Monday, June 19, 2006

What Causes Hair Loss

A blogger asks about the causes of hair loss in women and men.

A certain amount of hair loss about 50 - 200 per day is normal as hair goes through cycles of growth and rest. About 10% of hair is in the rest phase at any one time and will eventually fall out and new hair will grow in its place. Excessive hair loss or alopecia may occur as a diffuse thinning or in a patchy distribution. The reasons for alopecia are many according to our guest blogger consultant, Dr. Patricia Wong. These include the following:

  • Genetic predisposition called androgenetic alopecia is the most common cause for thinning. This can be inherited from the maternal or the paternal side of the family. It can start as early as in the teenage years.
  • Thyroid abnormalities which may be in the form of an over active or under active thyroid function. This can be reversed with proper treatment.
  • Anemia or iron deficiency.
  • Alopecia Areata in which hair completely falls out in round patches usually the size of a coin leaving a smooth skin. The cause is unknown.
  • Severe infection, high fever, chronic illness or major surgery may cause a temporary hair loss which usually corrects after several months.
  • Medications such as those used for high blood pressure, depression or for cancer treatment.
  • Excess intake of vitamin A.
  • Hormonal changes such as in taking birth control pills, post pregnancy or menopause.
  • Excessive or rapid weight loss.
  • Protein deficiencies such as in crash dieting or in malnutrition.
  • Skin infections of the scalp such as ringworm infection.
  • Chemical treatments to the hair such as coloring or perms especially when done improperly or too often.
  • Stress or Depression.

The hair loss may occur several months after the onset of any of these events. The "pull test" is one method which may be used to assess if the hair loss is normal. Hold 60 hairs between the thumb and the index and middle fingers then pull gently but firmly. If six or fewer hairs are pulled out then the shedding may be normal, but if more than six hairs are pulled out then active hair shedding may be occurring. Patients should not shampoo their hair 24 hours before the test is performed.

To determine the cause, it is recommended to see your health care provider and a dermatologist who specializes in hair disorders. An examination of the hair and scalp, blood tests and some times a biopsy may be required to fully assess the cause of the hair loss.

There is no scientific evidence showing efficacy of over the counter shampoos and treatments to stimulate hair growth. It is best to be evaluated by a specialist so that an effective treatment can be prescribed when possible.

References: American Academy of Dermatology. Dr Patricia Wong, board certified dermatologist specializing in diseases of skin, hair, and nails, practicing in Palo Alto. Shapiro J, Wiseman M, Liu H. Practical management of hair loss. Can Fam Physician 2000;46: 1469-77.


zenyenta said...

I was pretty sure my hair was getting a little thinner. Nothing radical or panic inducing, but thinner around the front. I'm taking Targretin, which is primarily a synthetic form of Vitamin A, I think the reason why is clarified now. I kind of thought so, but it's good to have clarity.

Dowell Taggart Team said...

I started loosing my hair at age 27. Now I'm 41 and have lost 75% of my hair. I have tried many remedies and nothing works. Lately I have been diagnosed with diabetes and the doctors say that is why I have lost my hair. What do you think.


Dr. Taraneh Razavi said...

I can not comment on specific cases with out examining the patient, but in general, the cause may be multifactorial. If the hair loss starts 15 years before the onset of diabetes, then it would seem that genetics may have played a bigger role than the diabetes alone.

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Kevin said...

I really think the genetic thing is the main cause of hair loss. I know there are loads of things that can slow it down. But once it starts's inevitable.

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Anonymous said...

Thank you so much for this post! I have been losing my hair around the face and ears..I am a twenty four year old female..I have been scared to death that something deeper was going on..but I suffer from extreme anxiety and I have a dr. appointment friday about my hormones..Been missing periods for a year. So this was very educational for me. I needed the peace of mind.It's scary not to know why things are happening to your body. So thanks again.

Anonymous said...

I am very scared too at the moment. I am 27 yr old, and at least 60% of my hair has gone (not to say 75%)My eyelashes and brows have started to fall as well (2 a day, i've noteced this week and my body hair is less than normal) My doctor said its normal, i begged her to refer me somewhere else, but she said is normal. I do have lots of dandruff, and it feels itchy sometimes even my eyebrows feel itchy and dandruff as well. What can it be? What should I do? I am waiting for the blood results to come back next week.

Anonymous said...

Avoid overconsumption of salt (most vegetables have their own natural sodium) and sugar; skip them entirely, if possible.
# Same with alcohol and tobacco, also contributing causes of hair loss and dandruff.# Overuse of hair dyes, hairdryer and curling iron can aggravate the problem of hair loss, leading to baldness. Hence, do not use such products on a regular basis, if you are facing the problem of excessive loss of hair.
# In case you are coloring your hair on a regular basis, be sure to leave a gap of at least 6 to 8 weeks between each session. This will prevent hair loss. Let your hair turn gray naturally. After all, it is better to sport gray hair than baldness!
# Tight hairstyles such as braids, buns and ponytails can also lead to hair loss. The best way to prevent hair loss is to adopt easy hairstyle.

Prevent Hair Loss