Tuesday, March 31, 2020
Hair loss can affect just your scalp or your entire body. It can be the result of heredity, hormonal changes, medical conditions or medications. Anyone can experience hair loss, 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 and to restore growth.
Before pursuing hair loss treatment, talk with your doctor about the cause of your hair loss and treatment options.
Symptoms:
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. Some types of hair loss are temporary, and others are permanent.
Signs and symptoms of hair loss may include:
Gradual thinning on top of head: This is the most common type of hair loss, affecting both men and women as they age. In men, hair often begins to recede from the forehead in a line that resembles the letter M. Women typically retain the hairline on the forehead but have a broadening of the part in their hair.
Circular or patchy bald spots: Some people experience smooth, coin-sized bald spots. This type of hair loss usually affects just the scalp, but it sometimes also occurs in beards or eyebrows. In some cases, 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 and not bald patches.
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.
1. Intense emotional or physical stress
When you're experiencing something stressful or traumatic—not your average day-to-day stress, but something big and life-altering like a divorce, a death in the family, a significant job change, or a big move—you may experience a temporary halt in hair growth as your body puts its resources toward getting you through said big event.
"Hairs don’t all grow at the same rate," Dr. Schlosser explains. "Some are growing, some are resting, and some are actively being shed. When you have these conditions, your body halts hair growth, and then things get restarted and all these hairs that have been halted start to get pushed out at the same time." The same thing can happen with physical stress and trauma, like having a big operation, being hospitalized, or even losing a significant amount of weight very quickly.
Usually this type of hair shedding is temporary. But if it bothers you, check in with a dermatologist to learn more about styling changes and products you can use to make your hair look and feel fuller.
2. Nutritional deficiencies
Creating and maintaining healthy hair relies on getting solid nutrition. In particular, deficiencies in iron, zinc, vitamin B3 (niacin), and protein have all been linked to various types of hair loss.
Treating a nutritional deficiency usually starts with a chat with your doctor and a blood test to accurately diagnose your issue. Then your doctor may treat your deficiency with prescription supplements or may refer you to an R.D. for further guidance.
3. Wearing too-tight hairstyles too often
This can cause traction alopecia, Dr. Schlosser says. "Classically, this happens when people wear tight braids chronically, but I’ve seen it with tight ponytails too," she explains. It can cause progressive thinning of the hairline, and if you do it for long enough, the hair loss may actually become permanent. It's considered a scarring process, which can damage the hair follicle beyond repair.
To help prevent and treat hair loss due to traction alopecia, Dr. Schlosser advises never wearing one hairstyle for too long, and trying not to pull too tightly if you can help it.
4. Overprocessing your hair
Getting frequent perms, chemical straightening procedures, or relaxing procedures—basically anything that uses harsh chemicals on your scalp and hair—can damage the hair follicle and cause permanent hair loss. "After repeated insults, the hair follicles just won't grow back," Dr. Schlosser says. This can cause hair to appear thinner, and may be especially noticeable on the scalp.
You can prevent further damage by avoiding those harsh procedures and using products designed to help hydrate and heal your hair and scalp. But if you want your hair to grow back, you’ll likely need to enlist the guidance of a board-certified dermatologist.
5. Autoimmune diseases
"An autoimmune condition makes the body recognize its own hair follicles as foreign and it attacks them and makes the hair fall out," Dr. Fusco explains.
This could be a condition like alopecia areata, in which the immune system attacks the hair follicles. Sometimes people with alopecia areata do see their hair grow back (although it may fall out again). But if not, dermatologists can help by prescribing various treatments, like corticosteroid injection to stimulate hair growth, the AAD says.
Conditions that primarily affect another part of the body—like thyroid disease, rheumatoid arthritis, or sickle-cell anemia—can also cause hair loss as one of many symptoms. Additionally, Dr. Schlosser notes that lupus can cause some scarring of the hair follicle, resulting in permanent hair loss.
These conditions can be serious and require an accurate diagnosis from an experienced health care provider. So if you think your hair loss may be connected to an underlying issue like an autoimmune condition, it’s important to talk to your doctor.
6. Childbirth
Normally, your hair goes through three major life stages. First, there’s a growth phase; second, there’s a transitional phase when the growing stops but the hair doesn’t fall out; and then there’s a resting phase. Finally, after the resting phase, your hair falls out.
But during pregnancy, most people notice their hair going into rapid growth mode. "That’s when everything is in a grow, grow, grow phase, because there are surges of hormones [estrogen] that make hair grow," Fusco says. Not only is the growth stage kicked into high gear, but also it lasts longer than normal, meaning that normal shedding doesn't occur.
Once estrogen levels go back to normal after delivery, hair resumes its normal growth cycles and starts to shed all that thick, luscious hair that accumulated over the last 10 months. Some women experience very mild shedding, but others experience intense shedding for a few months.
This type of hair loss (technically, hair shedding) is called telogen effluvium, and it can occur months after a stressful or major life event like childbirth, Bethanee Schlosser, M.D., assistant professor of dermatology and director of the Women's Skin Health Program for Northwestern Medicine, tells SELF. "Shedding peaks about four months after the incident" that caused it, she explains.
Postpartum hair loss is, luckily, temporary. So you don’t really have to do anything to treat it, the AAD says. But there are ways to make your hair look and feel fuller while you wait. For instance, look for volumizing shampoos and conditioners that are formulated for fine hair and avoid products that weigh down the hair.
7. Changes in birth control
Going off hormonal birth control or changing to a different type of hormonal contraception can also cause hormone-induced shedding. "Whether you're just starting it, discontinuing it, or changing brands, your body can react by causing the hair to go into an increased shedding mode," Dr. Fusco says.
This is another form of telogen effluvium, which means that it’s usually temporary. You can rely on volumizing products and styling tricks while you wait for your hair to regain its fullness.
8. Genetics
When we think of hereditary hair loss, we usually go straight to male pattern baldness. But people of all genders are susceptible to hereditary hair loss. In women the hair loss is usually concentrated at the crown of the head (especially noticeable at the hair part), while it’s more likely to affect men along the hairline, the American Academy of Dermatology (AAD) notes.
Although you can’t prevent this type of hair loss entirely, there are treatments available—such as over-the-counter minoxidil or finasteride—that can slow it down and make hair stay fuller longer. So the sooner you start treatment, the better.
9. Heat-styling your hair regularly
Fusco says that women will come to her and tell her they have hair loss, when really they have something called trichorrhexis nodosa. This is a condition in which damaged, weak points in the hair shaft cause hair to break off easily. The cause? Thermal damage to the hair from things like using hot tools and overbleaching. In this case, the hair loss “is not necessarily from the root but it's from somewhere along the shaft," she explains.
Treatment for trichorrhexis nodosa usually involves finding and avoiding the source of the damage, which could be hot tools, harsh chemicals, or aggressive brushing. Instead, opt for gentle brushing techniques and gentle, soothing hair products.
10. Medications
Some "medications can cause chronic shedding," Dr. Schlosser says. In particular, those used to manage high blood pressure, cancer, arthritis, and depression are known to cause hair loss issues, according to the Mayo Clinic.
If you think your medication may be causing hair loss, check in with your doctor. In many cases, this type of hair loss is temporary. But if your hair loss becomes chronic, your doctor may be able to prescribe a different medication that doesn’t cause this side effect.
11. Dandruff or scalp psoriasis
When the skin on the scalp is inflamed and itchy, it’s obviously tempting to scratch it. But that may cause your hair to shed more than usual.
Dandruff is the most easily treated cause of hair loss, Dr. Fusco says, because you can treat it with over-the-counter products, like a shampoo containing zinc pyrithione or exfoliating ingredients such as the classic Head & Shoulders Classic ($9, Amazon) or Oribe Serene Scalp Anti-Dandruff Shampoo ($46, Dermstore). "Consistency is the trick," Dr. Fusco says, so it's important to find a shampoo and conditioner you like enough to use regularly.
But other conditions can also cause itchiness and scalp flaking, including seborrheic dermatitis (a more severe version of dandruff caused by a buildup of yeast and oil) and psoriasis (an autoimmune condition that causes thick patches of skin). Treating these issues may take more time and effort than dandruff, so it’s important to check in with a dermatologist if you think you may be dealing with one of these conditions.