstyles, such as braids, buns or ponytails.
  • Avoid compulsively twisting, rubbing or pulling your hair.
  • Treat your hair gently when washing and brushing. A wide-toothed comb may help prevent pulling out hair.
  • Avoid harsh treatments such as hot rollers, curling irons, hot oil treatments, and permanents.
  • Avoid medications and supplements that could cause hair loss.
  • Protect your hair from sunlight and other sources of ultraviolet light.
  • Stop smoking. Some studies show an association between smoking and baldness in men.
  • If you are being treated with chemotherapy, ask your doctor about a cooling cap. This cap can reduce your risk of losing hair during chemotherapy.

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