Hair Loss

Hair loss, also called alopecia, can happen anywhere on the body, not just the scalp. It might be temporary or long-lasting. Different things can cause it, including family history, changes in hormones, health problems, or even just getting older. While anyone can lose some hair, it's more common in men. Baldness is a word for when a person loses a lot of hair on their head. The most frequent reason for baldness, especially as people get older, is inherited hair loss.

Some people don't worry about hair loss and let it happen naturally. Others might try to hide it with hairstyles, makeup, hats, or scarves. Still others might look for ways to stop more hair loss or make their hair grow back. If you're thinking about treating hair loss, it's a good idea to talk to your doctor first. They can help you figure out what's causing your hair loss and what treatment options might be best for you.

Different Types of Hair Loss and Their Symptoms

Hair loss comes in various forms, and understanding the different types can help you seek appropriate care. It can happen gradually or suddenly, affecting just your scalp or your entire body.

Male-pattern baldness often begins at the hairline or the crown of the head. Over time, this can lead to partial or complete baldness.

Female-pattern baldness typically starts with a gradual thinning of hair, particularly noticeable at the part and the top-center of the head.

Alopecia areata is a type of hair loss where hair falls out suddenly, usually in circular or oval patches on the scalp. These patches can sometimes overlap.

Tight hairstyles like pigtails, braids, cornrows, or tight rollers can cause hair loss, a condition called traction alopecia. This happens because the constant pulling on hair can damage the hair follicles.

Receding hairline (frontal fibrosing alopecia) in older women may have an unknown cause, but it's characterized by a receding hairline. Early treatment might prevent significant permanent baldness.

Common Hair Loss Patterns and Symptoms:

• Gradual thinning: This is a common type of hair loss, especially as people age. In men, it often starts with a receding hairline. Women may notice their part widening. In older women, a receding hairline (frontal fibrosing alopecia) is becoming more common.

• Circular or patchy bald spots: Some people experience hair loss in circular or patchy areas on the scalp, beard, or eyebrows. Sometimes, the skin in these areas might become itchy or painful before the hair falls out.

• Sudden hair loosening: Significant stress, whether physical or emotional, can cause hair to loosen. You might notice clumps of hair coming out when combing or washing your hair, or even with gentle pulling. This type of hair loss is usually temporary and leads to overall thinning.

• Full-body hair loss: Some medical conditions, such as chemotherapy for cancer, can cause hair loss all over the body. The hair usually grows back after treatment ends.

• Scalp scaling: Ringworm is a fungal infection that can cause patches of scaling on the scalp. These patches may be accompanied by broken hair, redness, swelling, and occasionally, oozing.

If you're experiencing hair loss, it's best to consult a doctor to determine the underlying cause and discuss appropriate treatment options.

If you or your child are losing a lot of hair and it's bothering you, see a doctor. Getting treatment early can help.

If a woman is losing hair at the front of her head (a receding hairline), talking to a doctor early on is important to prevent permanent hair loss.

Also, see a doctor if you notice hair loss that's sudden, patchy, or more than usual when brushing or washing your hair (or your child's hair). Sudden hair loss could mean there's an underlying health problem that needs medical attention.

People shed between 50 and 100 hairs a day. This is usually unnoticeable because new hair grows in at the same time. Hair loss becomes noticeable when the new hair doesn't replace the hair that falls out. There are several reasons for hair loss:

Genetics (Heredity): This is the most common cause, especially as we age. It's a condition called androgenic alopecia, which includes male-pattern baldness and female-pattern baldness. With male-pattern baldness, the hairline often recedes, and bald spots appear. Female-pattern baldness typically involves thinning hair, especially on the crown of the head. This type of hair loss usually happens gradually and predictably.

Hormonal Changes and Medical Conditions: Many things can cause temporary or permanent hair loss. Hormonal changes, like those during pregnancy, childbirth, menopause, or thyroid problems, can affect hair growth. Other medical issues can also be culprits. For example, alopecia areata is a condition where the body's immune system attacks hair follicles, leading to patchy hair loss. Scalp infections, like ringworm, can also cause hair loss. A hair-pulling disorder called trichotillomania can cause significant hair loss.

Medications and Supplements: Certain medications, such as those used to treat cancer, arthritis, depression, heart problems, gout, and high blood pressure, can sometimes cause hair loss as a side effect.

Radiation Therapy to the Head: Radiation therapy to the head can cause hair loss, and the hair might not grow back in the same way.

Stress: A major stressful event, whether physical or emotional, can lead to temporary hair loss. Many people experience a general thinning of hair several months after a shock.

Hairstyles and Treatments: Tight hairstyles like pigtails or cornrows, or excessive heat styling, can cause a type of hair loss called traction alopecia. Hot oil treatments and permanent hair straightening can also cause hair to fall out. If these practices cause scarring, the hair loss could be permanent.

In summary, hair loss can have various causes, from genetic predisposition to medical conditions and even lifestyle choices. If you're experiencing significant hair loss, it's important to consult a doctor to determine the underlying cause and discuss appropriate treatment options.

Many things can make you more likely to lose hair. These include:

• Family history: If your mom or dad (or other relatives) have experienced hair loss, you might be more prone to it too. This is because genetics play a big role.

• Getting older: As you get older, your hair loss risk generally increases. This is a natural part of aging for many people.

• Losing a lot of weight quickly: Sudden and significant weight loss can sometimes trigger hair loss. Your body may be going through a period of adjustment.

• Health problems: Some medical conditions, like diabetes and lupus, can affect your hair health. These conditions can interfere with the normal growth cycle of your hair.

• Stress: Feeling stressed can also contribute to hair loss. Stress can affect your body in various ways, including hair growth.

• Poor diet: If you don't get enough of the right nutrients, your hair might suffer. A healthy diet is important for healthy hair, as well as other aspects of your health.

Hair loss is often due to genes (like male and female pattern baldness). This kind of hair loss can't be stopped. However, there are things you can do to help prevent other types of hair loss.

Here are some tips:

• Treat your hair gently: Avoid pulling or tugging on your hair, especially when it's wet. Use a detangling brush or a wide-tooth comb to avoid breakage. Don't use harsh heat styling tools like curling irons, hot rollers, or hot oil treatments. Also, limit hairstyles that put a lot of tension on your hair, like tight braids or ponytails with rubber bands. When you do style your hair, use gentle techniques.

• Check your medications: Talk to your doctor about any medications or supplements you're taking that might be causing hair loss. Some medications can have unexpected side effects, including hair loss.

• Protect your hair from the sun: Just like your skin, your hair is vulnerable to the sun's harmful ultraviolet (UV) rays. Try to protect your hair from direct sunlight, especially during peak sun hours. Wearing a hat or using a hair product with UV protection can help.

• Quit smoking: Studies suggest a link between smoking and hair loss, particularly in men. If you smoke, quitting could potentially help prevent hair loss.

• Talk to your doctor about chemotherapy: If you're undergoing chemotherapy, talk to your doctor about a cooling cap. These caps can help reduce the risk of hair loss during treatment. This is especially important if hair loss is a concern for you.

By being gentle with your hair, managing medications, protecting it from the sun, considering lifestyle choices like quitting smoking, and seeking advice from your doctor about treatments like chemotherapy, you may be able to lessen the chances of preventable hair loss.

To figure out what's causing your hair loss, your doctor will first do a physical exam and ask about your diet, hair care habits, and your health history (including your family's). They might also order some tests.

One common test is a blood test. This can help find underlying medical conditions that sometimes lead to hair loss. For example, some illnesses can affect your body's ability to produce the nutrients your hair needs to grow.

Another test is a "pull test." Your doctor gently pulls on a bunch of hairs. If many hairs come out easily, it suggests a problem with the hair follicle, which is the part of your skin where hair grows. This helps the doctor understand how severe the hair loss is.

Sometimes, a small sample of skin and hair follicles is taken from your scalp for a biopsy. This sample is examined under a microscope. This can reveal if an infection or other problem is affecting your hair follicles.

A doctor might also use a special microscope (light microscopy) to look closely at the structure of your hair. This can help identify issues with the hair shaft itself, which is the part of the hair that grows out from your scalp. This might reveal problems with the hair's protein structure, making it weak or brittle.

Mayo Clinic has a team of experts who can help you understand and address your hair loss concerns. They can provide support and treatment options.

Treating Hair Loss: Options and Considerations

Many people experience hair loss, and thankfully, effective treatments are available. Sometimes, hair loss can be reversed or at least slowed down. For example, with conditions like alopecia areata, hair might grow back on its own within a year. Treatments can include medications and surgery.

If your hair loss is due to an underlying health problem, treating that problem is crucial. If a medication you're taking is causing hair loss, your doctor might suggest stopping it temporarily.

Several medications can help with pattern baldness (often due to genetics).

• Minoxidil (Rogaine): This is a common over-the-counter treatment available as a liquid, foam, or shampoo. Apply it to your scalp daily (once for women, twice for men). Foam is often applied when hair is wet for better absorption. While many people see results, it can take at least six months to see improvements, and possibly even longer to know if it's working for you. If it helps, you'll need to keep using it for continued benefits. Possible side effects include scalp irritation and unwanted hair growth elsewhere on your face or hands.

• Finasteride (Propecia): This is a prescription medication for men only, taken daily as a pill. It can help slow hair loss and even promote new growth in some men. Results may take several months to become noticeable. You need to keep taking it to maintain any improvements. This medication may not be as effective for men over 60. Rare side effects include changes in sex drive or function, and a slightly increased risk of prostate cancer. Crucially, women who are or might be pregnant should avoid contact with crushed or broken tablets.

• Other Medications: Other options include spironolactone (used for various conditions) and oral dutasteride.

Hair Transplantation (Surgical Options):

A hair transplant involves moving hair follicles from a part of your head with hair to a bald area. This is done one follicle at a time (micrografts and minigrafts), or sometimes a larger piece of scalp containing multiple follicles is used. The procedure is usually done under sedation to manage discomfort. While it doesn't require a hospital stay, it's still a surgical procedure so there are risks such as bleeding, bruising, swelling, and infection. More than one procedure may be needed to get the desired results. Importantly, even with a transplant, hereditary hair loss will likely continue to progress over time. Insurance typically doesn't cover hair transplant costs.

Other Treatments:

A low-level laser device is another FDA-approved treatment for hair loss, showing some promise in improving hair density in small studies. However, more long-term studies are needed to confirm its effectiveness.

Important Note: It's crucial to discuss any hair loss concerns with your doctor. They can help determine the underlying cause and recommend the most appropriate treatment options for you.