symptoms and causes of Hair Loss

Hair loss occurs in both men and women. The most important factors that contribute to hair loss are: androgenetic (heredity) alopecia, cicatricial and other types of alopecia such as, areata (patchy hair loss), cicatricial (scarring), mucinosa (scaly patches), barbae (facial hair loss), totalis, universalis, and traction (excessive styling). Further more are lupus, telogen and anagen effluvium (diffuse hair shedding), trichotillomania (hair pulling disorder), tinea capitis (scalp ringworm), thyroid and other diseases, medications, and last but not least, physical and emotional stress.

Androgenic Alopecia
(Male/Female Pattern Baldness)

Alopecia is the Latin word for hair loss, and includes a range of conditions, as we mentioned in the summary above. Androgenic alopecia (also known as androgenetic alopecia or alopecia androgenetica) is the most common reason for hair loss. It is caused by a combination of inherited genes and the changing hormones, and will affect up to 70 % of men and 40 % of women at some point in their lifetime. However, male and female androgenic hair loss differs. Male pattern baldness follows a distinct pattern; it affects only follicles that grow on top of the head. Over time, the hairline recedes to form a characteristic "M" shape, and often progressing to partial or complete baldness. Female hair loss follows a more diffuse pattern and differs from male-pattern baldness. In women, the hair becomes thinner all over the head, but the hairline does not recede. Androgenic alopecia in women rarely leads to total baldness.

The reason why some lose their hair and others do not may depend on several factors, but in most cases it depends on an inherited product of testosterone called dihydrotestosterone (DHT). Those who suffer, inherit hair follicles with a genetic sensitivity to DHT. Hair follicles that are sensitive to DHT begin to miniaturize, shortening the lifespan of each hair follicle affected.

Alopecia Areata (Patchy Hair Loss)

This type of hair loss is a result of an overactive immune system, meaning that the body gets confused. Under this condition, the person's immune system mistakenly attacks hair follicles, which is where hair growth begins. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a quarter. It affects about 4.7 million people in the United States and occurs equally in men and women. The extent of the hair loss varies. In some cases it is only in a few spots, in others the hair loss can be greater. Patchy hair loss usually affects scalp hair but the beard may also be affected. Some people may suffer a total loss of hair on the head (alopecia totalis) and others can experience hair loss on the entire body (alopecia universalis).

Lupus

Lupus is another type of hair loss caused by an overactive immune system. Lupus is a chronic autoimmune disorder in which the body's own immune system attacks healthy hair tissues. Unfortunately, hair loss of this type is 'scarring', meaning the hair would not grow back at the areas affected. The condition affects about 1.5 million people and tends to strike women during their childbearing years.

Anagen Effluvium

This hair loss is generally caused by intake of special types of medicines, mainly chemotherapy drugs which are used for treatment of cancer. It is a more widespread hair loss that may affect the whole body apart from the scalp. Initially it causes patchy hair loss, which often then becomes total hair loss.

Telogen Effluvium

It is a form of hair loss where more than normal amounts of hair fall out. It is a scalp disorder characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (the resting phase of the hair follicle). This may be the result of stress caused by intake of some medicines. Unlike some other hair losses and scalp conditions, it is temporary and the hair growth usually recovers.

Trichotillomania

Trichotillomania (or trichotillosis), which is classified as an impulse control disorderr, causes people to compulsively pull their hair out from the scalp, eyebrows or other areas of the body, despite trying to stop. Classified as an impulse control disorder, trichotillomania is often chronic and difficult to treat. It may be present in infants, but the peak age of onset is 9 to 13. Women are four times more likely to be affected than men.

Traction Alopecia (Over-Styling)

Rigorous styling and hair treatments over the years can cause your hair to fall out. This type of hair loss, which is called traction alopecia, is usually due to excessive pulling or tension on hair shafts as a result of certain hair styles. It is seen more often in women, particularly those of East Indian and Afro-Caribbean origin. Examples of extreme styling include tight braids, hair weaves or corn rows as well as chemical relaxers to straighten your hair, hot-oil treatments or any kind of harsh chemical or high heat. Excessive brushing can also weaken hair follicles. Prolonged traction alopecia can stop new hair follicles developing and lead to permanent hair loss. Because these practices can actually affect the hair root, your hair might not grow back.

Cicatricial Alopecia

This type of alopecia -– also called ‘Scarring Alopecia’, is mainly caused after a scar over the skin. In this case, the hair follicles that hold the roots of the hair may be completely destroyed. This means that the hair would not grow back at the areas affected. Some diseases and disorders also cause scarring alopecia, including lichen planus and discoid lupus erythematosus (DLE).

Diseases

Hair loss may also occur in diseases of the scalp, either in case of chronic skin diseases or infectious diseases. Skin conditions that lead to hair loss include seborrheic dermatitis (dandruff), psoriasis, and fungal infections such as ringworm (tinea capitis). Ringworm is a superficial fungal infection (dermatophytosis) of the scalp. At least eight species of dermatophytes are associated with tinea capitis.

There are several other diseases as well that lead to severe hair loss: such as anemia (when the number of red blood cells or concentrations of hemoglobin are low), thyroid disease, rheumatic diseases, too much vitamin A, vitamin B deficiency, lack of protein, dramatic weight loss, and cancer due to chemotherapy. Many medicines used to treat even common diseases can cause hair loss. However, only 2-5 percent of hair losses are caused by disease.

Medications

Certain classes of medication may also promote hair loss. More common among them are certain blood thinners and the blood-pressure drugs known as beta-blockers, and anabolic steroids. Other drugs that might cause hair loss include antidepressants, methotrexate (used to treat rheumatic conditions and some skin conditions), lithium (for bipolar disorder), and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Dieting may also be responsible for hair loss in some cases.

Physical Stress

Any kind of physical trauma — surgery, a car accident, or a severe illness, even the flu — can cause temporary hair loss. This can trigger a type of hair loss called telogen effluvium that we discussed above. Hair has a programmed life cycle: a growth, a rest, and a shedding phase. When you have a really stressful event, it can shock the hair cycle; pushing more hair into the shedding phase. Hair loss often becomes noticeable 3-6 months after the trauma. Giving birth is pretty traumatic as well. Pregnancy-related hair loss is seen more commonly after the baby has been delivered rather than actually during pregnancy. Hair loss is also increased or sped up by poor circulation or moving to a new country or change of environment. These events and conditions can cause a change in the body's hormones that affect DHT (dihydrotestosterone) which is a contributor to hair loss.

Emotional Stress & Psychological Distress

Emotional stress is less likely to cause hair loss than physical stress. However, it can happen for instance after the death of a loved one, while caring for an aging parent, or in the case of divorce. More often, though, emotional stress won't actually precipitate the hair loss. It will exacerbate a problem that's already there.

Psychological distress can also makes matters worse. Generally, a state of distress develops over a relatively long period of time. The transition of stress to distress depends on several factors, among others stressor duration and intensity. The bottom line is that emotional or physiological stress may result in an alteration of the normal hair cycle and cause the disorder. The more hair we lose the more we worry about it -– and then the more we worry about it, the more hair we lose. It is a vicious cycle!