What causes hair loss? 19 possible conditions

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What Is Hair Loss?

The American Academy of Dermatology (AAD) notes that 80 million men and women in America have hereditary hair loss (alopecia). (AAD) It can affect just the hair on your head or your whole body. Although it is more prevalent in older adults, excessive hair loss can even occur in children.

According to Kids Health and the AAD, it is natural to lose between 50 and 100 hairs a day. (Kids Health). With about 100,000 hairs on your head, that small loss is unnoticeable. The lost hair is normally replaced by new hair but not always. Hair loss can develop gradually over years or happen abruptly. Hair loss can be permanent or temporary.

It is impossible to count the amount of hair lost on a given day. You may be losing more hair than is normal if you notice:

  • a large amount of hair in the drain after washing your hair
  • clumps of hair in your brush
  • you notice thinning patches of hair
  • you experience baldness

If you notice that you are losing more hair than usual, you should discuss the problem with your doctor. He or she can determine the underlying cause of your hair loss and suggest appropriate treatment plans.

Causes of Hair Loss

First your doctor or dermatologist (a doctor who specializes in skin problems) will try to determine the underlying cause of your hair loss. The most common cause of hair loss is hereditary male- or female-pattern baldness. If you have a family history of baldness, you may be susceptible to this type of hair loss. It is triggered by certain sex hormones and may begin as early as puberty.

In some cases, hair loss may be related to a simple halt in the cycle of hair growth. Major illnesses, surgeries, or traumatic events can trigger hair loss. However, your hair will usually start growing back without treatment.

Hormonal changes associated with pregnancy, childbirth, discontinuing the use of birth control pills, and menopause can cause temporary hair loss.

Medical conditions that can cause hair loss include thyroid disease, alopecia areata (an autoimmune disease that attacks hair follicles), and scalp infections like ringworm. Diseases that cause scarring like lichen planus and some types of lupus can result in permanent hair loss because of the scarring.

Hair loss can also be caused by medications used to treat cancer, high blood pressure, arthritis, depression, and heart problems.

A physical or emotional shock may trigger hair loss that will be noticeable after the event. Examples of this type of shock include a death in the family, extreme weight loss, or a high fever. People with the mental illness trichotillomania (hair-pulling disorder) have a compulsion to pull out their hair—usually from their head, eyebrows, or eyelashes. Traction hair loss can be caused by hairstyles that put pressure on the follicles by pulling the hair back very tightly.

A diet lacking in protein, iron, and other nutrients can lead to thinning hair.

Diagnosing Hair Loss

Persistent hair loss is often indicative of an underlying health issue. Your doctor or dermatologist can determine the cause of your hair loss based on a physical examination and your health history. In some cases, simple dietary changes can help, along with switching prescription medications.

If your dermatologist suspects an autoimmune or skin disease, he or she might take a biopsy of the skin on your scalp. This will involve carefully removing a small section of skin for laboratory testing. It is important to keep in mind that hair growth is a complex process, so it may take time to determine the exact cause of your hair loss.

Medications for Hair Loss

Medications will likely be the first course of treatment for hair loss. Over-the-counter medications generally consist of topical creams and gels that are applied directly to the scalp. The most common products contain an ingredient called minoxidil (Rogaine). According to the American Academy of Dermatology, minoxidil achieves the best results when used in conjunction with other hair loss treatments. Side effects of minoxidil include scalp irritation and hair growth in adjacent areas like your forehead or face.

Prescription medications may also be used in the treatment of hair loss. The oral medication finasteride (Propecia) is prescribed for male-pattern baldness. It is taken daily to slow hair loss. Some men experience new hair growth when taking finasteride. Rare side effects of this medication include diminished sex drive and impaired sexual function. There may be a link between use of finasteride and a fast-growing type of prostate cancer.

Corticosteroids like prednisone may be prescribed for individuals with alopecia areata to reduce inflammation and suppress the immune system. Corticosteroids mimic the hormones made by your adrenal glands; when the amount of the corticosteroid is higher than would be made by your body, it reduces inflammation and suppresses the immune system. Side effects from these medications must be monitored carefully. They include:

  • glaucoma (high intraocular pressure)
  • fluid retention and swelling in lower legs
  • higher blood pressure
  • cataracts
  • high blood sugar
  • increased risk for infections
  • calcium loss from bones that may lead to osteoporosis
  • thin skin and easy bruising
  • sore throat
  • hoarseness

Medical Procedures

Sometimes, medications aren’t enough to stop hair loss. There are surgical procedures to treat baldness.

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 that type of hair loss is progressive, you would need multiple surgeries over time.

In a scalp reduction, a surgeon removes part of your scalp that lacks hair. The area is closed with a piece of your scalp that has hair. Another option is a flap: your surgeon folds scalp that has hair over a bald patch. This is a type of scalp reduction.

Tissue expansion can also be used to cover bald spots. It requires two surgeries; in the first a tissue expander is placed under a part of the scalp that has hair and is next to the bald spot. After several weeks, the expander will have caused the growth of new skin cells. In the second surgery, the expander will be removed, and the new skin with hair will be placed over the bald spot.

These surgical remedies for baldness tend to be expensive and carry risks, including:

  • patchy hair growth
  • bleeding
  • wide scars
  • grafts may not take, and the surgery would need to be repeated
  • infection

Lifestyle Changes

According to the Mayo Clinic, if you are experiencing hair loss there are things you can do to prevent further loss. (Mayo) Don’t wear tight hairstyles like braids, ponytails, or buns that put too much pressure on your hair. Over time those styles permanently damage your hair follicles. Make sure your diet is nutritionally balanced and that you are getting adequate amounts of iron and protein. Try not to pull on your hair or twist/rub it.

Certain beauty regimens can actually worsen or cause hair loss. If you are currently losing hair, use a gentle baby shampoo to wash your hair. Unless you have extremely oily hair, you may consider washing your hair only every other day. Always pat the hair dry and avoid rubbing your hair.

Styling products and tools are also common culprits in hair loss. Use the following sparingly, if at all:

  • blow dryers
  • heated combs
  • hair straighteners
  • coloring products
  • bleaching agents
  • perms
  • relaxers

If you do decide to style your hair with heated tools, only do so when your hair is damp or dry. Also, use the lowest settings possible.

Outlook for Hair Loss

Hair loss can be stopped and even reversed with aggressive treatment, especially if it’s caused by an underlying medical condition. Hereditary hair loss may be more difficult to treat, but certain procedures such as hair transplants can help reduce the appearance of baldness. This condition can be embarrassing, but it is important to know that you have options to lessen the effects of hair loss.

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See a list of possible causes in order from the most common to the least.

1

Male Pattern Baldness

Male pattern baldness, also called androgenetic alopecia, is the most common type of hair loss in men. It typically begins at the temples or crown of the head and recedes.

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2

Alopecia Areata

Alopecia areata is a disease that causes hair to fall out in small patches. Alopecia areata rarely causes total hair loss, however it can prevent hair from growing back.

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3

Hypothyroidism

The thyroid gland produces a hormone that controls how your cells use energy (metabolize). Hypothyroidism occurs when the body doesn't produce enough. Untreated, it can cause comlications like obesity and heart disease.

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4

Nutritional Deficiencies (Malnutrition)

A nutritional deficiency occurs when the body doesn't absorb the necessary amount of a nutrient. Symptoms include a pale complexion, fatigue, hair loss, and depression.

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5

Hyperthyroidism

The thyroid gland produces a hormone that controls how your cells use energy (metabolize). Hyperthyroidism occurs when the body produces excessive amounts, causing rapid heart rates, weight loss, and heat intolerance.

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6

Acute Stress Disorder

In the weeks after a traumatic event, you may develop an anxiety disorder called acute stress disorder (ASD). ASD typically occurs within one month of a traumatic event. It lasts at least two days and up to one month...

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7

Lichen Planus

Lichen planus is a fairly common skin rash that is thought to be triggered by the immune system. It causes lesions in the mouth that may be painful or burn.

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8

Hodgkin's Disease

Hodgkin's disease is a type of lymphoma, a blood cancer that starts in the lymphatic system. It can occur at any age, but is most prevalent between the ages of 15 and 40 and after the age of 55.

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9

Underactive Pituitary Gland (Hypopituitarism)

The pituitary gland releases hormones that play roles in body processes like bone growth and metabolism. An underactive pituitary can disrupt these processes. Causes may include tumors, traumatic injuries, and diseases.

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10

Syphilis

Syphilis is a sexually transmitted infection. It is caused by a type of bacteria known as Treponema pallidum. According to the Centers for Disease Control and Prevention, in 2006, more than 36,000 cases of syphilis wer...

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11

Hashimoto's Disease

Hashimoto's disease damages your thyroid function. It is also called chronic lymphocytic thyroiditis or just chronic thyroiditis. Hashimoto's is the most common cause of hypothyroidism, an underactive thyroid.Th...

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12

Systemic Lupus Erythematosus

The immune system normally fights off dangerous infections and bacteria to keep the body healthy. An autoimmune disease occurs when the immune system attacks its own body because it confuses it for something foreign...

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13

Addison’s Disease

Addison's disease occurs when the adrenal cortex is damaged and the adrenal glands do not produce enough steroid hormones called cortisol and aldosterone. Cortisol regulates the body's reaction to stressful situations...

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14

Systemic Sclerosis (Scleroderma)

Systemic sclerosis (SS) is an autoimmune disorder. This means that it's a condition in which the body's immune system attacks its own body. Healthy tissue is destroyed because the immune system mistakenly thinks it is ...

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15

Celiac Disease (Gluten Intolerance)

Celiac disease is a digestive disorder. It is caused by an immune reaction to gluten. Celiac disease is also known as: sprue nontropical sprue gluten intolerance gluten-sensitive enteropathy Gluten is a protein found i...

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16

The War of Cells: Graft vs. Host Disease

Graft vs. Host Disease (GvHD) is a reaction that develops after an allogeneic bone marrow transplant . An allogeneic transplant is one in which the donor is not the same person as the recipient. It is also possible t...

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17

Ito Syndrome (Incontinentia Pigementi Achromians)

Ito syndrome (IS) is a rare condition that researchers believe iscaused by genetic irregularities. The conditionis not inherited, however,and a family history of IS is rare. IS is characterized by loss of skin color o...

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18

Leishmaniasis

Leishmaniasis is a parasitic disease. It is spread by the bite of an insect called a sandfly. Leishmaniasis is sometimes called kala-azar. There are two main forms of the disease. Each is associated with differen...

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19

Bamboo Hair (Tricorrhexis Nodosa)

Bamboo hair (trichorrhexis invaginata) is a hair shaft abnormality that causes the hair strands to look similar to bamboo. Normal healthy hair strands appear smooth under a microscope; however, bamboo hair appears t...

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This feature is for informational purposes only and should not be used to diagnose.
Please consult a healthcare professional if you have health concerns.
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