Overview
Alopecia is a condition that results in either a partial or complete loss of the person’s hair. The term itself serves as an umbrella term – many different types and causes of hair loss are included. Average people lose up to 100 individual hairs on a daily basis – it’s a normal process. In those without alopecia, these hairs grow back without assistance.
Many different causes can result in alopecia. For example, lupus, thyroid issues, and diabetes can result in hair loss. Other causes include the normal process of aging, a low protein diet, high levels of stress, family history, poor nutrition, certain medications, or chemotherapy for cancer.
How hair loss is treated depends on what’s causing it. In many cases, if the underlying cause of the hair loss is addressed, the loss may stop. If that isn’t an option, certain medications and hair restoration procedures exist. Dermatologists can help with treatment options for hair loss or thinning.
Commonly Associated With
Scarring alopecia, Baldness, Non-scarring alopecia, and Loss of hair
Cause Of Alopecia
Hereditary Causes
The amount and thickness of a person’s hair tends to decrease as they age. This is true of both men and women, and is not usually the result of any particular disease. For the most part, it’s related to the aging process in general, hereditary factors, and changes in the person’s testosterone levels.
Male pattern baldness affects far more women than men, and can occur at any point past puberty. It’s an inherited condition, and exceedingly common. Roughly 80% of men are expected to have some signs of male pattern baldness by the time they reach the age of 70.
Physical Or Emotional Stress
High levels of physical or emotional stress can result in 50-75% of hair loss on the scalp. This variety of hair loss is named telogen effluvium. When a person has this condition, they tend to lose hair by the handful, especially when they comb their hair, use shampoo, or run their hands through it. They can notice this level of loss weeks or months after the actual stress episode occurred. The loss of hair will then decrease steadily over the course of 6-8 months. Telogen effluvium is usually a temporary condition, but it can become chronic (long-term) if not dealt with.
Examples of causes of telogen effluvium include:
- Childbirth
- Severe emotional stress
- Medications such as beta-blockers, retinoids, calcium channel blockers, birth control pills, specific antidepressants, and NSAIDs (including ibuprofen)
- Unsafe diets, often called “crash diets” that are not enough to sustain the human body. Diets that don’t contain enough protein are especially prone to causing hair loss.
- Severe infections or a high fever
- A major illness, a major surgery, or sudden severe blood loss
- For some women ages 30-60, a thinning of the hair on the entire scalp can occur. The hair loss may be heavy at first, and then slow down or stop over time. This type of telogen effluvium seems to occur without a known cause.
Other Causes
Other possible causes of hair loss (especially if it presents in an unusual pattern) can include:
- Burns, especially those on the scalp
- Autoimmune conditions, one example being lupus
- Alopecia areata (which presents as bald patches on the scalp and beard (if the person has one), and in some cases the eyebrows. Their eyelashes may also fall out
- A person’s nervous habits, such as rubbing the scalp or pulling/tearing the hair
- Too tight hairstyles that put too much tension on the person’s hair follicles
- Ovarian or adrenal gland tumors
- Scalp bacterial infections
- Specific infectious diseases, such as syphilis
- Anemia
- Excessive blow-drying, shampooing, bleaching, or dying of the hair
- Hormonal changes
- Thyroid diseases
- Radiation therapy
- Tinea capitis (ringworm of the scalp)
Symptoms Of Alopecia
Hair loss signs can show up in many different ways. Things to look for include:
- A receding hairline that becomes increasingly noticeable every year
- A thinning ponytail, if the hair is long enough to be in one
- A slowly-growing bald spot
- A gradual thinning of the person’s hair, especially on their head
- A widening part on the person’s scalp
Treatment Of Alopecia
Some people can become very concerned about their hair loss. How effective treatments will be depend heavily on what exactly is causing their hair loss. Some general tips to prevent or treat hair loss include:
A scalp massage
Consuming extra protein, especially if the person does not usually eat much protein in their diet
Maintaining good scalp and hair health
Eating a specific diet, such as a Mediterranean diet
Taking multivitamin supplements – but be sure to consult a health care provider on which ones will be effective first
Low-level light therapy for the scalp, if a health care provider recommends it
Taking hair loss medication recommended by a provider
Exams & Tests For Alopecia
A health care provider will usually not need more than a medical history and an examination of the scalp and hair to diagnose the cause of the person’s hair loss. However, some cases can be more complicated.
A provider will usually ask detailed questions about:
- Symptoms of the hair loss.
- If a pattern to the hair loss exists, or if there is a family history of hair loss
- Usual hair care routines, such as how often they shampoo or blow-dry their hair, or if they frequently use products in their hair.
- The person’s emotional state and psychological well-being, and if they’re currently under or were previously under considerable physical or emotional stress.
- Their diet, and if they’ve recently changed their diet in some way.
- If they’ve had any recent serious illnesses or surgeries, or if they’ve had a high fever.
Tests that could be performed in more complicated cases (that are rarely needed) can include:
- An examination of a plucked hair under a microscope
- Various blood tests to rule out any underlying disease
- A scalp skin biopsy
Other Information About Alopecia
Contact a health care provider if any of the following occur:
Itching or pain associated with the hair loss
A cisgender woman experiencing male pattern baldness
Muscle weakness, weight gain, fatigue, or intolerance to cold temperatures
Hair loss in an unusual pattern
Losing hair very rapidly or at an unusually early age. For example, a person losing a lot of hair in their teens or twenties
Bald spots on the eyebrows or beard (if the person has one)
Infected areas on the skin of the scalp
The person’s skin on their scalp beneath the area of hair loss is red, scaly, or abnormal in some other way
Unusual facial hair, acne, or an abnormal menstrual cycle
