Hair Loss in Men and Women (Alopecia)
Hair loss facts
- Hair loss is a very common condition and affects most people at some time in their lives.
- Hair loss from breakage of the hair shaft is different than hair loss due to decreased hair growth.
- Androgenetic hair loss is seen in both men and women but is more dramatic in men.
- Thyroid disease, anemia, protein deficiency, chemotherapy, and low vitamin levels may cause hair loss.
- Alopecia areata is a form of hair loss produced by the autoimmune destruction of hair follicles in localized areas of skin.
- Medications indicated for hair regrowth include minoxidil (Rogaine) and finasteride (Propecia).
- Prevention of hair loss includes good hair hygiene, regular shampooing, and good nutrition.
- Medical health screening for hair loss may include blood tests such as complete blood count (CBC), iron level, vitamin B, thyroid function tests (TFT), and a biopsy of the scalp.
What are causes and risk factors for hair loss?
Because there are many types of hair loss, finding the cause can be challenging. This review will cover the most common causes of hair loss occurring on normal unscarred scalp skin. The medical term for hair loss is alopecia.
Most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair
starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation (during strict dieting), and hormonal changes like those in pregnancy, puberty, and menopause may cause hair loss.
Several health conditions, including thyroid disease and iron deficiency anemia, can cause hair loss. While thyroid blood tests and other lab tests, including a complete blood count (CBC), on people who have ordinary hair loss are usually normal, it is important to exclude treatable causes of hair loss.
What types of doctors treat hair loss?
Such basic health screening can be done by a family physician, internist, or gynecologist. Dermatologists are doctors who specialize in problems of skin, hair, and nails and may provide more advanced diagnosis and treatment of hair thinning and loss. Sometimes a scalp biopsy may be necessary.
Although many medications list “hair loss” among their potential side effects, most drugs are not likely to induce hair loss. On the other hand, cancer chemotherapy and immunosuppressive medications commonly produce hair loss. Complete hair loss after chemotherapy usually regrows after six to 12 months.
There are numerous ways to categorize hair loss. One must first examine the scalp to determine if the hair loss is due to the physical destruction and loss of hair follicles (scarring alopecia). If the scalp appears perfectly normal with plenty of empty hair follicles, this is called non-scarring hair loss. On the other hand, the follicles are permanently destroyed in scarring hair loss. Non-scarring hair loss can also be seen in situations where there is physical or chemical damage to the hair shaft resulting in breakage. Occasionally, it may be necessary to do a biopsy of the scalp to distinguish these conditions. Sometimes, a physician may pull a hair to examine the appearance of the hair shaft as well as the percentage of growing hairs (anagen phase). This article will concentrate on the non-scarring types of hair loss.
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