What is hair loss?

What is hair loss?

The medical term for hair loss is alopecia. There may be associated scalp disease or scarring.

• Alopecia may be localized or Diffuse.
• It can affect the scalp or other parts of the body.
• It may be due to hair shedding, poor quality hair, or hair thinning.
• There may be areas of skin that are completely bald.
• There may be associated skin disease or scarring.

Unfortunately, hair loss may not be easy to remedy.

It can be the result of heredity, hormonal changes, medical conditions or a normal part of aging. Anyone can lose hair on their head, but it's more common in men. Baldness typically refers to excessive hair loss from your scalp. Hereditary hair loss with age is the most common cause of baldness.

Who gets hair loss?

As all our hair follicles are formed during fetal growth, it is inevitable that we will notice hair loss of some kind in later life.

Hair loss occurs in:

• Males and females
• Children and adults
• People with any colour or type of hair.

Hair loss can be an isolated problem or associated with another disease or condition. It can be temporary or permanent, depending on the cause.

 

What causes hair loss?

Hair loss has many causes. What’s causing your hair loss can determine whether your hair:

• Falls out gradually or abruptly
• Thins
• Can regrow on its own
• Requires treatment to regrow
• Needs immediate care to prevent permanent hair loss

 

Hereditary hair loss

Both men and women develop this type of hair loss, which is the most common cause of hair loss worldwide. In men, it’s called male pattern hair loss. Women get female pattern hair loss. Regardless of whether it develops in a man or women, the medical term is androgenic alopecia.

No matter which term you use, it means that you’ve inherited genes that cause your hair follicles (what each hair grows out of) to shrink and eventually stop growing hair. Shrinking can begin as early as your teens, but it usually starts later in life.

In women, the first noticeable sign of hereditary hair loss is usually overall thinning or a widening part.

When a man has hereditary hair loss, the first sign is often a receding hairline or bald spot at the top of his head.

Is regrowth possible?
Yes, treatment can help stop or slow hair loss. It may also help regrow hair. The earlier treatment is started, the better it works. Without treatment, you will continue to lose hair.

Hormonal imbalance

A common cause of this imbalance is polycystic ovary syndrome (PCOS). It leads to cysts on a woman’s ovaries, along with other signs and symptoms, which can include hair loss. Stopping some types of birth control pills can cause a temporary hormonal imbalance. Women who develop a hormonal imbalance can develop thinning hair (or hair loss) on their scalp.

 

 

Signs and symptoms of hair loss may include:

·         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. An increasingly common hair loss pattern in older women is a receding hairline (frontal fibrosing alopecia).

·         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.

·         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.

·         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.

·         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.

 

Diagnosis

Before making a diagnosis, your doctor will likely give you a physical exam and ask about your diet, your hair care routine, and your medical and family history. You might also have tests, such as the following:

·         Blood test. This might help uncover medical conditions that can cause hair loss.

·         Pull test. Your doctor gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process.

·         Scalp biopsy. Your doctor scrapes samples from the skin or from a few hairs plucked from the scalp to examine the hair roots under a microscope. This can help determine whether an infection is causing hair loss.

·         Light microscopy. Your doctor uses a special instrument to examine hairs trimmed at their bases. Microscopy helps uncover possible disorders of the hair shaft.

 

Treatment

Effective treatments for some types of hair loss are available. You might be able to reverse hair loss, or at least slow it. With some conditions, such as patchy hair loss (alopecia areata), hair may regrow without treatment within a year. Treatments for hair loss include medications and surgery.

Medication

If your hair loss is caused by an underlying disease, treatment for that disease will be necessary. If a certain medication is causing the hair loss, your doctor may advise you to stop using it for a few months.

Medications are available to treat pattern (hereditary) baldness. The most common options include:

·         Minoxidil (Rogaine). Over-the-counter (nonprescription) minoxidil comes in liquid, foam and shampoo forms. To be most effective, apply the product to the scalp skin once daily for women and twice daily for men. Many people prefer the foam applied when the hair is wet.

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 (Carospir, Aldactone) 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.

Surgical procedures to treat baldness are not usually covered by insurance.

Laser therapy

The Food and Drug Administration has approved a low-level laser device as a treatment for hereditary hair loss in men and women. A few small studies have shown that it improves hair density. More studies are needed to show long-term effects.