Overview

Hair loss or alopecia, can affect the scalp or the entire body and can last for a temporary or permanent period of time. Alopecia may be brought on by hereditary factors, hormonal changes, illnesses, or just the normal aging process. Although hair loss can affect everyone, males are more likely to experience it.

Baldness typically indicates severe scalp hair loss. Hereditary hair loss that develops with age is the most frequent cause of baldness. People who are experiencing baldness may choose to manage it in a variety of ways. Some may decide to accept it naturally, while others may want to cover it up with certain hairstyles, cosmetics, hats, or scarves. Some people may also choose to use one of the various treatments to stop additional hair loss or to encourage hair growth.

Individuals should explore the underlying cause of their hair loss and the available treatment options with their healthcare provider before seeking treatment for hair loss.

Symptoms

Depending on the underlying cause, hair loss can appear in many different ways. It might affect the scalp or the entire body and can happen quickly or gradually. Hair loss signs and symptoms might include the following:

  • Slow thinning on top of head: The most common type of hair loss is gradual thinning on the top of the head, which tends to occur as people age. Men often experience a receding hairline at the forehead, while women may notice a broadening of the part in their hair. Additionally, an increasing hair loss pattern observed in older women is a receding hairline known as frontal fibrosing alopecia.
  • Loosening of hair: A physical or mental trauma can cause hair to loosen, causing people to notice clumps of hair falling out while brushing, washing, or even after light tugging. Although temporary, this form of hair loss often results in overall hair thinning.
  • Hair loss in whole body: Certain medical conditions and treatments, like chemotherapy for cancer, may cause hair loss all over the body. However, in most cases, the hair tends to grow back after the treatment is completed.
  • Scaly patches that spread throughout the scalp: The presence of broken hair, redness, swelling, and sometimes, oozing, along with hair loss, can be indicative of ringworm, a fungal infection of the skin.
  • Circular or patchy bald spots: Certain individuals may experience circular or patchy bald spots on the scalp, beard, or eyebrows, where hair loss occurs. Prior to hair loss, the affected skin might become itchy or painful.

If you or your child are experiencing distress due to ongoing hair loss and wish to explore potential treatments, it is essential to seek advice from your doctor. For women facing a receding hairline, also known as frontal fibrosing alopecia, it is crucial to discuss early treatment options with your doctor to prevent irreversible and extensive baldness. Taking prompt action can make a significant difference in managing these conditions effectively.

If someone notices sudden or spots of hair loss, or if their hair loss increases when brushing or washing their hair, they should speak with a healthcare provider. Such events might be a sign of a serious illness that needs to be treated by a medical professional.

Causes

Due to the constant growth of new hair at the same time, the average person loses 50 to 100 hairs per day, which is usually undetectable. When new hair cannot replenish the hair that has fallen out, hair loss becomes noticeable. The following factors are frequently associated with hair loss:

  • Family history: A hereditary disorder that develops as people get older has been suggested as the main cause of hair loss. The condition referred to as androgenic alopecia, male-pattern baldness and female-pattern baldness. If you or someone you know is experiencing this type of hair loss, it is essential to seek appropriate medical advice and treatment options. As with a receding hairline and bald spots in men and thinning hair around the top of the scalp in women, it often develops gradually and in predictable patterns.
  • Hormonal changes and medical conditions: Numerous conditions can contribute to permanent or temporary hair loss, including hormonal changes stemming from pregnancy, childbirth, menopause, and thyroid issues. Medical conditions like alopecia areata, which involves immune system-related patchy hair loss, scalp infections like ringworm, and a hair-pulling disorder (trichotillomania) can also lead to hair loss.
  • Medications and supplements: Certain medications, such as those prescribed for high blood pressure, cancer, heart problems, gout, arthritis, and depression may cause hair loss as a side effect.
  • Radiation therapy: Hair regrowth following treatment may not result in the same appearance as it was before the hair loss occurred. When hair grows back, it may change in texture, color, or density.
  • Stressful event: This form of hair loss is transient. Some people may discover a general thinning of hair several months after enduring a physical or mental shock.
  • Hairstyles and treatments: Excessive hairstyling and doing hairstyles like cornrows and pigtails that cause your hair to be pulled tightly can cause traction alopecia. Hair loss may also result from procedures like hair permanents and hot oil hair treatments. Hair loss may be permanent in circumstances where scarring is present.

Risk factors

Several factors can elevate the risk of experiencing hair loss, including:

  • A history of baldness in your family, either on your mother’s or father’s side.
  • Age
  • Notable weight loss
  • Medical conditions: Individuaal that have certain medical conditions such as diabetes and lupus increase the risk in developing hair loss.
  • Other factors: Stress and poor nutrition contributes to the likelihood in developing hair loss.

Diagnosis

The following procedures will assist healthcare providers in diagnosing hair loss, this includes:

  • Physical examination: Hair loss is easily recognizable, but a healthcare provider can confirm the diagnosis through a physical examination of the scalp. They’ll inquire about medical history and observe the hairline and affected areas for signs of thinning or balding. They will also ask about the diet, and hair care routine.
  • Blood test: A blood test can be helpful in identifying medical conditions that may be responsible for hair loss.
  • Pull test: This test helps determine the stage of the shedding process. A healthcare provider may gently performs a hair-pull test, plucking several dozen hairs to assess the amount that comes out.
  • Scalp biopsy: To investigate the cause of hair loss and determine if an infection is responsible, a healthcare provider may scrape samples from the skin or from a few plucked hairs from the scalp. This examination helps in analyzing the hair roots under a microscope and identifying potential infections.
  • Light microscopy: In order to uncover potential disorders of the hair shaft, a healthcare provider uses a special instrument, known as microscopy, to examine hairs trimmed at their bases.

Treatment

There are effective treatments available for certain types of hair loss, which can potentially reverse or slow down the process. In cases like alopecia areata (patchy hair loss), hair may regrow naturally within a year without any treatment. Hair loss treatments encompass medications and surgical options.

  • Medication: If hair loss is due to an underlying medical condition, treatment for that specific disease will be essential. In cases where hair loss is linked to a particular medication, the healthcare provider may recommend discontinuing its use for a few months.

There are medications available for treatment. The most common options include:

    • Minoxidil: Available over-the-counter without a prescription, is offered in liquid, foam, and shampoo formulations. For optimal effectiveness, it is advised to apply the product to the scalp once daily for women and twice daily for men. Applying the foam while the hair is wet is a common preference among many users.

Minoxidil products help with hair regrowth and slowing hair loss. Treatment for at least six months is needed to prevent further hair loss and see regrowth. Continued use is essential for retaining the benefits.

    • Finasteride: Finasteride is a prescription drug for men taken daily as a pill. It can slow hair loss and promote new hair growth. Results may take a few months to become apparent, and continued use is necessary to retain benefits. However, it may not be as effective for men over 60.

Pregnant or potentially pregnant women should refrain from touching crushed or broken tablets.

    • Other medications: Additional oral options for hair loss treatment include spironolactone and oral dutasteride.
  • Hair transplant surgery: The most prevalent form of permanent hair loss typically affects only the top of the head. Hair transplant or restoration surgery offers a solution to maximize the utilization of the remaining hair you have.

In a hair transplant procedure, hair is taken from a hair-bearing area and transplanted to a bald spot. It can involve micrografts, minigrafts, or larger strips of skin. Sedation medicine is used to manage discomfort. Risks include bleeding, bruising, swelling, and infection. Multiple surgeries may be required for the desired effect, but hereditary hair loss may continue to progress despite the procedure.

  • Laser therapy: A low-level laser device has been approved by the Food and Drug Administration to treat male and female genetic hair loss. Only a few research have suggested that it might increase hair density. To ascertain its long-term consequences, more study is needed.
  • Platelet-rich plasma: Platelet-rich plasma (PRP) therapy involves a healthcare provider extracting blood, processing it, and then injecting it into the scalp to promote hair growth.

Doctors who treat this condition