Causes of Hair Loss in Men and Women

Men do it faster, earlier and more than women – lose their hair, that is. In fact, more than half of all men begin balding between age 40 and 49; by age 60, two-thirds of men have moderate to extensive hair loss. And as many as 25 percent of men have already started losing their hair before age 25!

However – and this may surprise you – an estimated two-thirds of American women will face hair loss at some point in their lives. Hair loss in women tends to be more diffuse than in men, thinning all over the scalp while a man’s hairline recedes and the crown thins. But in both sexes, hair loss can contribute to real feelings of low self-esteem and lack of confidence.

The #1 cause of hair loss in men and women is called androgenetic alopecia [link to page on androgenetic alopecia], the medical term for what’s commonly referred to as male pattern or female pattern baldness. Because this condition is so prevalent, we’ve created a separate page to explain why and how it occurs. Click here to go there now.

Other Culprits in Hair Loss

But there are other causes of hair loss, too. Sometimes it can be due to an underlying disease, such as diabetes or thyroid problems. That’s why we obtain a complete medical history as part of any hair-loss consultation. If no underlying illness is involved, here are some other potential culprits:

Telogen Effluvium – If you’ve recently undergone surgery, a serious illness or traumatic life event, you could experience telogen effluvium, the medical term for hair loss that occurs after a physical or emotional shock to the system. Similarly, if you’re taking certain medications such as antidepressants, anticoagulants, beta-blockers, retinoids and NSAIDS, these can contribute to this type of hair loss. So can poor nutrition from low-protein consumption, iron deficiency or crash dieting. To understand how telogen effluvium occurs, it’s important to understand how our hair grows. Each human scalp hair grows about a half-inch per month for two to six years – what’s called the anogen, or growth, phase. The hair rests at that length for one or two weeks (the catagen phase), then falls out in the telogen phase (we normally lose 50 to 100 hairs a day as part of this process). Soon afterward, a new hair begins growing in its place and the anogen phase begins again. About 85 percent of our hair is in the anogen phase at any given time.

With telogen effluvium, however, stress or some other trauma causes the hair follicles to enter the telogen phase prematurely. So while it’s normal to lose 50 to 100 hairs a day as part of hair’s natural growth cycle, people with telogen effluvium can lose thousands of hairs a day. The good news, however, is that this is usually a temporary condition and one that resolves on its own.

Alopecia areata is an autoimmune skin disease characterized by hair loss on the scalp as well as other parts of the body. It’s estimated to affect nearly 5 million Americans. It usually starts with one or more small, round and smooth patches on the scalp; how it progresses is different for each individual.

Another cause of hair loss is Scarring Alopecia. This can be caused by a few different things like having a bacterial or viral infection such as shingles – or even a fungal infection. These all destroy the hair follicle. Some systemic diseases also lead to scarring of the hair follicles. When scarring occurs on the scalp, the hair follicles don’t have a blood supply that can reach them, so they are not in a hospitable environment to grow.

A fungal infection called tinea capitis attacks the hair shafts and follicles of the scalp, eyebrows and eyelashes, causing bare patches of skin in infected areas. The incidence of infection has been reported to be five times greater in boys than girls before puberty, but this difference reverses after puberty.

The way you treat your hair can affect whether it stays on your head. Traction alopecia is a condition often experienced by women who wear tight braids or constantly pull their hair back in tight ponytails, damaging the hair follicle and preventing new hair growth in certain areas of the scalp.

And over-processing with chemical dyes, bleaching, perms and straightening processes can cause the hair shaft to break. When the harsh treatment has stopped, however, the hair usually grows back.

Thyroid disorders are another potential cause of hair loss – and women are five to eight times more likely than men to have thyroid disease. Hashimoto’s Thyroiditis and Graves’ disease are two forms of autoimmune thyroid disorders in which hair loss is often seen.

Additionally, trichotillomania – hair loss caused by compulsive twisting or pulling of the hair until it breaks off – affects as many as 10 million Americans. This condition is estimated to affect up to 10 million Americans, and symptoms usually begin before age 17. It occurs as frequently in boys as in girls during early childhood, but by adulthood only 10 to 20 percent of reported cases are men.

Treatment Options

Treatment for most of the above conditions is often highly individualized, and aimed at the underlying disease or behavior that contributes to hair loss, thereby resolving the problem.

When genetic predisposition to thinning hair or balding is the culprit (as is the case with androgenetic alopecia, or male and female pattern baldness), there are several effective treatment options that specifically address hair loss. To learn about these non-surgical treatment options, click here. And to learn about the most effective hair transplantation techniques, click here.

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Dr. Timothy Jochen Medical Director, Contour Dermatology and Cosmetic Surgery Center
Dr. Jochen specializes in Mohs Surgery for skin cancer removal, facial rejuvenation including cosmetic laser technology, Botox® and facial fillers, soft tissue augmentation, leg and facial vein treatment, tumescent liposuction and hair restoration/transplants.
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