Hair Loss

Medical Dermatology

Skin Conditions

 

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Hair Loss

Society has placed a great deal of social and cultural importance on hair and hairstyles. Unfortunately, some medical conditions, scalp diseases, prescription medications and improper hair care may result in hair loss. If you notice hair shedding in large amounts after combing or brushing, or your scalp feels inflamed or infected, you should consult a dermatologist. With correct diagnosis and early intervention, many people with hair loss can be helped.

Dermatologists specialize in treating diseases of the hair and skin and will evaluate the problem by asking questions about diet, medications, family history of hair loss, recent illness, and hair care habits. Hormonal effects may be evaluated in women by asking about menstrual cycles, pregnancies, and menopause. After examining the scalp and hair, sometimes blood tests or a scalp biopsy may be required for an accurate diagnosis. It's important to find the cause and whether or not the problem will respond to medical treatment.

About 90 percent of the hair on a person's scalp is growing at any one time. The growth phase lasts between two and six years. Ten percent of the hair is in a resting phase that lasts two to three months. At the end of its resting stage, the hair is shed and a new hair from the same follicle replaces it. Scalp hair grows about one-half inch a month. As people age, their rate of hair growth slows. Most hair shedding is due to the normal hair cycle and losing 50-to-100 hairs per day is no cause for alarm. However, if you are concerned about a sudden increase in hair loss or dramatic thinning, consult your dermatologist. Improper hair care including dyes, tints, bleaches, straighteners, and permanent waves may lead to damage if used too often. These treatments rarely damage hair if they are done correctly. If hair becomes brittle from chemical treatments, it's best to stop until the hair has grown out. Hairstyles that pull on the hair, like ponytails and braids, should not be pulled tightly and should be alternated with looser hairstyles. The constant pull can lead to hair loss, especially along the sides of the scalp.

Shampooing, combing and brushing too often, can also damage hair, causing it to break. When hair is wet, it is more fragile, so vigorous rubbing with a towel, and rough combing and brushing should be avoided. Don't follow the old rule of 100 brush strokes a day. Instead, use conditioners and wide toothed combs or a brush with smooth tips.

Hereditary balding or thinning is the most common cause of hair loss. The tendency can be inherited from either the mother's or father's side of the family. Women with this trait develop various degrees of thinning hair, but do not become completely bald. The condition can start in the teens, twenties, or thirties. There is no cure, although medical treatments have recently become available that may help some people. One treatment involves applying a lotion, minoxidil, to the scalp twice a day. Another treatment for men is a daily pill containing finasteride, a drug that blocks the formation of the active male hormone in the hair follicle.

When confronted with thinning hair or baldness, men and some women consider hair transplantation, which is a permanent form of hair replacement. The procedure involves moving some hair from areas of the scalp with thicker hair to bald or thinning portions. A hair transplantation surgeon can help you decide if this approach is right for you.

Alopecia Areata is a type of hair loss where hair falls out in totally smooth, round patches about the size of a coin or larger. It can, though rare, result in complete loss of scalp and body hair. This disease may affect children or adults of any age. The cause of alopecia areata is unknown. Apart from the hair loss, affected persons are generally in excellent health. In most cases, the hair regrows by itself. Dermatologists can treat many people with this condition.

Childbirth may lead to shedding. After a woman delivers her baby, many hairs enter the resting phase of the hair cycle. Within two to three months, some women will notice large amounts of hair coming out in their brushes and combs. This can last one to six months, but resolves completely in most cases. A similar situation may be seen with the cessation of oral contraceptive medication.

High fever, severe infection including severe flu may cause hairs to enter the resting phase. Four weeks to three months after the event, a person may be shocked to see a lot of hair falling out. This shedding usually corrects itself. Thyroid disease, both over-active and under-active, can cause hair loss. Laboratory tests can diagnosis thyroid disease and hair loss may be reversed with proper treatment.

Crash diets or abnormal eating habits resulting in low protein will force the body to will save protein by shifting growing hairs into the resting phase. Massive hair shedding can occur two to three months later. Hair can then be pulled out by the roots fairly easily. This condition can be reversed and prevented by eating the proper amount of protein and, when dieting, maintaining adequate protein intake.

Some prescription drugs may cause temporary hair shedding. Examples include some of the medicines used for the following: gout, arthritis, depression, heart problems, high blood pressure, or blood thinner. Excessive doses of vitamin A may also cause hair shedding.

Some cancer treatments will cause hair cells to stop dividing. Hairs become thin and break off as they exit the scalp. This occurs one to three weeks after the treatment. Patients can lose up to 90 percent of their scalp hair but will regrow after treatment ends.

Iron deficiency occasionally causes hair loss. Some people don't have enough iron in their diets or may not adequately absorb iron. Women who have heavy menstrual periods may develop iron deficiency. This can be detected by laboratory tests and can be corrected by taking iron pills.

Major surgery can result in hair shedding within one to three months. The condition reverses itself within a few months but people who have a severe chronic illness may shed hair indefinitely.

Caused by a fungus infection, ringworm begins with small patches of scaling that can spread and result in broken hair, redness, swelling, and even oozing. This contagious disease is most common in children, and oral medication will cure it.

Children and sometimes adults will twist or pull their hair, brows, or lashes habitually until they come out. Sometimes hair pulling can be a coping response to unpleasant stresses and occasionally is a sign of a serious problem needing the help of a mental health professional.