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Introduction to Hair Loss in Men & Women

Hair loss, quite simply, is the visible result of a hair follicle that is no longer viable and therefore unable to grow hair. The lack of viability can be either permanent or temporary, based on the underlying cause(s) and the effectiveness of timely treatment. When a hair follicle is destroyed, it does not regenerate… it never comes back, and the hair loss is always permanent.

Hair loss factors include genetics, hormones, age, health, nutrition, environment or stress and can be initiated by surgery, prescription drugs, testosterone or estrogen problems, thyroid problems, iron-deficiency, illness or trauma.

Temporary hair loss tends to reverse itself within 24 months, no matter how severe the temporary loss has become. After 24 months, the odds of the hair follicles re-growing are unlikely.

The normal cycle of hair growth, called the anagen phase, lasts approximately three years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 85 to 90 percent of the hair on your scalp is growing at any one time. About 10 to 15 percent of the hair on your scalp, at any one time, is in a resting or telogen phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.

When hair follicles begin the slow process of dying, the hair doesn’t stop growing. It initiates a gradual miniaturization of the hair by decreasing the growing cycle, which results in shorter, finer hair. This miniaturization process may take several years to complete, before the hair is so short it is no longer cosmetically useable. This explains why in certain areas of the scalp, the hair never seems to grow as long as other areas.

It is common to shed scalp hair (50-100 hairs) each day as part of the normal growth cycle. However, some people may experience excessive (more than normal) hair loss which can represent illness or trauma. Hair loss of this type can affect men, women and children.

What Causes Excessive Hair Loss?
A number of things can cause excessive hair loss. For example, approximately 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness or due to anesthesia, and is temporary.

Hormonal abnormalities may cause hair loss. If your thyroid gland is overactive or underactive, you may see an increase in hair loss. This form of hair loss usually can be corrected by treating the underlying thyroid disease. Hair loss may also occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop one’s hair loss.

Many women will notice hair loss about 3 months after they’ve had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair growing that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal growth cycle starts again.

Some medicines can also cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that have been known to cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants.

Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.

Hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated as early as possible.

Can Improper Hair Care Cause Hair Loss? Yes!
If you wear braids or cornrows, or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (pronounced: al-oh-pee-sha). If the pulling is stopped before scalp scarring develops, your hair will grow back normally. However, this scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called “perms”) may cause inflammation (swelling) to the hair follicle, which can result in scarring and hair loss.

Male Pattern Hair Loss
Most hair replacement surgeons refer to hair loss in stages as defined by the Norwood classification published in 1975 by O’Tar Norwood. It is the most widely used classification for hair loss in men in the world. It defines two major patterns and several variations of hair loss. In the standard Norwood pattern, two areas of hair loss—a bitemporal recession and thinning crown—gradually enlarge and coalesce until the entire front, top and crown (vertex) of the scalp are bald with natural angles. Most hair loss follows a predictable pattern although variations occur frequently. The stages of hair loss displayed are useful in determining baldness in most men. See Hair Loss Charts

Women and Hair Loss
Women very commonly develop female-pattern hair loss. In this form of hair loss, the hair can become thin or diffuse over the entire scalp. Typically, the hairline remains intact with diffuse thinning over the top of the scalp, and occasionally may affect the sides of the head. In some instances, women may experience baldness which can resemble male pattern hair loss. The most common hair loss classification in women is the Ludwig Classification.

Treatments
Depending on your type of hair loss, treatments may be available. If a particular medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.

Medications may also help slow or prevent the development of common pattern hair loss. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp twice daily. Both men and women can use it, although the 5% solution is only F.D.A. approved for men. Another medicine, Finasteride (brand name: Propecia) is available with a prescription. It is taken orally once a day and is only F.D.A. approved for men. It may take up to 12 months before you can tell if one of these medicines is working.

The good news is that both of these F.D.A. hair loss medications offer patients the chance not only to slow or stop their hair loss, but to improve the end result of hair restoration surgery by stabilizing any future hair loss. Low Level Laser Therapy also offers both men and women a chance to slow or stop their hair loss. Unfortunately, the ‘safe’ or donor region has a finite number of follicles that can be removed without causing the donor area to become too thin. Therefore, the less hair you lose, the less grafts you will require to achieve an acceptable, cosmetic result.

Ideally, all patients want to achieve a result that is dense and natural. In reality, a patient’s insufficient donor region and/or financial resources usually restricts the surgeon’s ability to accomplish the “ultimate result.”

See Also:
Intro to Hair Loss
Hair Loss, Self-Image, & Society
Hair Anatomy
How Hair Grows
How Hair is Lost
Hair Loss in Women
Traction Alopecia
Hair Loss in Men
Norwood Hair Loss Chart
Frontal Hair Loss
How to Stop Hair Loss