Hair loss is a normal part of life – it happens while you’re washing & drying your hair or just brushing & combing it. Losing from 50 to 100 hairs a day is the average number for most people. Hair goes through cycles and there will usually be a new one replacing the ones you lose. However, hair loss may also be a sign of a serious medical condition. The condition of your hair is an important indicator of your health; a proper evaluation by a dermatologist is the best way to determine if you have an actual health problem and what the possible treatment may be.
Here are several reasons for hair loss:
A phenomenon which occurs after pregnancy, major surgery, drastic weight loss, or extreme stress, in which you shed large amounts of hair every day, is called Telogen Effluvium. You will usually notice the hair loss when shampooing, styling, or brushing your hair. It can also be a side effect of certain medications, such as antidepressants, beta-blockers, and nonsteroidal anti-inflammatory drugs. During Telogen Effluvium, your hair shifts faster than normal from its growing phase into the “resting” phase before moving quickly into the shedding, or “Telogen”, phase. There are no tests for Telogen Effluvium, but your doctor may ask you about recent life events and look for small “club- shaped” bulbs on the fallen hair’s roots to determine a diagnosis.
Genetic hair loss is known as Androgenetic Alopecia and, according to the American Academy of Dermatology, is the most common cause of hair loss. The gene can be inherited from either your mother’s or father’s side of the family, though you’re more likely to have it if both of your parents had hair loss. Women with this trait tend to develop thinning at the hairline behind the bangs. This condition may start as early as your 20s. You may be vulnerable if your mother also has this pattern of thinning. In some cases, the hair loss may be diffuse (spread across the entire scalp). Your dermatologist will examine the pattern of hair loss to determine if it’s hereditary and may order blood work to rule out other causes.
Millions of people, most of them women, suffer from thyroid disease. When your body produces too little thyroid hormone, the hormone responsible for metabolism, heart rate, and mood, you are said to have Hypothyroidism, or an underactive thyroid. If your body makes too much of the hormone, you’re said to have Hyperthyroidism, or an overactive thyroid. Thyroid hormone is responsible for everything from your basal metabolic rate—the rate at which your body uses oxygen and energy to function—to the growth of your hair, skin, and nails. But when you don’t have the right amount, you may notice changes in bodily functions. Your doctor will order a blood test to measure the thyroid-stimulating hormone to determine if excess TSH levels indicate hypothyroidism, or abnormally low levels suggest hyperthyroidism.
A chronic autoimmune disease in which the body’s own immune system attacks healthy tissues is known as Lupus. Lupus often causes extreme fatigue, headaches, oral ulcers, and painful, swollen joints. Many people also experience hair loss, which may be mild and occur while shampooing or brushing your hair—or it may be more severe, coming out in patches and accompanied by a rash on the scalp. Because these symptoms occur in many other conditions, Lupus is sometimes overlooked. A rheumatologist will examine joints and other tissues for signs of inflammation, such as heat, pain, swelling, and redness. A blood test to measure levels of anti-nuclear antibodies (ANA) may also indicate lupus.
Iron deficiency anemiais another cause of hair loss. You may also notice headaches, difficulty concentrating, cold hands and feet, extreme fatigue, weakness, and pale skin. A blood test to measure ferritin, the protein that stores iron in your body, is usually needed to diagnose iron-deficiency anemia. Your doctor may also check your blood level of hematocrit, which gauges how much of your blood is made up of red blood cells.
A hormonal imbalance, in which the ovaries produce too many male hormones, is known as Polycystic Ovarian Syndrome (PCOS). PCOS can cause facial hair growth, irregular periods, acne, and cysts on the ovaries. And while you may experience hair loss on your scalp, you may notice more hair elsewhere on the body. Your doctor is likely to do a blood test to look for elevated levels of testosterone and DHEAS, a by-product of testosterone.
Skin conditions that lead to hair loss include Seborrheic Dermatitis (dandruff), Psoriasis, andFungal Infections such as ringworm. Any sign of scalp shedding or greasy, yellowish scales on your shoulders or in your hair need to be taken seriously. It may be the result of a particular yeast, hormonal changes, or excess oil in the skin. Psoriasis is an autoimmune condition that causes excessive skin cell turnover, producing a very thick white scale on the scalp that can bleed if pulled off. With ringworm, a fungus you contract by touching an infected person or animal, you’ll notice red patches on your scalp and other areas of your face and body. A physical exam of the scalp by your dermatologist will help determine which condition you have. A fungal culture and a possible biopsy of the scalp may also be necessary.
Alopecia Areatais an autoimmune disorder in which the immune system attacks hair follicles. The cause is unknown, but it may be triggered by stress or illness. The condition can occur in three subtypes: Alopecia Areata commonly causes round, smooth patches of baldness on the scalp, eyebrows, or legs. Total hair loss on the head is known as Alopecia Totalis, while hair loss that occurs all over the body is called Alopecia Universalis. Observing the pattern of hair loss can usually determine if you have Alopecia and blood tests for ANAs and hormones are usually done to rule out any associated conditions.
Excessive Styling from too much shampooing, styling, and dyeing can harm your tresses. Heat and chemicals can weaken your hair, causing it to break and fall out. Often, it’s a combination of treatments – keratin, coloring, and blow-drying, for instance – that does the damage. If the fallout is occurring from external damage caused by styling, it will simply break, and you won’t see those club-shaped telogen bulbs at the ends.Your doctor may perform a pull test, where a small handful of about 50 strands are pulled gently, and checked to see whether the hair that comes out has bulbs on the ends.
Recently, a shocking study reported on by CNN revealed that traction hairstyles, such as weaves and braids may contribute to a type of permanent hair loss known as Central Centrifugal Cicatricial Alopecia (CCCA) a form of baldness that begins at the crown of the head and leads to scarring. A staggering 59 percent of black women who participated in the study had hair loss on the top of their scalp.