Hair Loss (Alopecia)

Hair growth occurs in cycles with three phases: anagen (growth phase lasting 2-7 years), catagen (transition phase lasting 2-3 weeks), and telogen (resting phase lasting 2-3 months). At any time, about 90% of scalp hair is growing while 10% is resting. When this cycle is disrupted or hair follicles are damaged, hair loss occurs.

Hair loss can be temporary or permanent, affecting just the scalp or the entire body. It may appear as gradual thinning, circular bald patches, sudden loosening of hair, or full-body hair loss. The pattern and progression of hair loss, along with associated symptoms, help determine the underlying cause.

While hereditary hair loss is the most common cause, numerous factors can trigger hair loss including medical conditions, medications, physical or emotional stress, nutritional deficiencies, and hair care practices. Some types of hair loss are preventable or reversible, while others may be permanent without treatment.

Genetic and Hormonal

• Hereditary hair loss: Most common cause in both men and women
• Hormonal changes: Pregnancy, childbirth, menopause
• Thyroid disorders: Both hypo and hyperthyroidism
• PCOS: Polycystic ovary syndrome in women
• High testosterone: In women, causes male-pattern loss

Medical Conditions

• Alopecia areata: Autoimmune attack on hair follicles
• Scalp infections: Ringworm, folliculitis
• Trichotillomania: Hair-pulling disorder
• Lupus: Can cause scarring hair loss
• Diabetes: May affect hair growth
• Iron deficiency anemia: Common in women
• Protein deficiency: Impacts hair structure

Medications and Treatments

• Chemotherapy: Attacks rapidly dividing cells
• Blood thinners: Warfarin, heparin
• Antidepressants: Some SSRIs
• Blood pressure medications: Beta blockers, ACE inhibitors
• Birth control pills: Starting or stopping
• Vitamin A excess: From supplements
• Radiation therapy: To the head

Physical and Emotional Factors

• Physical trauma: Surgery, illness, high fever
• Emotional stress: Death, divorce, job loss
• Sudden weight loss: Crash dieting
• Hairstyling practices: Heat, chemicals, tight styles
• Nutritional deficiencies: Iron, zinc, biotin, protein

Hair loss may occur with other symptoms that help identify the underlying cause:

• Scalp symptoms: Itching, burning, pain, or tenderness
• Skin changes: Redness, scaling, scarring
• Fatigue: May indicate thyroid or nutritional issues
• Weight changes: Gain or loss with hormonal conditions
• Nail changes: Brittle nails with nutritional deficiencies
• Mood changes: Depression, anxiety with hormonal issues
• Menstrual irregularities: PCOS, thyroid disorders
• Joint pain: Autoimmune conditions like lupus
• Dry skin: Hypothyroidism
• Heat intolerance: Hyperthyroidism
• Muscle weakness: Nutritional deficiencies
• Headaches: Stress-related hair loss

Medical History

• Onset and progression of hair loss
• Pattern of loss
• Family history
• Medical conditions
• Medications and supplements
• Recent stressors or illness
• Hair care practices
• Diet and nutrition

Physical Examination

• Scalp examination
• Hair pull test
• Hair density assessment
• Pattern evaluation
• Skin examination
• Nail examination
• Body hair assessment

Diagnostic Tests

• Blood tests: CBC, thyroid, iron, hormones
• Scalp biopsy: For unclear cases
• Trichoscopy: Microscopic hair examination
• Hair pull test: Assess active loss
• Phototrichogram: Analyze growth patterns
• Fungal culture: If infection suspected

Gentle Hair Care Practices

• Use mild, sulfate-free shampoos
• Avoid excessive heat styling
• Let hair air dry when possible
• Use wide-toothed combs
• Avoid tight hairstyles
• Minimize chemical treatments
• Don't brush wet hair
• Sleep on silk pillowcases

Styling Tips

• Choose volumizing products
• Consider shorter hairstyles
• Use root lift techniques
• Avoid heavy products
• Try different partings
• Use dry shampoo for volume

• Nutrition: Ensure adequate protein, iron, vitamins
• Gentle handling: Avoid harsh treatments and tight styles
• Stress management: Practice relaxation techniques
• Regular check-ups: Monitor thyroid and hormone levels
• Protect from sun: Wear hats in strong sunlight
• Avoid smoking: Damages hair follicles
• Limit heat styling: Use heat protectants
• Choose gentle products: Avoid harsh chemicals
• Maintain scalp health: Keep clean and moisturized
• Stay hydrated: Important for hair health
• Exercise regularly: Improves circulation
• Get enough sleep: Supports hair growth

Schedule an Appointment For:

• Sudden or patchy hair loss
• Hair loss in unusual patterns
• Hair loss with other symptoms
• Excessive hair shedding (more than 100 hairs/day)
• Hair loss at a young age
• Scalp pain, itching, or inflammation
• Hair loss after starting medication
• No improvement with over-the-counter treatments
• Concerns about hair loss progression

Immediate Evaluation Needed:

• Rapid hair loss over days
• Complete hair loss in patches
• Hair loss with scalp changes
• Hair loss with systemic symptoms
• Hair loss in children