Hair Loss

Overview

When various conditions disrupt the normal hair growth cycle, hair loss (called alopecia) may occur.

The average person has 100,000 to 150,000 scalp hairs at any given time. Hair grows at a rate of approximately one half inch per month, and, on average, you can expect to lose up to 100 strands per day. If you lose more than the average number of hairs, you may notice thinner hair, a receding hairline, partial baldness, or even total baldness. That’s because you’re losing hairs faster than your body can replace them.

If you’re experiencing hair loss, our dermatologists are here to help. There are several medical and surgical treatments available that can help stop the process of hair loss and get your natural hair back. Find a dermatologist near you.

Hair Growth Cycle

Your hair is made up of two structures: what’s visible above the scalp (the shaft), and what’s not visible beneath it (the follicle). The follicle produces the protein keratin, which makes up all your hair. As old keratin cells die and new ones are produced, the dead cells are strung together and pushed through your scalp, creating the visible hair that you grow, cut and style.

The hair growth cycle consists of three distinct stages – anagen, catagen, and telogen. At any given time, each individual hair strand may be in a different hair growth stage. Hair loss often occurs when one or more of these phases is disrupted by another condition.

  • During the anagen stage – the active hair growth phase – the hair cells are dividing quickly and regularly. This phase typically lasts anywhere from 2 to 7 years. Once hair has stopped growing, it transitions into the next phase.
  • The catagen stage is a transitional stage, lasting for about 2 to 3 weeks where growth stops and hair detaches from the root, traveling outward toward the scalp.
  • The telogen stage is the resting phase, lasting for approximately 2 to 4 months, where the hair sheds to allow hair regrowth to begin.

Types

There are a number of ways people can lose their hair. The most common types of hair loss are:

Involutional alopecia, a natural condition that causes the hair to gradually thin as you age. This causes a greater number of hair follicles to go into the resting (telogen) phase, while the remaining hairs become shorter and fewer in number.

Androgenic alopecia, a genetic hair loss condition that can affect both men and women.

Men can experience androgenic alopecia (also known as “male pattern baldness”) as early as their teens or early 20s. Men with this condition may notice a receding hairline and gradually thinning hair around the crown of the head and the front of the scalp.

Alternatively, women can experience “female pattern baldness” which typically shows no noticeable thinning until at least age 40. It’s common for women to begin losing hair across the entire scalp, most extensively at the crown.

Alopecia areata is most common in children and adolescents. This condition may cause you to experience sudden hair loss. It may result in patchy hair loss, complete baldness (alopecia totalis) or total body hair loss, including eyebrows and eyelashes (alopecia universalis). The large majority of people with alopecia areata regrow hair within a few years.

Trichotillomania, sometimes referred to as the hair pulling disorder, is a psychological, self-inflicted condition in which you repetitively pull out your own hair. This condition is most commonly diagnosed in children.

Telogen effluvium can be characterized as a temporary bout of thinning hair which occurs due to changes in the growth cycle of hair. When a large number of hairs enter the resting (telogen) hair growth phase at the same time, you can experience excess shedding and thinning.

Scarring alopecia is a type of alopecia that results in permanent hair loss. Inflammatory skin conditions – such as folliculitis, acne and other various skin disorders – often result in scar tissue that destroys the hair follicles and, thus, the ability of the hair to regrow.

Traction alopecia is a type of gradual hair loss that is caused by constant pulling or tension of the hair that can create inflammation and eventually scarring, which can prevent future hair growth.

Causes

Shedding about 100 scalp hairs each day is completely normal. When you experience hair loss, you’re simply losing hair faster than normal – faster than your body can produce new hair. There are many possible causes of hair loss, including:

  • Aging
  • Illness
  • Hormonal changes
  • Heredity (male pattern baldness)
  • Medical treatments, such as chemotherapy
  • Getting too much or not enough of certain vitamins or minerals
  • Pregnancy
  • Stress
  • Certain medical conditions

Treatment Options

If you’re experiencing hair loss, we can discuss available treatment options with you. Some are aimed at treating an underlying condition, like a vitamin deficiency or ringworm. Often multiple medications or procedures are used together to most effectively treat your specific case.

If you’ve become bald due to aging or heredity, we can discuss with you how to help prevent hair loss from getting worse, as well as various surgeries or medication that can help regrow hair.

Surgical hair loss treatments include:

  • Hair transplantation: A procedure in which hair is taken off the back of your own scalp and transplanted to any balding areas.
  • Scalp reduction: A surgical treatment in which parts of the scalp affected by alopecia are removed and the healthier areas are stretched in order to increase the appearance of a fuller head of hair.
  • Tissue expansion: Stretching the scalp over a period of time. These stretched areas can then be expanded to cover more of the scalp, resulting in a fuller look.

Medical treatments include:

  • Finasteride (Propecia): A prescription drug to treat male pattern baldness.
  • Minoxidil (Rogaine): An over-the-counter hair regrowth product applied to bald areas of the scalp. Both men and women can use minoxidil, although women should use a lower-strength version. Although minoxidil is available at drugstores, talk to a dermatologist first to make sure you’re a good candidate for treatment.

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