The most common cause of hair loss is hereditary hair loss. Other names for this condition include androgenetic alopecia, male-pattern baldness and female-pattern baldness. Over 80 million men and women in the United States have this type of hair loss. Fortunately, there are treatments that can address this condition and your dermatologist can discuss these options with you.
Male-pattern baldness is seen in men and may begin any time after puberty but usually by age 40. The frequency and severity, however, increase with age and the majority of men show at least some signs of male-pattern hair loss by age 70. This usually presents as thinning and receding of the front hairline or thinning of the hair on the crown of the head. It may progress gradually over time to involve the entire top of the scalp. Usually, there is no itching or flaking associated with this hair loss.
Female-pattern baldness is seen in women and usually is first noticed by age 40 to 50. It tends to worsen as women ages, especially after menopause, but rarely leads to total baldness. The typical pattern is thinning of the hair over the top of the scalp without a recession of the front hairline. The first sign of hair loss for many women is a widening part. Usually, there is no itching or flaking associated with this hair loss.
A variety of genetic and environmental factors are the likely causes of androgenetic alopecia. Researchers have determined that this form of hair loss is related to hormones called androgens and there are likely several genes responsible. The majority of people with this hair loss have a family member on either side of the family with the same type of hair loss. This is not contagious and therefore, is not spread by sharing a hairbrush or wearing hats.
The majority of women affected by androgenetic alopecia do not have underlying hormonal abnormalities. However, a few women with this condition are found to have excessive levels of androgens and may have polycystic ovarian syndrome (PCOS). These women tend to also suffer from acne, irregular periods and excessive facial hair.
Because there are so many reasons for hair loss, a dermatologist will determine the cause by taking a complete medical history and performing a physical exam. Commonly asked questions include how long the hair loss has been occurring and if it was sudden or gradual. It is important to know what medical problems you have such as thyroid disease or anemia (low red blood count) and what medicines you are on. Women may be asked about their periods, pregnancies and menopause. All of this information is necessary to narrow down the cause of hair loss.
The dermatologist will carefully look at your hair and scalp. During the exam, the dermatologist may pull on your hair or even pull out a hair to examine the root. A biopsy or removal of a small piece of scalp skin may be needed to help make a diagnosis. A dermatologist can quickly and safely perform a biopsy during an office visit. In some cases, blood tests will be needed.
Because so many things can cause hair loss, it can take time to find the cause. You may need to make a few appointments to get to the answer.
Dermatologists recommend treating hair loss early- early before you lose a lot of hair.
One or more of the following treatments may be part of your treatment plan:
Once androgenetic alopecia has been diagnosed, your dermatologist can start treatment and tell you what to expect over time.
Treatment for hair loss helps many people feel better. Hair loss, especially in women, can cause low self-esteem and depression. Many women feel unattractive and embarrassed. Seeing a dermatologist can offer solutions to help you feel and look your best.