Everything You Need to Know About Hair Loss
Hair loss (alopecia) is a fairly common occurrence. While it’s more prevalent in older adults, anyone can experience it, including children.
It’s typical to lose between 50 and 100 hairs a day, according to the American Academy of Dermatology (AAD). With about 100,000 hairs on your head, that small loss isn’t noticeable. New hair normally replaces the lost hair, but this doesn’t always happen.
Hair loss can develop gradually over years or happen abruptly. Depending on the underlying cause, it may be temporary or permanent.
Trying to tell if you’re actually losing hair or just experiencing some normal shedding? Unsure if it’s time to see a doctor? Read on for more information about hair loss and how to manage it.
Hair loss symptoms
The main symptom of alopecia is losing more hair than usual, but this can be harder to identify than you might think.
The following symptoms can provide some clues:
- Widening part. If you part your hair, you might start to notice your part getting wider, which can be a sign of thinning hair.
- Receding hairline. Similarly, if you notice your hairline looking higher than usual, it may be a sign of thinning hair.
- Loose hair. Check your brush or comb after using it. Is it collecting more hair than usual? If so, this may be a sign of hair loss.
- Bald patches. These can range in size and can grow over time.
- Clogged drains. You might find that your sink or shower drains are clogged with hair.
- Pain or itching. If you have an underlying skin condition causing your hair loss, you might also feel pain or experience itching on your scalp.
What causes hair loss?
There are a few main types of hair loss, each with different underlying causes.
Androgenic alopecia refers to hereditary hair loss, like male pattern baldness or female pattern baldness. It’s the most common cause of hair loss, affecting up to 50 percent of peopleTrusted Source.
Hair loss related to androgenic alopecia tends to happen gradually. While some people might experience hair loss as early as puberty, others might not notice symptoms until their middle ages, which is between 6 and 11 years old.
Female pattern baldness often results in thinning all over the scalp. It might also look like widening or thinning around the part. Male pattern baldness typically involves progressive hair loss above the temples and thinning at the crown of the head, creating an “M” shape.
Alopecia areata is an autoimmune condition that causes your immune system to attack hair follicles, resulting in bald patches that can range from small to large. In some cases, it might lead to total hair loss.
In addition to losing hair on the scalp, some people with alopecia areata lose hair from their eyebrows, eyelashes, or other parts of the body.
Anagen effluvium involves a rapid loss of hair. This usually happens because of radiation treatment or chemotherapy.
Hair will usually regrow after the treatment stops.
Telogen effluvium is a type of sudden hair loss that results from emotional or physical shock, like a traumatic event, period of extreme stress, or a serious illness.
It can also happen because of hormonal changes, like those that happen in:
Other potential causes of telogen effluvium include:
- certain endocrine disorders
- starting or stopping hormonal birth control
Several types of medications can also cause it, including:
- oral retinoids
- thyroid medications
This type of hair loss typically resolves on its own once the underlying cause is addressed.
Tinea capitis, also called ringworm of the scalp, is a fungal infection that can affect the scalp and hair shaft. It causes small bald patches that are scaly and itchy. Over time, the size of these patches increases.
Other symptoms include:
- brittle hair that breaks easily
- scalp tenderness
- scaly patches of skin that look grey or red
It’s treatable with antifungal medication.
Traction alopecia results from too much pressure and tension on the hair, often from wearing it in tight styles, like braids, ponytails, or buns.
Diseases that cause scarring, such as lichen planus and some types of lupus, can result in permanent hair loss due to the scarring.
How is hair loss diagnosed?
Because so many things can cause hair loss, it’s best to schedule an appointment with a medical professional if you notice any changes in your hair.
They’ll likely use a combination of your health history and a physical exam to help narrow down the causes.
If they suspect an autoimmune or skin condition, they might take a biopsy of the skin on your scalp. This involves carefully removing a small section of skin for laboratory testing. It’s important to keep in mind that hair growth is a complex process.
They may also order blood tests to check for any nutrient deficiencies or signs of an underlying condition.
What are the treatment options for hair loss?
There’s a range of treatment options for hair loss, but the best option for you will depend on what’s causing your hair loss.
Medications will likely be the first course of treatment.
Over-the-counter (OTC) medications generally consist of topical creams, gels, solutions, or foams that you apply directly to the scalp. The most common products contain an ingredient called minoxidil.
Prescription medications, like finasteride (Propecia), may help, especially for male pattern baldness. You take this medication daily to slow hair loss, though some experience new hair growth when taking finasteride.
Your clinician might prescribe anti-inflammatory medications, like corticosteroids, if hair loss seems related to an autoimmune condition.
If medication does not help, your healthcare professional might recommend one of the following procedures.
Hair transplant surgery
Hair transplant surgery involves moving small plugs of skin, each with a few hairs, to bald parts of your scalp.
This works well for people with inherited baldness since they typically lose hair on the top of the head. Because some hair loss can be progressive, you may need multiple procedures over time.
In a scalp reduction, a surgeon removes part of your scalp that lacks hair and closes the area with a piece of your scalp that has hair. Another option is a flap, in which your surgeon folds scalp that has hair over a bald patch.
Tissue expansion can also cover bald spots, but this requires two procedures. In the first surgery, a surgeon places a tissue expander under a part of your scalp that has hair and is next to the bald spot. After several weeks, the expander stretches out the part of your scalp that has hair.
In the second surgery, your surgeon removes the expander and pulls the expanded area of scalp with hair over the bald spot.
How can I prevent hair loss?
There are a few things you can do to minimize hair loss:
- Keep hairstyles loose. If you regularly style your hair into braids, buns, or ponytails, try to keep them loose so they don’t put too much pressure on your hair.
- Avoid touching your hair. As much as possible, try not to pull, twist, or rub your hair.
- Pat hair dry. After washing, use a towel to gently pat your hair dry. Avoid rubbing your hair with the towel or twisting it within the towel.
- Aim for a nutrient-rich balanced diet. Try to incorporate plenty of iron and protein into snacks and meals.
Styling products and tools are also common culprits in hair loss. Examples of products or tools that can affect hair loss include:
- blow dryers
- heated combs
- hair straighteners
- coloring products
- bleaching agents
If you decide to style your hair with heated tools, only do so when your hair is dry and use the lowest settings possible.
If you’re currently losing hair, use a gentle baby shampoo to wash your hair. Unless you have extremely oily hair, consider washing your hair only every other day or less.
When to see a doctor about hair loss
It’s best to see a healthcare professional for any unexplained hair loss so they can determine the underlying cause and best course of treatment.
During your appointment, be sure to mention any other unusual symptoms you’ve noticed, including:
- unexplained weight loss
- limb swelling
- changes in bowel movements
- rashes or other skin changes on your scalp or body
Any information you can provide about how quickly the hair loss occurred, along with any family history of baldness, will also be helpful.