Hair loss (alopecia) can affect any region of the human body. Male pattern hair loss (androgenetic alopecia) is the most common type and it involves thinning or receding of the hairline on the forehead, along with a gradual thinning of hair at the temples and on top. Women usually experience diffuse thinning, which typically begins after menopause when hormone levels drop significantly.
1. Reddened and inflamed scalp, which may be painful.
2. Thinning hair on the forehead.
3. Receding hairline on the temples and in front of the ears.
4. Weakening of eyelashes or eyebrows, due to thinning of the hair, resulting in lines that cross over the eyes and/or loss of lashes
5. Loss of body or facial hair due to thinning at the base (core).
6. Premature graying or white (porous) patches on the scalp and elsewhere on the body caused by shedding hairs without replacement; this happens because new hairs are not being formed at those sites
7. Itching and/or burning sensations on the scalp due to drying of the scalp, with or without dandruff
8. Softening, thinning and splitting of hair that tangles easily
When to see a doctor?
If you observe any of the usual symptoms of hair loss, visit your doctor to determine whether therapy is indicated.
What causes alopecia?
The most common cause of hair loss (androgenetic alopecia) is genetics. Male pattern baldness, for instance, can be passed on from either parent's side of the family. Researchers have identified two genes linked to androgenetic alopecia and both are inherited from the mother's side. If a woman has this condition, her children have a 50% chance of inheriting it. Some other causes are:
1. Drug reactions such as steroids
2. Low iron levels
3. Carcinoid tumours
4. Autoimmune disorders such as alopecia areata
5. Stress, anxiety and depression can lead to stress hormone release which can cause hair to fall out by stimulating the hair follicles and increasing the amount of stress hormones in your body.
6. Birth control pills
7. Dental treatment
8. Thyroid disorders
9. Acute illness
10. Hormonal changes in women including pregnancy, menopause and use of oral contraceptives or hormone replacement therapy (HRT) can lead to hair loss in some people. HRT gives many women new hair growth, but it can also cause more hair loss than usual in the first year of treatment because women sometimes shed more hair during this time due to the change in hormones. Hair loss may continue after this initial period if the woman continues on HRT or if she stops it, so she needs to discuss this with her doctor before making a decision about stopping treatment.
Hair loss is considered a medical condition, so it should be diagnosed by your doctor.
How does the doctor make a diagnosis?
If you have unexplained thinning of your hair, you will be asked about any medications and other conditions that may be causing it. A physical examination (including an assessment of the scalp and hair) is also performed to check for other causes of hair loss besides genetic factors. One or more blood tests may be needed to determine if low levels of certain hormones are causing symptoms such as hair thinning and loss.
There is no cure for male pattern baldness but there are many treatments available to help reduce or stop hair loss associated with it.
The most common treatments to promote hair growth are:
1. Hair transplant surgery
2. Minoxidil, an over-the-counter medicine with proven benefits in treating male pattern baldness and thinning of the hair in women. The medicine comes in topical form (for the scalp) and oral solution. It is effective when started before significant hair loss has occurred
3. Finasteride, is a pill to treat male pattern baldness and it blocks production of a hormone that makes hair fall out but it can lead to sexual dysfunction so consider the side effects carefully before starting this treatment if you have experienced any sexual dysfunction or if your partner has experienced any changes or problems in her sexual response.
4. HRT (hormone replacement therapy)
Treatment involves prescribing a high dose of a powerful form of estrogen that is similar to what you would have during pregnancy. In women, this will stop the production of the male hormones and may cause more hair growth than in women who were not taking HRT before the condition occurred. The treatment usually lasts for about 1 year, but in some cases it may be necessary to take it continually for several years (for example, if you are older than 40 years of age or you have started or stopped HRT at a young age). It also helps prevent hair loss in women who have already experienced hair loss.
5. Hair removal with electrolysis or laser therapy
7. Herbal treatments such as saw palmetto, nettle root and lavender oil lotions and shampoos
9. Hairpieces, hair extensions and wigs
10. Shaving the head, which may be necessary after chemotherapy or for some body areas (underarms, bikini area) for women who have a medical condition that causes permanent baldness in these areas (alopecia areata).
11. Intralesional injection with cortisone is sometimes used to treat alopecia areata when symptoms are severe enough to require treatment.
12. Surgical removal of hair follicles (hair transplant)
13. Follicle Stimulating Hormone (FSH) Injections
14. Hyperbaric oxygen therapy (HBOT)
15. Botox injections, both for adults and children with special needs or for adults with major depressive disorders and hair loss who want to restore their hair or regrow lost hair so that they will be happier when they look in the mirror, but it is not a permanent solution and may cause further hair loss because of its temporary effects on the body's circulation system.
The best way to prevent hair loss is to make sure your scalp is healthy and to keep your hair clean and nourished.
Many people have problems with maintaining a healthy scalp. If anything on your head is irritated, it can lead to hair loss. This includes excessive dandruff, seborrheic dermatitis and psoriasis. Your doctor may recommend medications to help your scalp stay healthy and stop this type of irritation from causing hair loss.
What you can do:
1. Help keep the head clean by washing it with a mild soap or shampoo at least once a day or every other day (if you are having trouble keeping up with this, ask for help when you see the doctor). 2. Don't overdo it. Try not to wash your hair every day, and if you do, use a mild shampoo or a special medicated shampoo your doctor may have prescribed for you.
3. Try not to use styling products or dyes frequently or anything else that might irritate the scalp.
4. Don't scratch or pick at the scalp and don't rub it too much with a towel when you are drying it after washing. This can cause irritation which can lead to loss of hair in that area of the scalp. 5. Help your health care provider keep an eye on you and make sure you are getting the right medication if your scalp has a problem.