Hair loss (alopecia) can affect just your scalp or your entire body, and it can be temporary or permanent. It can be heredity, due to 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. Some people prefer to let their hair loss run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still others choose one of the treatments available to prevent further hair loss or restore growth.
Before pursuing hair loss treatment, talk with your doctor about the cause of your hair loss and treatment options.
Hair loss can appear in many different ways, depending on what's causing it. It can come on suddenly or gradually and affect just your scalp or your whole body.
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 fibro sing 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.
There are various reasons for hair loss. Some of the factors include:
- Hereditary - family history of alopecia increases the risk
- Hormonal changes - imbalances caused by pregnancy or menopause could lead to hair loss
- Medical conditions such as scalp infections, lichen planus, lupus, sarcoidosis, hair-pulling disorder, an autoimmune disorder
- Medications such as cancer drugs, intake of Vitamin A, etc
- Radiation therapy to the head
- Stressful experiences such as sudden weight loss, surgery, high fever, loss of loved one, can trigger hair loss
- Certain hairstyles that pull hair tightly
- Beauty treatments that could cause inflammation of the hair follicle
Risk factors which trigger hair loss include:
- Family history
- Age - more common among older people
- Poor nutrition
- Medical conditions such as diabetes, lupus, etc
- Eat a well-balanced diet and consume adequate iron rich food.
- Avoid tight hairstyles
- Avoid pulling your hair
- Treat your hair gently while washing it
- Avoid hot oil treatments
- Do not get chemical beauty treatments often
Before making a diagnosis, your doctor will most 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.
Effective treatments for some types of hair loss are available. You might be able to reverse hair loss, or at least slow it down. 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.
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).
Lifestyle and home remedies
You might want to try various hair care methods to find one that makes you feel better about how you look. For example, use styling products that add volume, color your hair, choose a hairstyle that makes a widening part less noticeable. Use wigs or extensions, or shave your head. Talk with a hair stylist for ideas. These approaches can be used to address permanent or temporary hair loss.
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