Hair loss (alopecia) can affect your scalp or even other parts of the body and it can develop gradually over years or happen abruptly. Hair loss can be permanent or temporary. Anyone can lose hair on their head, both men and women. It can be the result of heredity, hormonal changes, medical conditions, or a normal part of ageing.
It is normal to lose around 50-100 hairs in a day. With about 100,000 hairs on your head, that small loss isn’t significant. New hair normally replaces the lost hair, but this sometimes, it may not happen.
It’s difficult to count the amount of hair fall on a given day. You may be losing more hair than normal if you notice a large amount of hair in the drain after washing your hair, lots of hair over the pillows while you wake up, or clumps of hair in your brush. You may also notice bald patches or thinning of hair from the sides, front, or center.
If you notice that you’re losing more hair than usual, you should discuss the problem with your skin doctor as it is important to find out the cause of your hair fall and the treatment options available because each and every case of hair fall may be unique.
What are the types of hair loss?
Hair loss can appear in many different ways and it has been classified according to the appearance, the cause as well as whether it is permanent or temporary hair loss.
Hair loss from the scalp may be temporary or permanent.
Scarring Alopecia: If the hair loss is due to the destruction and loss of hair follicles it is known as scarring or cicatricial alopecia. Because of the loss of follicles, it tends to be permanent.
Non-ScarringAlopecia: If the scalp is normal with empty hair follicles, this is called non-scarring hair loss. Because the follicles are spared, there is scope for regrowth.
Hair loss from the scalp may also follow different patterns:
Patchy hair loss: Some conditions produce only small areas of hair loss or patches of alopecia, while others affect large areas of the scalp.
Diffuse hair loss: Hair loss is from the entire scalp.
Here are some of the common patterns of hair loss people often encounter:
Gradual thinning on top of head: This is the most common type of hair loss which can affect both men and women as they age. In men, hair often begins to recede at the hairline on the forehead. Women usually have a broadening of the central partition in their hair.
Hair Shedding: Hair may come out by the handful when combing or washing or even after gentle tugging. This type of hair fall is usually temporary.
Circular or patchy bald spots: Some people lose hair in circular or patchy bald spots on the scalp, beard or eyebrows.
Full-body hair loss: Some conditions and medical treatments, such as chemotherapy for cancer, can result in the loss of hair all over your body.
Patches of scaling that spread over the scalp: It could be a sign of fungal infection affecting the scalp.
Top 10 Causes of Hair Fall:
Family history (heredity). The most common cause of hair loss is a hereditary condition that happens with ageing known as androgenic alopecia which includes male-pattern baldness and female-pattern hair loss. It usually occurs gradually and in predictable patterns — a receding hairline and bald spots in men and thinning hair along with the crown of the scalp in women. Many men and women may notice mild physiologic thinning of hair starting in their 30s and 40s.
Hormonal changes can cause temporary hair fall. Examples include: • During Pregnancy • After Childbirth • After discontinuing the use of birth control pills •Menopause
Polycystic ovary syndrome (PCOS): Women withpolycystic ovary syndrome(PCOS) have a hormonal imbalance which creates high levels of androgens. This often causes hair growth on the face and body, while the hair on the head grows thinner. PCOS can also lead to ovulation problems, weight gain, and acne.
Medical conditions that can cause hair fall include: • Thyroid disease • Alopecia areata (an autoimmune disease that attacks hair follicles) • Scalp infections like ringworm • Some types of lupus
Hair fall can also be due to medications used to treat: • Cancer • High blood pressure • Arthritis • Depression • Heart problems
A physical or emotional shock: Many people experience a general thinning of hair several months after a physical or emotional shock. This type of hair loss is temporary. Some of the examples of such events are:
• Death of someone in the family • Extreme weight loss • High-grade fever • Major illnesses like typhoid, malaria • Any major surgery
Diet: A diet lacking in protein, iron, and other nutrients can also lead to thinning hair. Protein deprivation (during strict dieting) can also lead to hair shedding.
Hairstyles and treatments: Excessive hairstyling or hairstyles that pull your hair tight, such as pigtails or cornrows, can cause a type of hair loss called traction alopecia. Hot-oil hair treatments and permanents also can cause hair to fall out. If scarring occurs, hair loss could be permanent.
Traction hair loss: This can occur due to pulling the hair back very tightly.
Trichotillomania (hair-pulling disorder): Some people tend to pull out their hair, usually from their head, eyebrows, or eyelashes. It usually occurs at a young age may occur in adults too and may sometimes be associated with other psychological conditions.
When to see a doctor?
One should consult a doctor if you are worried about persistent hair loss and want to stop hair fall. Also, talk to your doctor if you notice sudden or patchy hair loss or more than usual hair loss when combing or washing your child’s hair.
How will the doctor diagnose the cause of your hair fall?
Before making a diagnosis, your doctor will perform a physical exam and ask about your diet, your hair care routine, and your medical and family history. He might also perform tests such as:
Blood tests: This might help uncover medical conditions that can cause hair fall.
Hair Pull test: The doctor gently pulls a few hairs to see how many come out from the roots. This helps to determine the stage of the shedding process and confirm certain hair fall disorders like Telogen Effluvium.
Dermatoscopy: This is a modern diagnostic technique that helps to visualize the surface and subsurface features of the scalp as well as the hair. Because it is a non-invasive and painless examination of the hair, usually this is performed in all cases to confirm the diagnosis.
Scalp biopsy: The doctor may take sample(s) from the scalp which can help determine the cause of the hair loss. Usually, it is not performed unless there is an absolute need to do it and a dermatoscopic examination suffices.
Other specialized tests: Sometimes there may be a need to perform advanced diagnostic techniques and modern tools for the diagnosis of hair loss. Your dermatologist will usually explain what to do and why it is required.
Questions to ask the doctor.
Your time with your dermatologist is limited but these are some of the important questions a person suffering from hair loss should ask the specialist:
What is causing my hair loss?
Are there other possible causes?
What kinds of tests are required?
Is my hair loss permanent or will it grow back?
How long will it take for my hair to grow back andwill it have a different texture after it grows back?
What is the best course of action?
Should I change my diet?
Should I change my hair care routine?
Are there any restrictions that I should keep in mind?
Where can I find more information about ways to prevent hair fall?
What to expect from your dermatologist?
Your doctor is likely to ask you a number of questions. Some of the commonly asked questions which will help the specialist in diagnosing your hair fall condition and choosing the right plan of treatment include:
When did the hair loss start?
Is the hair loss continuous or occasional?
Have you noticed poor hair growth, hair breakage or hair shedding?
Is your hair falling from a patch or overall?
Did you have a similar problem in the past?
Has anyone in your immediate family experienced hair loss?
