Information on the causes of hair loss in men and female hair loss.

What is Hair Loss?

Human hair grows in three phases: it grows, rests and falls out. During the hair growth phase, about 90% of your strands grow and last for several years. Growth stops during the resting phase, which lasts two to three months. During the shedding phase, strands fall out of the hair follicle and new growth begins to form.

Some amount of shedding is normal. Finding a few strands in your brush each morning is nothing to worry about. In fact, the American Academy of Dermatology estimates that the average head sheds an average of 50 to 100 hairs each day.

Excessive hair loss is also known as baldness or alopecia. Any part of the body can be affected, including the scalp, eyebrows, beard and pubic area. Although more common in men, alopecia affects both men and women.

Men may accept baldness more easily than women, due to social norms. Alopecia can severely affect a woman’s self-esteem and self-image, resulting in depression and anxiety.

There are many possible reasons for alopecia. Medical conditions, side effects from medications, and physical or emotional stress are some common culprits.

Types of Alopecia:

Permanent baldness

• Male pattern baldness (androgenetic alopecia) affects men during their teens or early 20s. Bald spots appear at the top of the head with a receding hairline at the temples. The recession creates an “M” shape. Thickness on top of the head also decreases.
• Female pattern baldness (androgenetic alopecia) is the same as male pattern baldness. It usually begins with gradual thinning at the part, which radiates from the top of the head. Women’s hairlines rarely recede, and complete baldness is much less common.
• Cicatricial (scarring) alopecia is caused by scarring of the follicle. This rare condition is often marked by itching or pain.

Temporary baldness

• Alopecia areata occurs in small, bald spots in a particular area, usually the scalp. Strands eventually grow back after several months. If all body hair is lost, it may never grow back.
• Telogen effluvium is sudden loss due to interruption of the normal growth cycle. Hair begins to thin and fall out of the scalp, especially during washing or combing.
• Traction alopecia is a result of hairstyles that pull too tightly on the follicle. These include braids, tight ponytails, cornrows, chignons, buns or twists.

What Causes Hair Loss?

A number of factors may contribute:

• Pattern baldness (androgenetic alopecia) develops as a result of hereditary factors due to family history.
• Scarring alopecia (cicatricial) is caused by scarring to the follicle. There can also be damage from inflammation in the affected area.
• Alopecia areata is an autoimmune disease. Symptoms of alopecia areata include small areas of baldness on the scalp. Doctors believe there may be genetic factors involved.
• Telogen effluvium is caused by changes to the growth cycle due to physical or emotional stress. Specific triggers can include high fever, weight loss, severe grief, nutritional deficiencies or surgery.
• Traction alopecia is caused by pulling hairstyles back too tightly.

Other causes include poor nutrition, certain medications, medical treatments, underlying diseases, hormonal changes and trichotillomania (hair-pulling disorder). Treatments like bleaching, dyeing, tight braiding, blow drying, straightening or hot rollers can also cause damage.

Medical factors such as hormones, thyroid problems and diseases can also cause alopecia.

Hormones

Women sometimes experience strands shedding for several months after giving birth or during menopause due to female hormone imbalances. Hormones can impact men’s hair, too. Male follicles respond to the hormone dihydrotestosterone (DHT) 

Thyroid

Thyroid problems are well-known for causing alopecia. Hyperthyroidism (too much thyroid hormone) and hypothyroidism (too little thyroid hormone) can both cause shedding. Fortunately, this is usually reversed with thyroid treatments.

Medication

Prescription medication can sometimes cause balding. Common culprits include thyroid medications, antidepressants, anticoagulants, anticonvulsants, beta-blocks and some oral contraceptives.

Stress

Physical and emotional stress can trigger alopecia. Surgery, losing a large amount of blood and fevers may cause physical stress that results in hair falling out. While not as well-documented in medical literature, anecdotal evidence suggests mental stress and anxiety can also cause alopecia.

Alopecia from stress is often temporary. As the body or mind heals, the hair regrows.

Nutrition

Nutritional deficiencies, especially zinc and iron deficiency, can be linked to alopecia. Some medical evidence also points the finger at inadequate intake of fats, vitamins and minerals, including vitamin D, vitamin B12, vitamin A, vitamin C, biotin, selenium and copper.

How is Hair Loss Diagnosed?

If you’re losing more hair than usual, or you experience sudden or patchy hair loss, contact your health care practitioner. They can help figure out what’s causing the problem and recommend appropriate treatment.

Your doctor will perform a physical exam and ask about your medical and family history. To determine the cause of hair loss, they may perform tests such as the pull test, skin biopsy or skin scrapings.

If alopecia is causing emotional distress, consider a support group or therapist to help you process your feelings.

Treatments for Alopecia

Treatment depends on what is causing your alopecia. If it’s because of an underlying medical condition or disease, then the condition needs to be treated first.

Other types of alopecia are treated with medication such as antibiotics, corticosteroids or steroid injections. Minoxidil or Rogaine is a popular drug for baldness that is approved by the FDA (Food and Drug Administration) but can have unpleasant side effects.

Surgical procedures such as hair transplants, scalp reduction or skin grafts are options for more serious baldness.

Transplantation

Transplantation has been used since the 1950s to treat baldness. In the original transplant method, a strip of scalp was surgically removed from the back of the head and used to fill in a bald patch.

Today, most surgeons instead use follicular unit transplantation, a technique created in the mid-1990s. This more precise procedure separates the scalp strip into smaller sections and results in a more natural look.

For a natural option to boost regrowth, try an herbal supplement like ReGrow Plus™ for Healthy Hair, which supports circulation to follicles and roots for a healthy head of hair.

References:

1. Schaefer, Anna. “Why is My Hair Falling Out?” Healthline. Accessed January 30, 2020. https://www.healthline.com/health/beauty-skin-care/why-is-my-hair-falling-out

2. “Hair Loss.” Mayo Clinic. Accessed January 30, 2020. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926

3. “Hair Loss.” Medline Plus. Accessed January 30, 2020. https://medlineplus.gov/hairloss.html

4. “Hair Loss Health Center.” WebMD. Accessed January 30, 2020. https://www.webmd.com/skin-problems-and-treatments/hair-loss/default.htm

5. “Treating Female Pattern Hair Loss.” Harvard Health Publishing, Harvard Medical School. Accessed January 30, 2020. https://www.health.harvard.edu/staying-healthy/treating-female-pattern-hair-loss