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Hair loss

Loss of hair; Alopecia; Baldness; Scarring alopecia; Non-scarring alopecia

Partial or complete loss of hair is called alopecia.

Images

Hair follicle
Ringworm, tinea capitis - close-up
Alopecia areata with pustules
Alopecia totalis - back view of the head
Alopecia totalis - front view of the head
Alopecia, under treatment
Trichotillomania - top of the head
Folliculitis, decalvans on the scalp

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Considerations

Hair loss usually develops gradually. It may be patchy or all over (diffuse). You lose roughly 100 hairs from your head every day. The scalp contains about 100,000 hairs.

Causes

HEREDITY

Both men and women tend to lose hair thickness and amount as they age. This type of baldness is not usually caused by a disease. It is related to aging, heredity, and changes in the hormone testosterone. Inherited, or pattern baldness, affects many more men than women. Male pattern baldness can occur anytime after puberty. About 80% of men show signs of male pattern baldness by age 70.

PHYSICAL OR EMOTIONAL STRESS

Physical or emotional stress may cause one-half to three-quarters of scalp hair to shed. This kind of hair loss is called telogen effluvium. Hair tends to come out in handfuls while you shampoo, comb, or run your hands through your hair. You may not notice this for weeks to months after the episode of stress. Hair shedding decreases over 6 to 8 months. Telogen effluvium is usually temporary. But it can become long-term (chronic).

Causes of this type of hair loss are:

Some women ages 30 to 60 may notice a thinning of the hair that affects the entire scalp. The hair loss may be heavier at first, and then gradually slow or stop. There is no known cause for this type of telogen effluvium.

OTHER CAUSES

Other causes of hair loss, especially if it is in an unusual pattern, include:

Home Care

Hair loss from menopause or childbirth often goes away after 6 months to 2 years.

For hair loss due to illness (such as fever), radiation therapy, medicine use, or other causes, no treatment is needed. Hair usually grows back when the illness ends or the therapy is finished. You may want to wear a wig, hat, or other covering until the hair grows back.

Hair weaves, hair pieces, or changes of hair style may disguise hair loss. This is generally the least expensive and safest approach to hair loss. Hair pieces should not be sutured (sewn) to the scalp because of the risk of scars and infection.

When to Contact a Medical Professional

Call your health care provider if you have any of the following:

What to Expect at Your Office Visit

A careful medical history and examination of the hair and scalp are usually enough to diagnose the cause of your hair loss.

Your provider will ask detailed questions about:

Tests that may be performed (but are rarely needed) include:

If you have ringworm on the scalp, you may be prescribed an antifungal shampoo and oral medicine for you to take. Applying creams and lotions may not get into the hair follicles to kill the fungus.

Your provider may prescribe a solution, such as Minoxidil that is applied to the scalp to stimulate hair growth. Other medicines, such as hormones, may be prescribed to decrease hair loss and promote hair growth. Drugs such as finasteride and dutasteride can be taken by men to decrease hair loss and grow new hair.

Hair transplant may also be recommended.

Related Information

Male pattern baldness
Testosterone
Female pattern baldness

References

Avram MR, Keene SA, Stough DB, Rogers NE. Hair restoration. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 157.

Sperling LC, Sinclair RD, El Shabrawi-Caelen L. Alopecias. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 69.

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Review Date: 4/14/2015  

Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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