Hair loss (Baldness) - Facts, causes & classification

Hair loss facts

• Hair loss is a very common condition and affects most people at some time in their lives.
• Hair loss from breakage of the hair shaft is different than hair loss from decreased hair growth.
• Androgenetic hair loss is seen in both men and women but is worse in men.
• Thyroid disease, anemia, protein deficiency, and low vitamin levels may cause hair loss.
• Alopecia areata is a relatively common cause of hair loss that usually resolves on its own.
• Medications indicated for hair regrowth include minoxidil (Rogaine) andfinasteride (Propecia).
• Prevention of hair loss includes good hair hygiene, regular shampooing, and good nutrition.
• Medical health screening for hair loss may include blood tests such ascomplete blood count (CBC), iron level, vitamin B, and thyroid function tests (TFT).

What are causes of hair loss?

Because there are so many types ofscalp hair loss, finding the cause can be challenging. This review will cover the most common causes of hair loss occurring on normal scalp skin. The medical term for hair loss is alopecia.

Most hair loss is not associated with systemic or internal disease, nor is poordiet a frequent factor. Hair may simply thin as a result of predetermined genetic factors and the overall aging process. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s. Life vicissitudes, including illness, emotional trauma, protein deprivation (during strict dieting), and hormonal changes like those inpregnancy, puberty, and menopause may cause a reversible hair loss.

Several health conditions, includingthyroid disease and iron deficiency anemia, can cause hair loss. Whilethyroid blood tests and other lab tests, including a complete blood count (CBC), on people who have ordinary hair loss are usually normal, it is important to exclude underlying causes in sudden or severe hair loss. Such basic health screening can be done by a family physician, internist, orgynecologist. Dermatologists are doctors who specialize in problems of skin, hair, and nails and may provide more advanced diagnosis and treatment of hair thinning and loss. Sometimes a scalp biopsy may be taken to help in diagnosis of severe or unexplained hair loss.

Although many medications list "hair loss" among their potential side effects, mostdrugs are not likely to induce hair loss. On the other hand, cancer chemotherapy and immunosuppressive medications commonly produce hair loss. Complete hair loss after chemotherapy regrows after 12 months.

How do physicians classify hair loss?

There are numerous ways to categorize hair loss. One must first examine the scalp to determine if the hair loss is due to the physical destruction and loss of hair follicles. If the scalp appears perfectly normal with plenty of empty hair follicles, this is called non-scarring hair loss. On the other hand, the follicles are permanently destroyed in scarring hair loss. Localized, small areas, large areas, or the whole scalp may be affected in scarring and non-scarring hair loss. Non-scarring hair loss can also be seen in situations where there is physical or chemical damage to the hair shaft resulting in breakage. Occasionally, it may be necessary to do a biopsy of the scalp to distinguish these conditions. Sometimes, a physician may pull a hair to examine the appearance of the hair shaft as well as the percentage of growing hairs (anagen phase). This article will concentrate on the non-scarring types of hair loss.

Patchy hair loss

Some conditions produce small areas of hair loss, while others affect large areas of the scalp. Common causes of patchy hair loss are

• alopecia areata (small circular or coin size patches of scalp baldness that usually grow back within months),
• traction alopecia (thinning from tight braids or ponytails),
• trichotillomania (the habit of twisting or pulling hair out),
• tinea capitis (fungal infection).