Hair Loss

Introduction

Hair loss, also referred to as alopecia or balding, is a very common condition.  Balding is very common in men, although both men and women tend to lose hair thickness as they age.  In most cases, hair loss is inherited and requires the presence of certain hormones to occur. 

There are several options for people that are bothered by hair loss.  Hair restoration products can be helpful for some people.  Hair plug surgery can transfer hair follicles to affected areas for regrowth. Other options include wigs or hair weaves.
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Anatomy

The average adult scalp has about 100,000 hairs.  Each hair has its own growth, resting, and shedding cycle.  Your hair grows about ½ inch each month.  An individual hair typically lasts for about 4 ½ years, after which time it falls out and is replaced by a new hair.  You normally lose about 100 hairs a day.
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Causes

Both men and women tend to lose hair thickness as they age.  Hair loss can occur for several reasons.  Male pattern baldness is very common.  The exact cause is unknown, but researchers do know that it is inherited and requires the presence of androgen hormones.  Inherited hair loss is caused by the failure of new hair to grow and replace the hair that has fallen out.  Male pattern baldness usually begins as a receding hairline and eventual balding on top of the head.
 
Female pattern baldness may be related to genetics and hormones, especially around childbirth or menopause.  Females tend to experience hair thinning throughout the scalp with the hairline remaining intact.  Complete female baldness is rare.
 
Other causes of hair loss include trauma, stress, certain medications, some medical conditions, and poor nutrition.  Hair loss can occur following a severe illness or fever.  Chemotherapy and radiation therapy treatments used for cancer can cause temporary hair loss.  Hair loss can also occur because of hair breakage from excessive blow-drying and harsh hair products.
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Symptoms

You may notice hair loss when you look in the mirror.  You may find hairs on your pillow after sleeping, in your hairbrush, or in your shower drain.  Women may notice a decreased thickness in a ponytail.
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Diagnosis

You should see your doctor if you lose large amounts of hair and feel ill.  Your doctor will rule out any underlying medical cause.  You may also want to contact your doctor if you experience hair loss and are concerned about your appearance.  Your doctor will compare the amount of hair that you have and its location with hair distribution charts.  In some cases, doctors may test for skin problems associated with hair loss.
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Treatment

Treatment of underlying medical conditions usually resolves hair loss caused by illness.  In other cases, if you are bothered by the appearance of hair loss, you have several options.  Hairpieces, wigs, and hair weaves can cover hair loss.  Your doctor can recommend medications that can help male and female pattern baldness.  Additionally, cosmetic procedures can change the appearance of your scalp or hair.

Hair transplantation is a cosmetic surgery procedure that relocates plugs of growing hair from one area of the scalp to another.  Follicular hair transplants relocates individual hairs. Tattooing can make thinning hair on the scalp, eyebrows, or eyelashes appear thicker.  Scalp rotation surgery is a cosmetic procedure that moves an area with good hair growth to an area with poor hair growth. In this process, the skin is stretched with implants prior to the surgery.  The area without hair is surgically removed, and the area with growing hair replaces it.
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Prevention

Hair loss prevention works best if medications are started very early.  Researchers state that medication that is applied to the scalp works best if it is started within the first five years of hair loss.  Your doctor should supervise the use of hair loss medications.  You should ask your doctor for medication recommendations and be cautious of fraudulent products.
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Am I at Risk

Risk factors may increase your likelihood of developing hair loss, although some people that develop the condition do not have any risk factors.  People with all of the risk factors may never develop hair loss; however, the chance of developing the condition increases with the more risk factors you have.  You should tell your doctor about your risk factors and discuss your concerns. 


Risk factors for hair loss:


_____ Men experience hair loss more frequently than women do.
_____ Hair loss is associated with aging.
_____ Caucasians experience the greatest incidence of hair loss.  People that are Japanese or African American experience hair loss less frequently.
_____ Hair loss has a hereditary genetic component.  If your close relatives experienced hair loss, your risk is higher.
_____ Temporary hair loss is a side effect of certain medications and treatments, including chemotherapy and radiation therapy used to treat cancer.
_____ In females, hair loss is associated with hormone changes that occur during pregnancy and menopause.
_____ Hair loss can be caused by trauma, such as from burns or hair that was pulled out.
_____ Alopecia areata is a condition that causes hair loss on the scalp, eyebrows, eyelashes, and beard.
_____ Emotional stress is linked to hair loss.
_____ Severe illness and some medical conditions, such as thyroid disorders, can cause hair loss.
_____ Hair breakage can occur as a result of over-processing or over-blow drying hair.


 
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Complications

With hair loss, the scalp loses its natural protection from the sun.  People that experience hair loss should wear a hat and sunblock to help prevent sunburn and skin cancer.  You should ask your doctor to inspect your scalp during your routine full body mole check. 
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.