Symptoms
Loss of 50, 100, or even more hairs each day is part of the normal hair growth cycle. If you notice unusually large amounts of hair in your sink or tub, in your hairbrush, on clothing, or on pillows, you may be experiencing abnormal hair loss. Other symptoms include thinning hair, a receding hairline, or bald patches.
The symptoms of pattern baldness (androgenetic alopecia) are different in men and women. In men, hair loss can begin any time after puberty, and is most likely to start for men in their twenties. In women, hair loss may also start at puberty, but typically is not apparent until at least 10 years later. In both men and women, the body's normal hair growth cycle gradually changes, and eventually hair in certain parts of the scalp stops growing entirely.
Hair loss follows a pattern Table 01. In men, the thinning begins at the temples and crown. Eventually, men become completely bald or have only a rim of hair along the side and back of the scalp. Women experience less severe hair loss. The hairline along the temple and forehead seldom recedes, as it does in men.
Table 1. Types of Hair Loss
Type of hair loss Symptoms Hereditary pattern baldness in men Thinning and loss start in the front, crown, and sides of the hairline Hereditary pattern baldness in women Thinning occurs in the front and crown Alopecia areata Loss of small round or oval patches of hair Telogen effluvium Loss of a considerable amount of hair in a short time, usually in response to a stressful situation, medication, medical treatment, or illness Trichotillomania The urge to pull hair from the scalp or other parts of the body If you are losing hair because of a delayed reaction to stress, illness, hormonal change, or drug side effects, you are likely to experience hair loss all over the head. However, if your hair comes out in patches, you may have a tinea infection. Other signs of a fungal infection include scaling and crusting on the scalp and broken-off hairs.
Alopecia areata is marked by the loss of round or oval patches of hair. The bald patches usually appear suddenly. In severe cases, which are rare, hair loss may occur over the entire scalp or the entire body. This condition may occur only once or strike again at unpredictable intervals.
Trichotillomania is a mental health problem in which the main symptom is a compulsion to pull out hair, resulting in noticeable hair loss. Individuals with this disorder usually pull out scalp hair through frequent twisting and tugging, but may also pull their eyebrows, eyelashes, or hair on other parts of their body. Trichotillomania often begins in childhood or adolescence. Some experts believe it may be a way of attracting attention or a response to stress or tension.
Risk Factors
Since pattern baldness is inherited, the strongest risk factor is having a parent who experienced hair loss or thinning. Heredity also influences the age at which hair loss begins, as well as the speed, pattern, and extent of the loss. While you cannot change your family history, you can try to slow hair loss by using FDA-approved treatments as soon as you notice symptoms.
Male and female pattern baldness is caused by a combination of genetics, hormones, and aging. Pattern hair loss affects an estimated 40 million men and 20 million women. About half of men will develop baldness by age 50, and about half of women will have some degree of hair loss or thinning by age 60.
Alopecia areata is also hereditary. However, you can develop this condition even if there is no history of it in your family. It can occur at any age, but is most likely to begin in childhood or the young adult years. Stress, seasonal factors, and infections may trigger alopecia areata. It is sometimes associated with autoimmune diseases such as rheumatoid arthritis, lupus, and early-onset diabetes.
Your risk for temporary hair loss is affected by many factors. Nutrition, certain drugs, medical treatments, stress, childbirth, and hair treatments are just a few of the things that can increase your risk for short-term hair loss.
Sharing combs, brushes, or hats with other people increases the risk that you will develop a fungal infection of the scalp.
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I'm Kristen Dore, PharmD. Welcome to PDR Health!
