Hair loss can be a matter of concern for both men and women. Keep reading the article to learn about the common causes and treatment modalities for hair loss.
Hair loss or alopecia can affect the scalp or entire body, and depending upon the cause; it can be temporary or permanent. It can result from genetics, medical conditions, hormonal fluctuations, or as a normal sign of aging. Baldness is a condition of excessive hair loss from the scalp, with hereditary hair loss, with age being the most common reason for baldness. When a person starts losing hair, it impacts psychological health, self-esteem, and confidence. Therefore, one should see a doctor immediately if something is wrong because the sooner the treatment, the better the outlook is. Before seeking hair loss treatment, discuss with a doctor the causes of hair loss and treatment options.
Although anybody can suffer from hair loss, it is more common in men. In addition, hair loss occurs more often among people with family members with autoimmune disorders like diabetes, lupus, or thyroid disease.
The human scalp has around one hundred thousand hair follicles. Hair grows in three cycles. Therefore, the hair follicle undergoes three different phases of activity and inactivity.
Anagen- Active Growing Stage - The duration of growth ranges from two to 10 years for scalp hair; around 80 to 90 % of scalp hair will be at anagen (growing phase) at any given time.
Catagen- Involutory Stage - The hair stops growing and undergoes slow degeneration. This phase lasts for weeks. Around 1 % of scalp hair will be at this phase any time. Losing up to 50 to 100 hairs daily is considered normal (physiological).
Telogen- Resting Stage - Around 10 % of the scalp hair will be at the resting stage for two to three months before it is actively shed. Once the hair is shed, new hair starts growing.
Depending on the cause of hair loss, different names are given.
Androgenetic Alopecia (AGA) - Also called patterned alopecia, it is seen in both men and women. It is a hormonal, progressive condition with genetic influence. Hair becomes thinner as age advances. It may start as early as in the 20s. In men, hair loss will be seen on both sides of the temporal scalp and over the vertex (center of the scalp). In addition, men may notice hair fall, delayed hair growth, thinning of hair diameter, visibility of scalp skin, initially over frontal area and vertex. As the alopecia progresses, these two patches of hair loss join together, leaving a band of hair limited to the occipital scalp area (back of the scalp). In women, the pattern of hair loss is different from men. Here they notice thinning of hair, visibility of scalp limited to the central scalp, around the parting line. It is very unusual for women to go completely bald as men do. However, male pattern baldness can rarely be seen in women, presenting as baldness over the frontal scalp and vertex.
Telogen Effluvium - This is a stress-induced hair loss. Hair loss will be seen after two to three months of stressful episodes. Stress can be physical stress (illness, malaria, typhoid, surgeries, excessive bleeding, crash diet, after childbirth) or mental stress (examinations, grief, depression). Usually, 10 % of hair will be under the telogen (resting) phase. These stressful episodes push more hairs into the resting phase, ranging from 20 to 25 %. These resting hair start falling after three months.
Alopecia Due to Endocrine Disorders - Endocrine disorders and subsequent hormone imbalances can cause hair loss. Hypothyroidism is the most common cause among these.
Drug-Induced Alopecia - Certain medications such as anti-cancer and anti-thyroid medications, increased vitamin A, and retinoids can cause diffuse hair loss.
Nutritional Alopecia - Protein-energy malnutrition, zinc deficiency, biotin deficiency, essential fatty acid deficiency, malabsorption syndromes, and anemia can cause hair loss.
Alopecia Areata - It is characterized by smooth, patchy hair loss. It can affect scalp hair, eyebrow, beard, and mustache.
Trichotillomania - This condition is more common in women than in men. It is an impulse control disorder, and there is an unintentional yet conscious pulling of one's own hair.
Traction Alopecia - Hair loss is due to continuous pull on the hair. For example, traction during hairstyling with tight clips or bands, tight braiding practices, tight ponytails, and a tight scarf tied over the scalp can cause traction alopecia.
Before making a diagnosis, the doctor often performs a physical examination and asks questions about the hair care routine, diet, and medical and family history. In addition, the doctor may order other tests such as the following:
Blood Test: It can help uncover any medical conditions that can cause hair loss.
Scalp Biopsy: It involves scraping skin samples or a few hairs plucked from the scalp to examine the hair roots under a microscope. This helps determine whether an infection is causing hair loss.
Pull Test: The doctor gently pulls a dozen hairs to check how many hairs come out. This test measures the severity of hair loss.
Light Microscopy: The doctor analyzes hairs trimmed at their bases with a special instrument to detect possible disorders of the hair shaft.
Hair loss is considered severe when there is a loss of more than 100 hairs per day. Treatment of hair loss depends on the cause of hair loss. The most common options include:
Corticosteroids: These are the anti-inflammatory drugs that are usually prescribed for autoimmune disorders. These can be injected into the scalp or other areas, taken orally as a pill, or applied topically (directly on the skin) as a cream, ointment, or foam. The response to corticosteroid therapy may be gradual.
Minoxidil: This is an over-the-counter topical drug used for pattern baldness treatment. It typically takes about 12 weeks of therapy with Minoxidil before hair starts growing. The drug is available in liquid, foam, and shampoo forms. To get the best results, apply the product to the scalp skin once daily for women and twice daily for men.
Finasteride: This is a prescription drug for men. It is taken daily as a pill. Many men who take Finasteride experience a slowing of hair loss, and some may show new hair growth. Finasteride may not benefit well for men over 60 years of age.
Routine Hair Care Tips:
Always use lukewarm water for washing your hair. Never use hot water.
Use any suitable shampoo for washing hair at least thrice a week. Washing hair frequently keeps the scalp free from dandruff. Use antidandruff shampoo for dandruff.
Avoid using a hairdryer. Allow it to dry naturally after a bath.
Avoid hot iron straighteners.
Avoid tying hairs too tight.
Hair needs protein for its growth. Hence, the diet has to be rich in protein (eggs, chicken, fish, curd, milk, lentils).
Use a comb that has a wide space between each tooth, and the tip of the tooth should be blunt.
Always comb gently.
Avoid smoking. Nicotine decreases blood supply to the hair roots, affecting hair growth.
Do regular exercise for 40 to 50 minutes daily, six days a week. This is essential to keep the body active and helpful in the management of androgenetic alopecia.
Hair loss (alopecia) is a common medical problem. While anyone can experience it, it is more prevalent in men. In addition, hair loss can be socially distressing as it negatively impacts psychological health, self-esteem, and confidence. However, treatment can often help address hair loss by stimulating hair health, thickness, and strength. Prompt diagnosis and treatment can yield better results, so consult a doctor immediately after noticing hair loss.
Last reviewed at:
10 Oct 2022 - 5 min read
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