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Alopecia


It’s normal to lose hair and we can lose between 50 and 100 hairs a day, often without noticing. Hair loss is not usually anything to be worried about, but occasionally it can be a sign of a medical condition. Baldness typically refers to excessive hair loss from your scalp. Hereditary hair loss with age is the most common cause of baldness. Some types of hair loss are permanent, like male and female pattern baldness.

Types of Alopecia

Male-pattern baldness
Female-pattern baldness
Patchy hair loss (Alopecia Areata)
Traction alopecia
Frontal fibrosing alopecia

Signs and Symptoms

  1. Gradual thinning on top of head. This is the most common type of hair loss, affecting people as they age. In men, hair often begins to recede at the hairline on the forehead. Women typically have a broadening of the part in their hair.
  2. Circular or patchy bald spots. Some people lose hair in circular or patchy bald spots on the scalp, beard or eyebrows. Your skin may become itchy or painful before the hair falls out.
  3. 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 but is temporary.
  4. 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.
  5. 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.

Causes

  • Family history

The most common cause of hair loss is a hereditary condition that happens with aging. This condition is called androgenic alopecia, male-pattern baldness and female-pattern baldness. It usually occurs gradually and in predictable patterns — a receding hairline and bald spots in men and thinning hair along the crown of the scalp in women.

  • An Ilness

A variety of conditions can cause permanent or temporary hair loss, including hormonal changes due to pregnancy, childbirth, menopause and thyroid problems.

  • Stress

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

  • Cancer treatment
  • Weight loss
  • Iron deficiency

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:

  • Be gentle with your hair. Use a detangler and avoid tugging when brushing and combing, especially when your hair is wet. A wide-toothed comb might help prevent pulling out hair. Avoid harsh treatments such as hot rollers, curling irons, hot-oil treatments and permanents. Limit the tension on hair from styles that use rubber bands, barrettes and braids.
  • Ask your doctor about medications and supplements you take that might 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.
  • Avoid high-heat hair styling tools.
  • Don’t chemically treat or bleach your hair.
  • Use a shampoo that’s mild and suited for your hair

Treatment

Most hair loss does not need treatment and is either temporary and it’ll grow back or a normal part of getting older. However, effective treatments for some types of hair loss are available. Treatments for hair loss include medications and surgery.

Medication

  • Minoxidil (Regro, Minox). Products with minoxidil help many people regrow their hair or slow the rate of hair loss or both. It’ll take at least six months of treatment to prevent further hair loss and to start hair regrowth. It may take a few more months to tell whether the treatment is working for you. If it is helping, you’ll need to continue using the medicine indefinitely to retain the benefits. Possible side effects include scalp irritation and unwanted hair growth on the adjacent skin of the face and hands.
  • Finasteride (Propecia). This is a prescription drug for men. You take it daily as a pill. Many men taking finasteride experience a slowing of hair loss, and some may show new hair growth. It may take a few months to tell whether it’s working for you. You’ll need to keep taking it to retain any benefits. Finasteride may not work as well for men over 60. Rare side effects of finasteride include diminished sex drive and sexual function and an increased risk of prostate cancer. Women who are or may be pregnant need to avoid touching crushed or broken tablets.
  • Other medications. Other oral options include spironolactone and oral dutasteride (Avodart).

Hair Transplant Surgery

In the most common type of permanent hair loss, only the top of the head is affected. Hair transplant, or restoration surgery, can make the most of the hair you have left. During a hair transplant procedure, a dermatologist or cosmetic surgeon removes hair from a part of the head that has hair and transplants it to a bald spot. Each patch of hair has one to several hairs (micrografts and minigrafts). Sometimes a larger strip of skin containing multiple hair groupings is taken. This procedure doesn’t require hospitalization, but it is painful so you’ll be given a sedation medicine to ease any discomfort. Possible risks include bleeding, bruising, swelling and infection. You may need more than one surgery to get the effect you want. Hereditary hair loss will eventually progress despite surgery.

Supplements

  • Biotin

Biotin (vitamin B7) is important for cells inside your body. Low levels of it can cause hair loss, skin rashes, and brittle nails.

  • Zinc

Zinc can play a key role in making proteins in your hair and other cells. Your body can’t make it, so you need to get it from food or supplements. Signs of low zinc levels include hair loss, poor wound healing, and a weak sense of taste or smell. 

References

1. Androgenetic alopecia. Retrieved from: https://medlineplus.gov/genetics/condition/androgenetic-alopecia/#references
2. Hair loss. Retrieved from: https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
3. Wasserman D, Guzman‐Sanchez DA, Scott K, McMichael A. Alopecia areata. International journal of dermatology.