Hair loss

  • What are causes of hair loss?
    • Alopecia areata
    • Traction alopecia
    • Trichotillomania
    • Tinea capitis (fungal infection)
    • Telogen effluvium
    • Androgenetic alopecia (“male-pattern baldness”, “female-pattern baldness”)
  • What treatments are there for hair loss in men?
    • Minoxidil (Rogaine)
    • Finasteride (Propecia)
  • What other options do I have for hair loss?
    • Hairpieces
    • Hair transplant
  • Is hair loss in women different than men?
  • What treatments are there for hair loss in women?

What are causes of hair loss?

There are many causes of scalp hair loss. This article will cover the common
ones.

In general, most hair loss is not associated with systemic or internal
disease, nor is poor diet a frequent factor. Thyroid disease can cause hair
loss, but thyroid tests on people who have ordinary hair loss are usually
normal. Although many medications list “hair loss” among their potential
side effects, drugs are also not overall common causes of thinning or lost hair.
On the other hand, with cancer treatments and immune suppression medications,
hair loss is not uncommon.

One useful way to classify hair loss is by whether
the loss is localized and patchy, or whether it affects large areas or the whole
scalp.

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:

  • alopecia areata (patches of baldness that usually grow back)
  • traction alopecia (thinning from
    tight braids or ponytails)
  • trichotillomania (the habit of twisting or pulling
    hair out)
  • tinea capitis (fungal infection)

Alopecia areata

A common condition,
alopecia areata usually starts as a single, quarter-sized circle of perfectly
smooth baldness. Alopecia patches usually regrow in three to six months without
treatment. Sometimes, hair grows back in white. In another variant, alopecia can
produce two or three bald patches. When these grow back, they may be replaced by
others. The most extensive form is called alopecia totalis, in which the entire
scalp goes bald. It’s important to emphasize that patients who have localized
hair loss generally don’t go on to lose hair all over the scalp. Alopecia can
affect hair on other parts of the body too– for example, the beard.

Alopecia areata is considered an autoimmune condition, in which the body attacks itself
(in this case its own hair follicles). Most alopecia patients, however, do not
have systemic problems and need no medical tests. Alopecia is also often blamed
on “stress,” but in fact it’s usually the other way around: having alopecia
causes the stress, at least until people find out what it is.

 Treatments for
alopecia areata include injecting steroids into affected patches to stimulate
hair growth. This is not practical for large areas. Other treatments, such as
oral steroids or ultraviolet light therapy, are either toxic or impractical. In
most mild cases, patients can comb over the affected areas. In more severe and
chronic cases, some patients wear hairpieces; nowadays some men shave their whole
scalp, now that this look has become fashionable.

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