Hair Loss

Hair loss, a widespread concern, affects millions, leading to thinning or baldness.

Overview

Hair loss is a prevalent concern that can impact individuals of all ages and genders, often resulting in thinning hair or baldness. It can have a profound effect on self-esteem and self-image. This article delves into the symptoms, causes, available treatments, and management techniques for hair loss, offering valuable insights for those experiencing this common issue. Types of hair loss:

Androgenetic Alopecia

Androgenetic alopecia is the most common type of hair loss, affecting more than 50 million men and 30 million women in the United States. Commonly known as male pattern hair loss or female pattern hair loss, androgenetic alopecia is hereditary but can be managed with medication or surgery.

Male Pattern Hair Loss

In men, hair loss can begin any time after puberty and progress over the course of years or decades. It starts above the temples and continues around the perimeter and the top of the head, often leaving a ring of hair along the bottom of the scalp. Many men with male pattern hair loss eventually become bald.

Female Pattern Hair Loss

In women, hair slowly thins all over the scalp, but the hairline usually doesn’t recede. Many women experience this type of hair loss as a natural part of aging, although hair loss may begin any time after puberty. Female pattern hair loss can cause hair to thin dramatically, but only rarely does it lead to baldness.

Telogen Effluvium

Telogen effluvium, a type of hair loss, occurs when large numbers of follicles on the scalp enter the resting phase of the hair growth cycle, called telogen, but the next growth phase doesn’t begin. This causes hair to fall out all over the scalp without new hair growth.

Telogen effluvium does not generally lead to complete baldness, although you may lose 300 to 500 hairs per day, and hair may appear thin, especially at the crown and temples.

A medical event or condition, such as a thyroid imbalance, childbirth, surgery, or a fever, typically triggers this type of hair loss. Telogen effluvium may also occur as a result of a vitamin or mineral deficiency—iron deficiency is a common cause of hair loss in women—or the use of certain medications, such as isotretinoin, prescribed for acne, or warfarin, a blood thinner. Starting or stopping oral contraceptives (birth control pills) may also cause this type of hair loss.

Telogen effluvium usually begins three months after a medical event. If the triggering event is temporary—for example, if you recover from an illness or stop taking the medication causing the hair loss—your hair may grow back after six months. Telogen effluvium is considered chronic if hair loss lasts longer than six months.

For reasons that are unclear to doctors, this type of hair loss may last for years in some people. If hair doesn’t regrow on its own, our dermatologists can offer medication that can help.

Anagen Effluvium

Anagen effluvium is rapid hair loss resulting from medical treatment, such as chemotherapy. These potent and fast-acting medications kill cancer cells, but they may also shut down hair follicle production in the scalp and other parts of the body. After chemotherapy ends, hair usually grows back on its own. Dermatologists can offer medication to help hair grow back more quickly.

Alopecia Areata

Alopecia areata is an autoimmune condition, which means the body’s immune system attacks healthy tissues, including the hair follicles. This causes hair to fall out and prevents new hair from growing.

This condition can affect adults and children, and hair loss can begin suddenly and without warning. Hair from the scalp typically falls out in small patches and is not painful. Hair in other parts of the body, including the eyebrows and eyelashes, may also fall out. Over time, this disease may lead to alopecia totalis, or complete hair loss.

Dermatologists treat alopecia areata with medication that may help hair regrow. If you are interested in talking with other people who have alopecia areata, NYU Langone hosts a monthly support group for people with this condition.

Tinea Capitis

Tinea capitis, also called scalp ringworm, is a fungal infection of the scalp that’s a common cause of hair loss in children. This condition causes hair to fall out in patches, sometimes circular, leading to bald spots that may get bigger over time.

The affected areas often look red or scaly, and the scalp may be itchy. Sores or blisters that ooze pus can also develop on the scalp. A child with the condition may have swollen glands in the back of the neck or a low-grade fever as a result of the immune system fighting the infection.

Dermatologists can prescribe an antifungal medication taken by mouth to eliminate the fungus. If tinea capitis is diagnosed and treated early, most children have excellent hair regrowth.

Cicatricial Alopecia

Cicatricial alopecia, also known as scarring alopecia, is a rare type of hair loss in which inflammation destroys hair follicles and causes scar tissue to form in their place. After scar tissue forms, hair doesn’t regrow.

Hair loss may begin so slowly that symptoms aren’t noticeable, or hair may start to fall out all at once. Other symptoms include severe itching, swelling, and red or white lesions on the scalp that may resemble a rash. This type of hair loss can occur at any age and affects men and women.

Treatment depends on the type of cicatricial alopecia causing your symptoms. Our doctors have years of experience treating people with cicatricial alopecia and can recommend a variety of treatments to help you. Types of cicatricial alopecia include:

Lichen Planopilaris

Lichen planopilaris, a type of alopecia, occurs when a common skin condition, called lichen planus, affects the scalp. Lichen planopilaris may cause a dry, flaky rash to appear on the skin that causes hair on the scalp to fall out in clumps. The scalp may also become red, irritated, and covered in small white or red itchy, painful, or burning bumps.

Lichen planopilaris is not common and affects more women than men. A doctor may prescribe medication to stop the hair loss.

Discoid Lupus Erythematosus

Discoid lupus erythematosus is a type of cutaneous lupus, an autoimmune disease that affects the skin. It can lead to inflamed sores and scarring on the ears, face, and scalp. Hair loss is one symptom of the disease. When scar tissue forms on the scalp, hair can no longer grow in that area.

Folliculitis Decalvans

Hair loss caused by folliculitis decalvans, an inflammatory disorder that leads to the destruction of hair follicles, is often accompanied by redness, swelling, and lesions on the scalp that may be itchy or contain pus, known as pustules. This type of hair loss is not reversible, but dermatologists can offer medication to control symptoms and, in some instances, stop the progression of hair loss.

Dissecting Cellulitis of the Scalp

Dissecting cellulitis of the scalp, a rare condition, causes pustules or lumps to form on the scalp. This condition may also cause scar tissue to develop, destroying hair follicles and causing hair loss. Medications may help control symptoms.

Frontal Fibrosing Alopecia

Frontal fibrosing alopecia typically occurs in a receding hairline pattern and may also result in hair loss in the eyebrows and underarms. Frontal fibrosing alopecia most commonly affects postmenopausal women. Certain medications can manage symptoms and stop the progression of the disease. The cause is unknown.

Central Centrifugal Cicatricial Alopecia

Central centrifugal cicatricial alopecia may occur as a result of hair products or styling techniques that damage hair follicles. The use of hair relaxers, blow dryers, curling irons, and hair extensions can cause central centrifugal cicatricial alopecia, as can the process of creating a permanent wave, or a “perm.”

The frequent application of oils, gels, or pomades can also cause this condition, which may be reversible if you stop using these hair products or styling techniques. Our dermatologists may recommend taking medication to help hair grow back.

Symptoms

Hair loss presents various symptoms, including gradual thinning of hair, particularly around the crown and temples, leading to a receding hairline. Bald spots, whether small or large, may appear on the scalp. Excessive hair shedding, noticeable on pillows, in the shower, or on hairbrushes, is also a common sign. 

Changes in hair texture, such as increased fineness, weakness, or brittleness, can be observed. Hair loss may manifest as either patchy areas or widespread thinning across the entire scalp. Understanding these symptoms is essential for early detection and seeking appropriate hair loss management.

Causes

Hair loss can result from diverse factors, including genetic predisposition, hormonal changes during pregnancy, menopause, or medical conditions. Certain health issues like alopecia areata, thyroid disorders, and autoimmune diseases may lead to hair loss. Medications like chemotherapy drugs and specific antidepressants can also have this side effect. 

Stress, whether physical or emotional, can trigger telogen effluvium, causing hair shedding. Poor nutrition, particularly insufficient protein and iron intake, can impact hair health. Additionally, hair damage and breakage can occur due to hairstyling practices involving excessive heat, tight hairstyles, or chemical treatments. Understanding these factors is crucial for effective hair loss management.

Treatment

Hair loss treatment varies based on its cause and individual preferences. Options include medications like minoxidil for promoting hair growth and prescription drugs like finasteride and spironolactone to inhibit hair loss. Surgical procedures like hair transplants or scalp reduction can restore lost hair. 

Non-surgical solutions like low-level laser therapy devices and platelet-rich plasma (PRP) therapy stimulate hair follicles. Wigs and hairpieces offer non-surgical ways to conceal hair loss. Lifestyle changes, including improved nutrition and stress reduction, can contribute to overall hair health.

Management

A healthy lifestyle plays a key role in hair care, involving a balanced diet rich in essential vitamins and minerals. Gentle hair care practices, such as using mild shampoos and avoiding excessive heat or chemical treatments, are essential. Stress reduction through techniques like meditation, exercise, or counseling can benefit hair health. 

Regular check-ups with a dermatologist or hair specialist ensure accurate diagnosis and treatment options. Joining support groups offers both emotional support and practical advice, while embracing changes in hair appearance and exploring confidence-boosting hair styling options can be empowering.

Conclusion

Hair loss is a common concern that can have a significant impact on self-esteem and self-image. Understanding its causes, recognizing the diverse symptoms, exploring available treatment options, and adopting effective management techniques are crucial for individuals experiencing this issue. Myths surrounding hair loss, such as the belief that it's solely due to aging, should be dispelled for informed self-care. By adhering to appropriate treatment and management methods, individuals can regain control over their hair health, boost self-confidence, and address this common concern with a holistic approach.

Explore other Skin Conditions

Presentations will be focused on reaching different communities, like pre-pubescent school presentations for early acne intervention, ethnic hair presentations for hairdressers for early detection of scarring alopecia, elderly community presentations about treatable skin growths, and the importance of body checks.

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