It is normal to lose between 50-100 hairs a day, this is part of the hair renewal process. However most people suffer from excessive hair loss at one time in their life. There are many reasons for this including medication, radiation, chemotherapy, exposure to chemicals, hormonal and nutritional factors, thyroid disease, generalized or local skin disease, and stress. Many of these causes are temporary and a few are permanent. These are some of the more common reason for hair loss.

HORMONAL

Since hormones both stimulate hair growth and cause hair loss, hormonal changes by far have the biggest impact on hair loss. These can affect both men and women in the following ways: This is the most common cause of thinning and affects both men and women. Men generally have hair loss concentrated in a specific pattern from the front through to the crown. Women tend to have thinning throughout their head without being in any specific pattern. This type of hair loss is caused by the androgen DHT, or Dihydrotestosterone. Since everyone has DHT that is produced by their bodies and only some people suffer from hair loss there has to be another factor involved. This other factor is having follicles that have a greater number of Androgen receptors for the DHT to attach to. This is the component that is inherited through the genes. To date the most effective preventative treatments are anti androgens, drugs that prevent the creation of DHT. In the future gene therapy will one day be able to alter the genes to prevent the follicles from being affected by DHT.

Childbirth

After pregnancy many women experience a loss of hair, this is caused many hair simultaneously entering the resting (telogen) phase. Within two to three months after giving birth, some women will notice large amounts of hair coming out in their brushes and combs. This can last one to six months, but resolves completely in most cases. This condition is caused by the hormonal changes that take place after a woman’s body recovers from her pregnancy.

Birth control pills

Women who have a genetic predisposition to suffer from Androgenic Alopecia can have it occur at a much younger age by taking birth control pills. The hormonal changes that occur trigger the onset of the Androgenic Alopecia. If a woman has a history of female pattern loss in her family she should advise her doctor before going on the pill. After the discontinuation of the pill the woman may notice that her hair begins shedding two or three months later. This may continue for six months when it usually stops. In some cases the process cannot be reversed and the woman may not regrow some of the hair that was lost.

DISEASE OR ILLNESS

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Since the follicle is a very sensitive it does respond to imbalances in the body. Most hair loss causes by disease or illness is temporary and resolves itself after the body has returned to a healthy condition.

High fever, severe infection, severe flu

Sometimes one to three months after a high fever, severe infection or flu, a person may experience hair loss, this is usually temporary and corrects itself.

Thyroid disease

Both an overactive thyroid and an underactive thyroid can cause hair loss. Thyroid disease can be diagnosed by your physician with laboratory tests. Hair loss associated with thyroid disease can be reversed with proper treatment.

Deficient diet

Some people who go on low protein diets, or have severely abnormal eating habits, may develop protein malnutrition. To help save protein the body shifts growing hair into the resting phase. If this happens massive amounts of hair shedding can occur two to three months later. A sign of this is if the hair can be pulled out by the roots fairly easily. This condition can be reversed and prevented by eating the proper amount of protein. Its very important when dieting to maintain an adequate protein intake.

Medications

Some prescription drugs may cause temporary hair shedding in a small percentage of people. Examples of such drugs include some of the medicines used for the following: gout, arthritis, depression, heart problems, high blood pressure, or blood thinner. High doses of vitamin A may also cause hair shedding.

Cancer treatments

Chemotherapy and radiation treatment will cause hair loss because it stops hair cells from dividing. Hairs become thin and break off as they exit the scalp. This occurs one to three weeks after the treatment. Patients can lose up to 90 percent of their scalp hair. The hair will regrow after treatment ends and patients may want to get wigs before treatment. There are some drugs in development to help prevent this hair loss from occurring.

Low serum iron

Iron deficiency occasionally produces hair loss. Some people don’t have enough iron in their diets or may not fully absorb iron in their diets. Women who have heavy menstrual periods may develop iron deficiency. Low iron can be detected by laboratory tests and can be corrected by taking iron pills.

Major surgery/chronic illness

Anyone who has a major operation – a tremendous shock to the system – may notice increased hair shedding within one to three months afterwards. The condition reverses itself within a few months but people who have a severe chronic illness may shed hair indefinitely. A relatively unknown fact is that hair transplantation surgery can actually cause additional hair loss or “shock fallout”. Hairs lost from shock fallout usually don’t regrow.

Alopecia Areata

This type of hair loss is believed to be caused by the immune system reacting to hair follicles as if they were antibodies and shutting them down. The hair loss is usually limited to a coin sized area and all the hair in the area is lost leaving a totally smooth round patch. In a more severe rarer condition called Alopecia Totalis, all hair on the entire body is lost, including the eyelashes. Treatments include topical medications, a special kind of light treatment, or in some cases drugs.

Fungus Infection (Ringworm) of the scalp

Caused by a fungus infection, ringworm (which has nothing to do with worms) begins with small patches of scaling that can spread and result in broken hair, redness, swelling, and even oozing. This contagious disease is most common in children and oral medication will cure it.

Stress

Stress can cause hair loss is some people. Usually it occurs 3 months after the stressful event has occured and it may take 3 months after the stress period has ended for the hair growth to resume. In most cases it is temporary if the person is not predisposed to genetic or Androgenic Alopecia, if they are stress may trigger the onset of genetic hair loss or may worsen existing Androgenic hair loss.

MECHANICAL DAMAGE

Damage to the hair can be self inflicted either by intentional or unintentional means. Some people going through stress continuously pull at their hair until it comes out. Styling hair by bleaching, braiding and straightening can also cause damage and results in hair being lost.

Trichotillomania or Hair Pulling

Some children and less often adults play with their hair by pulling on it or twisting it. This can be part of a behavioral problem or a bad habit that is often done unconsciously. If the behavior is not stopped permanent hair loss can result from the constant stress on the hair. Its best to seek the help of a mental health professional to solve this problem.

Hair Styling Treatments

Many people change the appearance of their hair by using chemical treatments like dyes, tints, bleaches, straighteners, relaxers and permanent waves. If correctly done and done using reputable products, its rare to have any damage. However, hair can become weak and break if any of these chemicals are used too often. Hair can also break if the solution is left on too long, if two procedures are done on the same day, or if bleach is applied to previously bleached hair. Some chemical relaxers do contain powerful chemicals and there have been instances of people get chemical burns from these products resulting in permanent hair loss. Only go to qualified hair stylists and if doing it yourself make sure you only use reputable products and follow the product directions.

Hair Braids/Weaves/Hair Extensions

Many women and some men braid their hair or wear hair weaves. Under normal conditions these cause no problems. However if the weave is attached too tight or the braids are wrapped too tight, and the hair is being pulled against the root direction, they put a constant strain on the hair follicle. If this is done for both a short and extended period of time permanent hair loss can result. This is known as Traction Alopecia and is fairly common among people who braid or weave their hair. Make sure the person applying the braids or weave is qualified to do so and don’t wear braids or weaves continuously for extended periods of time. With hair extensions the sections may be too small and uneven while hanging heavy Indian or Chinese hair from each small section causing uneven weight distribution causing scar tissue on the scalp.

Frequently Asked Questions

What is the normal cycle of hair growth and loss?

The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.

It is normal to shed some hair each day as part of this cycle. However, some people may experience excessive (more than normal) hair loss. Hair loss of this type can affect men, women and children.

What causes excessive hair loss?

A number of things can cause excessive hair loss. For example, about 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.

Hormonal problems may cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your hair loss.

Many women notice hair loss about 3 months after they’ve had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.

Some medicines can cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants.

Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.

Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.

Can improper care of my hair cause hair loss?

Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called “perms”) may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.

What is common baldness?

The term “common baldness” usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.

Women may develop female-pattern baldness. In this form of hair loss, the hair can become thin over the entire scalp.

Can my doctor do something to stop hair loss?

Perhaps. Your doctor will probably ask you some questions about your diet, any medicines you’re taking, whether you’ve had a recent illness and how you take care of your hair. If you’re a woman, your doctor may ask questions about your menstrual cycle, pregnancies and menopause. Your doctor may want to do a physical exam to look for other causes of hair loss. Finally, blood tests or a biopsy (taking a small sample of cells to examine under a microscope) of your scalp may be needed.

Is there any treatment for hair loss?

Depending on your type of hair loss, treatments are available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.

Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.

If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement.