Hair Loss – Causes, Symptoms and Treatment
Hair loss refers to excessive shedding or thinning of hair on the scalp or body. It can be temporary or permanent and has a variety of possible causes.
Things worth knowing about "Hair Loss"
Hair loss refers to excessive shedding or thinning of hair on the scalp or body. It can be temporary or permanent and has a variety of possible causes.
What is Hair Loss?
Hair loss (medically known as alopecia) refers to a loss of hair that exceeds the normal daily shedding of 50 to 100 hairs. When hair falls out in greater quantities and does not regrow, it is considered pathological hair loss. It can affect the scalp as well as other areas of the body, including eyebrows, eyelashes, and body hair.
Types of Hair Loss
Androgenetic Alopecia
Androgenetic alopecia is the most common form of hair loss and is largely genetic. In men, it typically begins with a receding hairline and thinning at the crown. In women, it presents as diffuse thinning across the top of the scalp. The underlying cause is a sensitivity of the hair follicles to the hormone dihydrotestosterone (DHT).
Diffuse Hair Loss (Telogen Effluvium)
Telogen effluvium involves widespread thinning across the entire scalp. Common triggers include physical or emotional stress, nutritional deficiencies, hormonal changes (e.g., post-pregnancy), thyroid disorders, or changes in medication.
Alopecia Areata
Alopecia areata is an autoimmune condition in which the immune system mistakenly attacks the hair follicles, resulting in round, well-defined patches of hair loss. In severe cases, it can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis).
Scarring Alopecia
In scarring alopecia, the hair follicles are permanently destroyed by inflammation, infections, or injury. Hair cannot regrow in these affected areas.
Causes
- Genetic predisposition
- Hormonal changes (e.g., pregnancy, menopause, thyroid disorders)
- Nutritional deficiencies (e.g., iron, zinc, biotin, vitamin D)
- Chronic or acute stress
- Autoimmune conditions
- Medications (e.g., chemotherapy drugs, antihypertensives, anticoagulants)
- Infectious diseases or high fever
- Mechanical damage from hairstyles or chemical treatments
Symptoms
- Increased hair shedding during washing or brushing
- Thinning of hair at the crown or temples
- Round or oval bald patches
- Itching or burning of the scalp (in inflammatory forms)
- Visible scalp due to thinning hair
Diagnosis
Diagnosis is made through a dermatological examination. The physician will take a detailed medical history and examine the scalp. Common diagnostic tools include:
- Trichoscopy: Magnified examination of the scalp and hair follicles
- Blood tests: Assessment of hormone levels, nutritional status, and thyroid function
- Trichogram: Microscopic analysis of hair root samples
- Scalp biopsy: Used when scarring or inflammatory alopecia is suspected
Treatment
Medication
For androgenetic alopecia, the most commonly used treatments are minoxidil (applied topically as a solution or foam) and finasteride (taken orally; approved for men only). Both can slow hair loss progression and, in some cases, stimulate regrowth.
Treatment for Alopecia Areata
Alopecia areata is often treated with corticosteroids (topical or injected), immunomodulators, or newer agents such as JAK inhibitors, which help regulate the misdirected immune response.
Nutrition and Supplementation
When a nutritional deficiency is confirmed, targeted supplementation with iron, zinc, biotin, or vitamin D can help reduce hair loss and support regrowth.
Hair Transplantation
For permanent hair loss, a surgical hair transplant may be considered. This procedure involves moving healthy hair follicles from dense areas to thinning or bald regions of the scalp.
Other Approaches
Additional treatment options include Platelet-Rich Plasma (PRP) therapy, low-level laser therapy, and lifestyle modifications such as stress management and a balanced diet.
When to See a Doctor
If hair loss occurs suddenly, worsens over time, is accompanied by other symptoms, or affects quality of life, it is advisable to consult a physician — ideally a dermatologist. Early diagnosis and treatment significantly improve outcomes.
References
- German Dermatological Society (DDG): Guideline on Diagnosis and Treatment of Alopecia. AWMF Register No. 013-019, 2021.
- Vary JC Jr. Selected Disorders of Skin Appendages -- Acne, Alopecia, Hyperhidrosis. Med Clin North Am. 2015;99(6):1195-1211. PubMed PMID: 26476248.
- Wolff K, Johnson RA, Saavedra AP: Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology. 8th edition. McGraw-Hill Education, 2017.
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