Hair Loss Causes and Solutions for Men and Women: Insights from an Expert Dermatologist

Types of Hair Loss (Alopecia)

Hair loss, or alopecia, occurs in various forms:

Nonscarring Alopecia

• Involutional alopecia is a natural condition in which the hair gradually thins with age. More hair follicles enter the resting phase, and the remaining hairs become shorter and fewer.
• Androgenic alopecia is a hereditary condition that affects both genders. Male-pattern baldness, as it is known in men, can start as early as the teenage years or early twenties. It is characterized by a receding hairline and gradual hair loss from the crown and frontal scalp. Female-pattern baldness, on the other hand, does not manifest in noticeable thinning until the 40s or later. Women experience a general thinning over the entire scalp, with the most significant hair loss at the crown.
• Alopecia areata is a type of hair loss that occurs when your immune system mistakenly attacks hair follicles, where hair growth begins. Alopecia areata often starts suddenly and causes patchy hair loss in children and young adults. This condition may result in complete baldness (alopecia totalis). But in about 90% of people with the condition, the hair returns within a few years.
• Telogen effluvium is temporary hair thinning on the scalp that occurs due to changes in the hair growth cycle. A significant number of hairs enter the resting phase simultaneously, leading to hair shedding and subsequent thinning. Learn more about the causes of telogen effluvium.

Hair loss (alopecia)

Hair loss (alopecia) is categorized as scarring (with permanent destruction of hair follicles) or nonscarring. Nonscarring alopecia is the most common form of hair loss and can be classified as patterned, diffuse, or focal, based on the distribution of hair loss.

• Patterned hair loss involves progressive, symmetrical thinning of the hair, most prominently at the front, top, and sides of the scalp. Thinning of the hairline in these areas occurs in both sexes; however, pronounced recession of the hairline is seen primarily in men. The most common form of patterned hair loss worldwide is androgenetic alopecia, which is a hereditary condition caused by exposure to the male sex hormone dihydrotestosterone. The onset of androgenetic alopecia usually occurs after puberty.
• Diffuse hair loss involves the even loss of hair across the scalp. The most common type of diffuse hair loss is telogen effluvium, which results in the loss of more than 200 scalp hairs per day. It usually develops after an acute event, such as a severe illness, major surgery, thyroid disease, pregnancy, iron-deficiency anemia, malnutrition or rapid weight loss, or vitamin D deficiency. Other causes of telogen effluvium include the use of certain medications (such as lithium, valproate, fluoxetine, warfarin, propranolol, retinoids, and isoniazid) or the cessation of estrogen-containing oral contraceptive pills. Hair shedding usually begins about 2 to 4 months after an acute inciting event and typically resolves within 6 to 9 months.
• Focal hair loss involves the loss of hair in patches on the scalp, and sometimes the face and body. The most common form of focal hair loss is alopecia areata, an autoimmune disorder that often develops in childhood but can affect individuals of any age, sex, or race/ethnicity. It is associated with asthma, allergic rhinitis, atopic dermatitis, and other autoimmune disorders such as type 1 diabetes. Spontaneous hair regrowth may occur in up to 30% of individuals with milder forms of alopecia areata.

Factors Contributing to Hair Loss

There are several factors that can contribute to hair loss:

1. Hormonal imbalances, such as abnormal levels of androgens (male hormones naturally produced by both men and women).
2. Genetic predisposition inherited from both male and female parents can influence an individual’s susceptibility to male- or female-pattern baldness.
3. Temporary hair loss can occur due to stress, illness, or childbirth. Additionally, ringworm, a fungal infection, can also cause hair loss. It is important to understand the potential causes of stress-induced hair loss and explore available solutions.
4. Burns, injuries, and X-ray exposure can lead to temporary hair loss. In most cases, normal hair growth resumes once the injury heals, unless scarring occurs, in which case hair regrowth may not be possible.
5. Hair thinning can result from cosmetic procedures such as frequent shampooing, perming, bleaching, and dyeing, which weaken and embrittle hair. Tight braiding, using rollers or hot curlers, and running hair picks through tight curls can also cause hair damage and breakage. However, these practices do not directly lead to baldness. In most cases, hair regrowth occurs once the problematic source is eliminated. However, severe damage to the hair or scalp may occasionally result in permanent bald spots.
6. Medical conditions such as thyroid disease, lupus, diabetes, iron deficiency anemia, eating disorders, and anemia can also contribute to hair loss. Typically, hair regrowth occurs upon successful treatment of the underlying condition, unless scarring occurs, as observed in certain forms of lupus, lichen planus, or follicular disorders.
7. A low-protein or severely calorie-restricted diet can also temporarily cause hair loss. Information on dietary options that aid in hair loss prevention is available.
8. Deficiencies in vitamins A, B, C, D, and E, as well as iron and zinc, have been associated with hair loss.

Treatment Options for Hair Loss

Various treatment options are available for different types of hair loss:

Certain individuals affected by androgenetic alopecia experience hair regrowth when applying minoxidil solution or foam topically to the affected areas of the scalp. Furthermore, an oral medication that obstructs the production of dihydrotestosterone (finasteride) can result in hair regrowth or decelerate hair loss. However, this medication may cause fetal abnormalities, and individuals who are capable of becoming pregnant should refrain from taking it. Low-level laser light therapy utilizing devices that emit low-frequency red light may also enhance hair density.

Individuals with telogen effluvium should receive treatment for any underlying causes that can be corrected (such as iron supplementation for iron deficiency, vitamin D supplementation for vitamin D deficiency, management of thyroid disease, and cessation of medications that can induce telogen effluvium). Patients with telogen effluvium and patterned hair loss may benefit from topical minoxidil to augment the density of hair regrowth.

For alopecia areata, the injection of corticosteroid medication into localized areas of hair loss may stimulate hair regrowth. Additional potential treatment options include topical application of corticosteroids, minoxidil, contact irritants (such as anthralin), and contact allergens (such as squaric acid dibutyl ester and diphenylcyclopropenone). A class of oral medications known as Janus kinase inhibitors may prove beneficial for individuals with severe alopecia areata.

Laser Therapy

Studies have revealed that low-level laser treatments work on hair loss. This will be beneficial for those who do not want to risk taking medication for fear of the side effects. Or getting more invasive solutions such as hair transplant surgery. It works by allowing weak cells to absorb photons into scalp tissues. By doing so, it helps to move the follicles into a growth phase. This helps to restore hair follicles to coax the hair into regrowing.

Hair Transplant Surgery

Hair transplant surgery works by removing the hair follicles from a denser area of hair. That is not affected by Hair Loss and implanting the hair into the affected areas of the scalp. Because the hair the area was taken from is not affected by miniaturization, the transplanted hairs will usually grow normally.

Resolve Hair Loss and Restore Your Self-Assurance

Ultimately, the best way to choose the ideal treatment option for you is to consult Dr. Fehmida. Because an early diagnosis will ensure a better chance of keeping the remaining hair follicles. Early treatment may also help achieve better results. Contact us for details or book a consultation today.