Hair Loss Causes, Symptoms & Treatment

Overview

Hair loss which is also called “alopecia”, is a condition where there is an interruption (stop or break in continuity) in the body’s cycle of hair production. Hair loss can occur anywhere in the body. But it is seen mostly in the scalp (head) area. On average, the scalp area has about 1,00,000 to 1,50,000 hairs and loses up to 100 of them per day. Hair is made up of a special protein called Keratin, which is produced by the hair follicles in the outer layer of the skin. The hair that we see is a string of dead keratin cells.

Each hair follicle has its own life cycle and the life cycle of the follicle will be influenced by several factors such as age, gender, disease, and a wide variety of other factors.

The life cycle of the hair follicle

The life cycle of the hair follicle can be divided into 3 phases. They are listed below:

• Anagen phase - During this phase, there is active hair growth, which lasts for about 2-8 years.
• Catagen phase - During this phase, there is transitional hair growth which lasts for about 2-3 weeks.
• Telogen phase- Telogen phase is also known as the resting phase and it usually lasts for about 2-3 months. By the end of this phase, the old hair is shed and replaced by new hair.

Types of hair loss

There are several types of hair loss. They are listed below:

Androgenic alopecia

 It is a genetic condition that can affect both men and women. Men with this condition usually develop male-pattern baldness. Most of men can notice extensive hair loss in their early 20s or in their teen’s age. It is characterized by receding hairlines and the gradual disappearance of hair from the crown and frontal scalp. Whereas women with this condition, develop female-pattern baldness. Females with this condition notice thinning of their hair during their 40s or later, not in their early 20s. In females, it is characterized by the general thinning of hair over the entire scalp, with the most extensive hair loss at the crown.

Alopecia areata

It is most commonly seen in children and young adults. It is characterized by sudden patchy hair loss. This condition may often lead to complete baldness which is called alopecia totalis.

Alopecia universalis

This is a condition, where total body hair loss is noted. It includes hair loss of the eyebrows, eyelashes, and pubic hair.  

Involutional alopecia

It is a condition where there is gradual thinning of hair with age. During this condition, most of the hair enters the resting phase of the hair life cycle, while the remaining hair becomes shorter and fewer in number.

Telogen effluvium

It is a condition, where there is temporary thinning of hair over the scalp is noticed. It occurs due to changes in the growth cycle of the hair.

Trichotillomania

It is a condition seen mostly in children. It is a psychological condition, where the patients pull their own hair.

Traction alopecia

It is a condition seen mostly in people who use hot hair dryers, hot combs, or who tightly tie their hair and pull, which can result in permanent hair loss.

Scarring alopecia

It is a condition seen mostly in inflammatory skin conditions such as acne, cellulitis, or folliculitis or in other skin conditions such as some form of lupus and lichen planus, which will result in the formation of scars and lead to permanent hair loss.

Central centrifugal cicatricial alopecia

It is mostly seen in black women. It often leads to the development of small bald patches in the center of the scalp that grows over a period.

Causes of hair loss

There are several factors that can contribute to hair loss. They are listed below:

• Hereditary (family history)- it is the most common cause of hair loss.
• Hormonal medications and other medical conditions- a few of the patients might face temporary or permanent hair loss due to hormonal changes during pregnancy, childbirth, thyroid problems, or menopause.
• Medications and supplements
• Hairstyles and treatment
• Stressful events
• Radiation therapy to the head

Risk factors for hair loss

The risk factors for hair loss are listed below:

• Family history
• Poor nutrition
• Age
• Stress
• Burns, injuries, or too much radiation exposure
• Autoimmune diseases
• Vitamin deficiency
• Certain hormonal changes in the body
• Patient who underwent radiotherapy or chemotherapy

Symptoms of hair loss

The symptoms of hair loss vary from person to person, based on their condition and type of hair loss. A few of the symptoms are listed below:

• Gradual thinning of the hair
• Decrease in the growth of the hair
• Circular or patchy bald spots
• Receding hairline
• Sudden loosing of the hair
• Hair loss all over the body
• Patches of scaling that spread over the scalp

Illness that can cause hair loss

Medical conditions that can cause hair loss are listed below:

• PCOS (polycystic ovarian syndrome)
• Syphilis and other sexually transmitted infections
• Thyroid disease
• Scalp psoriasis 

Diagnosis of hair loss

In order to diagnose the cause of hair fall, the doctor initially will ask a couple of questions to the patient, which include- their food habit, history of undergoing any chemotherapy or radiation therapy, routine hair care, and medical and family history. The doctor will advise the patient to undergo a couple of tests, which are listed below:

• Blood test- this test will help us know if there is any sort of vitamin deficiency or any signs of infection which may cause hair loss.
• Pull test- this test will help us to determine the stage of the shedding process.
• Scalp biopsy- during this test, the doctor scrapes samples from the skin of the skull and sends them for pathological study.
• Light microscopy

Treatment for hair loss

Hair loss can be treated in various forms. Some of them are listed below:

• Lifestyle and home remedies
• Medications- they help in treating hair loss caused due to hereditary. Some of the medications prescribed by the doctor are minoxidil, finasteride, spironolactone, and oral dutasteride.
• Hair growth supplements
• Corticosteroids
• Topical medications to improve hair growth- they include anthralin, diphencyprone, etc.
• Hair transplant surgery- During this procedure, the dermatologist, or the cosmetic surgeon harvests hair from the part of the head where there is well hair growth and transplants that hair to the bald area. In a few cases, a large strip of skin that contains multiple hair grouping is taken.
• Laser therapy- this is a new technique that can be used in promoting hair growth. During this procedure, low-level laser technology is used to stimulate the scalp and hair follicles, promoting hair growth and blood flow

Prevention of hair loss

Although the hair loss cannot be prevented completely. There are a few measures that can minimize hair loss. They are listed below:

• Consume healthy food which includes green leafy vegetables, fruits, and vegetables that contain multivitamins, avoid junk food, etc.
• Protect the hair from sunlight and other sources of UV light
• Avoid using hair dryers, hair straighteners, hot combs, etc.
• Stop smoking
• Avoid using too much of chemicals in the hair
• Comb properly, choose products wisely, and avoid pulling hair tightly.
• Avoid getting stressed
• Patients on chemotherapy should make use of a cooling cap.

References

1. https://www.forila.com/blog/Types-of-hair-loss.html
2. https://www.webmd.com/skin-problems-and-treatments/hair-loss/understanding-hair-loss-basics
3. https://www.webmd.com/skin-problems-and-treatments/hair-loss/understanding-hair-loss-basics
4. https://www.webmd.com/skin-problems-and-treatments/hair-loss/understanding-hair-loss-basics
5. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
6. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
7. https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932
8. https://www.webmd.com/skin-problems-and-treatments/hair-loss/understanding-hair-loss-treatment
9. https://www.healthline.com/health/hair-loss#takeaway