Hair loss (alopecia) can be a result of aging, or it can arise due to medications or other health factors. Learn more about this condition. Hair loss, known clinically as alopecia, thins hair in some, changes the hairline in others, and can lead to partial or total baldness. While it’s usually hereditary and a result of aging (androgenetic alopecia, or pattern baldness), it can also
Hair loss, known clinically as alopecia, thins hair in some, changes the hairline in others, and can lead to partial or total baldness. While it’s usually hereditary and a result of aging (androgenetic alopecia, or pattern baldness), it can also be the result of physical or emotional stress, a side effect of cancer treatment or other medications, or due to other factors.
Though hair loss isn’t a medical emergency, it can be distressing, impacting self-esteem and mental health. However, certain medications and other therapies may help manage the problem, and some types resolve independently. This article discusses the symptoms and possible causes of alopecia and provides a quick breakdown of how it can be treated.
The exact pattern of hair loss depends on what’s causing it, and it can vary based on sex.
Androgenetic alopecia is the most common type. It arises more gradually, as you lose about 100 hair follicles a day (the typical scalp has 100,000). Male pattern baldness starts above the temples and works its away around the edges and top of the head. In women, the hair usually thins more evenly, and there’s less of a change along the hairline.
However, nervous habits, burns, ringworm (tinea capitis), or other dermatological conditions can bring on bald patches or circles. Furthermore, physical or emotional stress, radiation therapy, and some medications can cause hair to fall out in clumps.
At its core, hair loss occurs due to disruptions of the body’s hair follicle growth cycle. Whether balding or not, your hair goes through these three phases:
Basically, when this cycle is disrupted, hair falls out without being regenerated. In most cases, this is a gradual process, though it can set on more quickly in some people.
Common types of hair loss are androgenetic alopecia, telogen effluvium, anagen effluvium, tinea capitis, and alopecia areata.
Most people who experience hair loss have inherited the condition from a parent, something commonly called pattern baldness.
While male pattern baldness is more common, women can also be affected. About 80% of men and 38% of women over age 70 experience it. Female pattern baldness causes more diffuse (widespread) thinning and is generally more gradual in its progression, whereas in men, pattern baldness causes partial or complete hair loss.
Hair loss can also occur from physical and emotional stress. Clinically referred to as telogen effluvium, it arises when hair goes into a resting phase without subsequently starting new growth. This phase often is temporary. Causes include:
Though it rarely causes complete baldness, telogen effluvium causes very rapid hair loss. Most people see hair regrowth around three months after its trigger.
Hair loss can also be a side effect of certain drugs or treatments. This type of baldness, called anagen effluvium, usually reverses once the therapy is over or you stop taking the medication. This is particularly the case with chemotherapy and other cancer-treating drugs, such as:
Additionally, many other types of drugs also bring on baldness, including:
Tinea capitis—commonly called scalp ringworm—is hair loss due to a fungal infection. It is most often seen in children. It leads to hair falling out in (often) circular patches, which can grow over time. The exposed skin in these cases is red, flaky, itchy, and can be covered in sores.
This type of hair loss occurs due to an autoimmune disorder (such as lupus or fibromyalgia), in which the immune system attacks hair follicles and prevents their growth. Alopecia areata can lead to total baldness.
Other causes of hair loss include:
Most kinds of hair loss, such as pattern baldness and both telogen and anagen effluvium, can be diagnosed based on symptoms and medical history alone. However, other tests may be needed:
When the hair loss is caused by illness, treating the underlying cause allows hair to grow back. Discontinuing medications or radiation therapy and chemotherapy can also reverse balding. In other cases, medications and dermatological therapies can help. Here’s a breakdown of what’s done about hair loss.
Effective for both male and female pattern baldness, application of Rogaine (topical minoxidil) on the scalp can spur hair regrowth. For males, 2% or 5% concentrations work, while for females, 2% is recommended. You will need to use this treatment indefinitely; if you stop, you will lose the regrown hair.
Male pattern baldness can be treated with inhibitors of alpha-reductase, an enzyme associated with steroid production. Drugs like Propecia (finasteride) and Avodart (dutasteride) are prescribed to reduce or stop the progression of hair loss.
Injections of corticosteroids help in cases of alopecia areata, which is when the hair loss is caused by autoimmune dysfunction. In a clinical procedure, dermatologists inject these drugs just below the skin of affected areas in the scalp to spur regrowth.
Tinea capitis (ringworm) treatments depend on the type of fungus causing the infection. For Trichophyton infection, oral Lamisil (terbinafine), Sporanox (itraconazole), and Diflucan (fluconazole) may be prescribed. There’s some evidence that Gris-PEG (griseofulvin) is effective against another fungus, Microsporum. These may need to be applied as a shampoo.
When hair loss is caused by compulsive hair pulling or twisting (trichotillomania), cognitive behavioral therapy (CBT), a form of talk therapy, may be recommended. This therapy involves focusing on the reasons behind why this compulsion developed, and working on strategies to regulate unwanted behaviors.
A number of other medical, cosmetic, and at-home therapies may also help manage hair loss. These include:
If hair loss is causing you significant distress and affecting your quality of life, seek out support from others. Along with friends and family, talking to a therapist or mental health counselor can help, as can joining support groups.
If you try supplements for hair loss, make sure you know what exactly you’re taking. While some vitamins and minerals help, excess amounts of vitamins A, E, and selenium can actually make matters worse.
At-home strategies won’t reverse hair loss, but they can help manage it. Here’s what you should keep in mind:
While hair loss is rarely a medical emergency, it can be a sign of something more serious. Contact your healthcare provider if you experience:
Hair loss, known clinically as alopecia, is very common and can arise for many reasons. In many cases, it’s hereditary and a natural result of aging. However, emotional and physical stress, medical treatments, and infections of the scalp can also contribute to it. Treatments, such as minoxidil, can spur hair regrowth, and others can help manage underlying causes of hair loss. Lifestyle changes and cosmetic treatments can also help.
Experiencing hair loss can be embarrassing and can make you feel insecure. Keep in mind that you are not alone—35 million men and 21 million women in the United States are also experiencing hair loss.
As long as your hair loss doesn't occur suddenly and isn't accompanied by the symptoms shared above, it's unlikely that it is due to a serious medical condition. If you are concerned about your appearance, there are cosmetic products and procedures that can help.
Most cases of baldness are inherited or the result of aging. However, hair loss can also arise due to physical or emotional shock, chemotherapy or radiation treatment, or as a side effect of certain medications. Infections of the scalp, thyroid conditions, vitamin or mineral deficiency, autoimmune disorders (such as lupus), and compulsive hair pulling (trichotillomania) are among the other causes.
Treatment and management approaches to hair loss depend on the underlying cause. Medications, such as Rogaine (minoxidil) and Propecia (finasteride) can help with pattern baldness. Prescribed hormone therapies and steroid injections can also help, as can taking certain supplements, and making changes to your hair care routine. Hair transplantation surgery and laser therapy to spur hair growth are additional cosmetic options.
Physical stress, as in severe illness, or emotional shock can cause a type of hair loss called telogen effluvium. While this causes hair to fall out rapidly, typically on top of the scalp, it continues to grow back. As such, this type is usually reversible, with hair growing back within 12 months.