Alopecia is the general term given to hair loss. It can manifest itself in several ways, but it most often affects the scalp in a pattern. Alopecia can be a very emotional problem, as it affects an area of our bodies that we take great pride in. Because of this, it may cause a loss of self-esteem if you feel like you cannot put your best face forward. As hair loss can affect any age or sex, this can be particularly agonizing for young people, especially women. It can trigger anxiety and depression which can ultimately make some forms of alopecia worse.
Alopecia is usually permanent if it is triggered by your genetic makeup, however most other forms of hair loss are only temporary if the trigger can be removed or controlled.
What are the symptoms of hair loss?
Hair loss can present differently for each individual however it’s often first noticed during the combing or washing of one’s hair. Hair loss may be rapid, such as losing clumps of hair in the shower, or gradual such as with a receding hairline.
In male pattern baldness, hair loss generally follows a very distinct pattern that follows a horseshoe shape around the head. With an autoimmune disorder, hair loss can appear as patchy, coin-sized bald spots across the scalp, eyebrows, eyelashes or beard. In the most severe cases, such as with the use of chemotherapy drugs, a full loss of all body hair may occur.
What Causes Hair Loss to Happen?
Alopecia can take on many different forms, but these are the 10 most common causes of hair loss:
1. Male-and-Female-Pattern Baldness
Male pattern baldness is the most common type of hair loss and it tends to affect around 50% of all men by the time they reach 50 years of age. The onset of this type of alopecia is usually in the late 20s and early 30s and it follows a very specific pattern – a receding hairline, thinning on the crown then thinning at the temples leaving behind a sort of horseshoe shape of hair around the head. Male pattern baldness is a hereditary condition which has been found to have a key gene on the X chromosome, meaning that men may inherit this from their mother’s side of the family. Though new research has found that the fault doesn’t lie entirely here, as people are just as likely to go bald if their own father is bald. Two new studies have now found a small region on chromosome 20 as also being associated with balding.
Male pattern baldness is thought to be caused by oversensitive hair follicles that may have too much of a certain male hormone. Pattern-balding can also affect women, though less commonly, and usually as thinning on the top of the head. This tends to affect mostly post-menopausal women who have less female hormones, which lends itself to this male hormone theory.
2. Alopecia Areata
Alopecia Areata is an autoimmune disease which affects the hair follicles. An autoimmune condition is where the immune system mistakenly attacks the body’s own cells, perceiving them as the enemy. But alopecia areata is more common that you might think, affecting 2% of all American (over 6 million people).
In alopecia areata, the immune system attacks the hair follicles causing inflammation, which results in hair loss. Like most autoimmune diseases it’s hard to know why the immune system decides to attack a particular part of the body. Only that it sees it as a harmful invader. It is, however, thought that genetics are involved with alopecia areata as one in five people have a family member with the same condition. A history of other autoimmune disorders, such as an thyroid disease, diabetes or Down’s Syndrome are also thought to increase one’s risk.
The key symptom of alopecia areata is patchy hair loss that may come on suddenly or over several weeks. There may also be itching or burning around the area due to the inflammation in the hair follicles. Thankfully, the hair follicles are not destroyed in alopecia areata and hair should regrow once the hair follicles calm down. Though for many, this is easier said than done. Alopecia areata can also affect the eyebrows, lashes, and beard.
Many people believe that stress causes alopecia areata but there is still no scientific evidence to back this theory.
Anagen effluvium is a type of widespread hair loss commonly caused by chemotherapy, immunotherapy and radiotherapy. It can affect the scalp, face and body. Chemotherapy drugs are powerful medications that are on the attack to kill cancer cells. But as we know, they also have to kill a lot of “good” cells in order to do so. Including those that help hair to grow. The extent of hair loss will always vary between patients but there are now special “cool caps” available that can help to reduce hair loss during treatment. The good news is that hair loss from cancer treatment is only temporary and hair should start to grow back between 1-3 months after treatment has stopped.
4. Fungus Infections
Tinea Capitis is a fungal infection that occurs on the scalp. It is also known as “ringworm of the scalp” and is not too dissimilar from tinea of the feet (Athlete’s Foot). Tinea Capitis creates bald patches on the scalp due to hair that has broken off around inflamed, scaly areas of skin. As with all fungal infections, Tinea Capitis is infectious which explains why it is mostly seen in young children who pass infections easily between them at school. You can catch fungal infections if you come into direct contact with it on someone else’s body or on their combs or clothing. Medications and medicated shampoos are used to easily treat Tinea Capitis.
5. Female-Specific Hair Loss
Androgenetic alopecia is a thinning of the scalp hair in women and is due to androgens, male hormones that are typically present in only very small amounts. But various actions can cause hormones to become imbalanced, such as ovarian cysts, high androgen birth control pills, pregnancy, and menopause. It appears that the male hormone known as DHT, a derivative of testosterone, is somewhat to blame here. Though heredity can also play a role.
When women’s bodies experience traumatic experiences such as childbirth, major surgeries or extreme stress their hair growth can switch from a growing phase to a shedding phase known as telogen effluvium. As far as six weeks to three months after the stress event, hair can begin to shed as a result. Telogen effluvium still ultimately exists as a mysterious chronic disorder, however, without a full understanding of the factors involved.
6. Poor Styling Techniques
If you wear the same type of hair style every day, you may be causing more than regular hair fall (50-100 hairs per day). Tie your ponytails or braids loosely. Also, use a metal-free rubber band, so you don’t cause any more damage to thick, healthy hair strands. And always use hot styling tools on a medium-to-low setting. This helps avoid breakage, which can contribute to hair thinning and hair fall.
7. Hormone Changes
Hormone changes can contribute to hair loss. In women, studies suggest androgenic hair loss may be due to an interaction with the thyroid gland. Androgen metabolism may also be to blame. This process produces hair loss hormones, including testosterone.4
Hormone-altering medications, including birth control pills, may contribute to hair fall. Natural hormone changes associated with pregnancy or perimenopause may also cause hair fall.
8. Iron Deficiency
If you’re not eating enough nutritious foods, you may have nutrient deficiencies. Your hair could suffer as a result.
Iron is one such example. It’s needed for many different processes within the hair follicle. For this reason, iron deficiency may disrupt the growth of thick, healthy hair strands.5
Several studies support the relationship between iron in the body and hair loss. Low iron levels are strongly linked with the development of, or the worsening of, hair loss. This is especially true in premenopausal women.6,7
Are you concerned an iron deficiency is contributing to higher-than-normal hair fall or hair loss? Talk to your doctor about a simple nutrient test. If you are deficient, dietary changes or supplements may help.
The daily recommendation for iron is between 8-18 mg for adults, and 27 mg for pregnant women.8
9. Chronic Inflammation
Inflammation is a function of the immune system. In those with chronic inflammation (which can last for months or years), hair loss may result. Research suggests that micro-inflammation can attack hair follicles. This can result in hair loss, balding, and even androgenic alopecia.9
To reduce the risk of inflammation-associated hair loss, add anti-inflammatory foods to your diet. Green leafy vegetables, seeds and nuts, and fatty fish like salmon and tuna are all great choices. Fruits, such as strawberries and oranges, are also rich in antioxidants.10
Several studies show chronic stress suppresses the immune system. This, in turn, can negatively affect hair growth.11
Chronic stress is especially problematic. Several studies state this kind of stress can trigger the onset of alopecia areata.12
You know stress is bad for your health. It’s also bad for your hair. Do what you can to reduce your stress levels. Consider meditation, or try yoga or other exercises. Tune into your body, and tune out the stress.
Is there a Cure?
There is no specific cure for alopecia areata but hair may grow back on it’s own within 12 months or with effective medicated shampoo, like Juvatress. It is often also treated with corticosteroid (steroid) injections which appear to work well on small patches of alopecia by suppressing the immune system, and hence preventing it from continuing to attack itself.
Though not a treatment per se, many people choose to make use of wigs and hair pieces to hide their hair loss while they are trying to treat it.
How can I prevent alopecia?
Due to the fact that most alopecia is caused by either genetic or autoimmune factors it is almost impossible to prevent it. However, if the hair loss is due to other, more controllable, factors there are certainly healthy lifestyle practices that can be adopted to lessen the chances of hair loss. These include eating a healthy, balanced diet; avoiding undue stress; and taking good care of your hair by using gentle wide tooth combs, avoiding tight pony tails or braids, and minimizing the use of hot irons and curlers.
1. “The Genetics Of Balding | Understanding Genetics”. Genetics.thetech.org. N.p., 2017. Web. 22 June 2017.
2.”Hair Loss (Alopecia) – NHS Choices”. Nhs.uk. N.p., 2017. Web. 22 June 2017.
3. “American Hair Loss Association – Women’s Hair Loss / Causes Of Hair Loss“. Americanhairloss.org. N.p., 2017. Web. 22 June 2017.
e4. Schmidt JB, Lindmaier A. Hormone studies in females with androgenic hairloss. Gynecol Obstet Invest. 1991;31(4):235-9.
5. Elston DM. Commentary: Iron deficiency and hair loss: problems with measurement of iron. J Am Acad Dermatol. 2010 Dec;63(6):1077-82.
6. Moeinvaziri M, Mansoori P. Iron status in diffuse telogen hair loss among women. Acta Dermatovenerol Croat. 2009;17(4):279-84.
7. Song Youn Park, Se Young Na. J Korean Med Sci. 2013 Jun; 28(6): 934–938. Iron Plays a Certain Role in Patterned Hair Loss. J Korean Med Sci. 2013 Jun; 28(6): 934–938.
8. National Institutes of Health. Office of Dietary Supplements. Iron.
9. Emin Tuncay Ustuner, MD. Cause of Androgenic Alopecia: Crux of the Matter. Plast Reconstr Surg Glob Open. 2013 Oct; 1(7): e64.
10. Foods that fight inflammation. Harvard health Publishing Harvard Medical School.
11. Mohd. Razali Salleh. Life Event, Stress and Illness. Malays J Med Sci. 2008 Oct; 15(4): 9–18.
12. Vladimir A. Botchkarev. Stress and the Hair Follicle Exploring the Connections. Am J Pathol. 2003 Mar; 162(3): 709–712.