Hair loss (alopecia) can affect both men and women and is a frequent cause for individuals seeking medical attention. There are many options for treatment but you should see your doctor first to determine the exact cause of hair loss and the best possible treatment for your particular hair loss.
How to recognise hair loss?
Everyone loses some hair everyday. Losing up to 100 hairs a day is normal, but if you are losing more than this then you might have a problem. You can have hair loss in many different ways. It can be a gradual process or can occur fairly quickly. Common ways of presentation include the following:
• Gradual thinning on top of head. This is the most common type of hair loss, affecting both men and women. In men, hair often begins to recede from the forehead in a line.
• Circular or patchy bald spots. Some people experience smooth bald spots, often about an inch (2.6 centimeters) across.
• Sudden loosening of hair. A physical or emotional shock can cause hair to loosen. Handfuls of hair may come out when combing or washing your hair or even after gentle tugging. This type of hair loss usually causes overall hair thinning and not bald patches.
• Full-body hair loss. Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body. The hair usually grows back after treatment ends.
What are some common causes of hair loss?
Most people normally shed 50 to 100 hairs a day. Most healthy individuals have about 100,000 hairs in the scalp, so this amount of hair loss should not cause noticeable thinning of the scalp hair. As people age, hair tends to gradually thin. In most cases, hair loss is inherited which means it is passed down from one or both of your parents. This is called male-pattern or female-pattern hair loss.
Other causes of hair loss include hormonal factors, medical conditions and medications.
Hormonal factors
The most common cause of hair loss is a hereditary condition called male-pattern baldness or female-pattern baldness. In genetically susceptible people, certain sex hormones trigger a particular pattern of permanent hair loss. Most common in men, this type of hair thinning can begin as early as puberty.
Hormonal changes and imbalances can also cause temporary hair loss. This could be due to pregnancy, childbirth, discontinuation of birth control pills or the onset of menopause.
Medical conditions
A variety of medical conditions can cause hair loss. These include:
• Thyroid problems.
• Alopecia areata. This disease occurs when the body’s immune system attacks hair follicles — causing smooth, roundish patches of hair loss.
• Scalp infections. Infections, such as ringworm, can invade the hair and skin of your scalp leading to hair loss. Once infections are treated, hair generally grows back.
• Other skin disorders. Diseases that can cause scarring, such as lichen planus and some types of lupus, can result in permanent hair loss where the scars occur.
Medications
Hair loss can be caused by drugs used to treat a number of conditions such as cancer, arthritis, depression and high blood pressure.
Other causes of hair loss
Hair loss can also result from other things such as:
• A physical or emotional shock. Examples include sudden or excessive weight loss, a high fever, or a death in the family.
• Hair-pulling disorder. This mental illness causes people to have an irresistible urge to pull out their hair – whether it is from the scalp, their eyebrows or other areas of the body.
• Certain hairstyles. Traction hair loss can occur if the hair is pulled too tightly into hairstyles such as pigtails or cornrows. Very long braids can also lead to hair loss.
See your doctor
When you see your doctor he/she would take a complete medical history, family history and physical examination to help make a diagnosis. The pattern and rate of hair loss, the appearance of nearby hairs, and accompanying symptoms, are considered when making the diagnosis.
Your doctor may perform blood tests to determine if you have a medical condition, such as thyroid disease, diabetes or lupus that causes hair loss.
During a pull test, several dozen hairs are gently pulled to see how many come out. This helps determine the stage of the shedding process. Scraping samples taken from the skin, or from a few hairs plucked from the scalp, can help verify whether an infection is causing hair loss. When a diagnosis is difficult to confirm, your doctor may perform a punch biopsy. During this test, the doctor uses a circular tool to remove a small section of your skin’s deeper layers.
Treatment
Some people prefer to let their baldness run its course untreated and unhidden. Others may cover it up with hairstyles, makeup, hats or scarves. And still others choose one of the medications or surgical procedures that are available to treat hair loss.
For some types of hair loss, hair may resume growth without any treatment. In other situations, treatments may help promote hair growth or hide hair loss.
If your hair loss is caused by an underlying disease, treatment for that disease will be necessary. This may include drugs to reduce inflammation and suppress your immune system.
In the most common type of permanent hair loss, only the top of the head is affected. Surgical procedures can make the most of the hair you have left.
Surgical procedures to treat baldness are expensive and can be painful. Possible risks include infection and scarring.
Wigs and hairpieces
If you would like an alternative to medical treatment for your baldness or if you do not respond to treatment, you may want to consider wearing a wig or hairpiece. They can be used to cover either permanent or temporary hair loss.
Prevention
In some cases of hair loss there is little you can do, but the following might prove helpful to some individuals:
• Eat a nutritionally balanced diet.
• Avoid tight hairstyles, such as braids, buns or ponytails.
• Avoid compulsively twisting, rubbing or pulling your hair
Conclusion
Anyone — man, woman and child— can experience excessive hair loss, but most individuals experience some hair loss as they get older. How you choose to treat your hair loss depends on the cause. It also depends on your feelings. You may decide that you need treatment, or you may not be worried about thinning hair or baldness. The choice is up to you. Some men take the bold decision and shave their scalp completely. This appears to be growing in popularity especially since most females seem to admire these men. Whatever you do with hair loss the decision is up to you!
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
