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What Is Normal Hair Loss?

Hair loss is a common complaint among our patients, both men and women.

Although is it normal to shed hairs each day, excessive hair loss can lead to a thinning hair line, and areas of baldness. Luckily, there are hair loss treatments that help promote hair growth or hide hair loss.

Normal Hair Growth

In order to understand how hair loss happens, it is helpful to understand how hair normally grows.

Each shaft of hair is produced by a hair follicle. The cells in the hair follicle produce hair for about 2 to 3 years. During this “growth phase”, each hair grows about 1 centimeter (1/2 inch) per month.

After this growth phase, the hair follicle enters a resting phase during which the hair remains in place, but stops growing. This “resting phase” lasts about 3-4 months, after which the hair falls out. After the hair falls out, the hair follicle starts producing a new shaft of hair.

On average, 90% of the hairs on the head are in the “growth phase” at any one time (and 10% are in the resting phase). People normally shed hairs each day as the hair follicles reach the end of the resting phase and prepare to produce new hairs.

Common Causes

Common causes of hair loss include male-pattern baldness, female-pattern baldness, autoimmune conditions, stress, hormonal problems, and certain medications.

Let’s take a closer look at each cause and how to treat each condition.

Male-pattern baldness

This is also referred to as androgenic alopecia. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. With male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.

Treatment For Male-Pattern Baldness

The two medications commonly used are: Rogaine and Propecia. The first medication Rogaine (minoxidil) is a non-prescription topical medication applied to the scalp to grow hair and to prevent further hair loss. Rogaine is usually recommended for use twice daily and can be used by both men and women.

When you use Rogaine, the new hair may be thinner and shorter than previous hair. There may be sufficient hair growth in some to hide bald spots and have the new hair blend with existing hair. It is important to note that hair growth stops after you discontinue the use of Rogaine. Side effects can include irritation of the scalp.

Another medication, Propecia (finasteride) is a prescription medication taken daily by mouth. It is available for use by men only. Many men taking Propecia experience a slowing of hair loss, and some may show some new hair growth. It may take several months for new hair growth to appear.

New hair growth will stop after the medication is no longer taken. Propecia works by stopping the conversion of male hormones into dihydrotestosterone (DHT), which can shrink hair follicles in men who are susceptible to its effects.

Female-pattern baldness

With this form of hair loss, the hair can become thin over the entire scalp. Female-pattern baldness is much more common than is generally recognized.

Women are also able to use Rogaine (minoxidil) is a non-prescription topical medication applied to the scalp to grow hair and to prevent further hair loss. Rogaine is usually recommended for use twice daily and can be used by both men and women.

New hair resulting from Rogaine (minoxidil) use may be thinner and shorter than previous hair. But there may be sufficient hair growth in some to hide bald spots and have the new hair blend with existing hair. It is important to note that hair growth stops after you discontinue the use of Rogaine. Side effects can include irritation of the scalp.

Alopecia areata

Alopecia areata is an autoimmune disease, in which the body’s own immune system mistakenly attacks the hair follicles leading to hair loss. In most cases the hair falls out in small, round patches about the size of a quarter. More severe cases can involve the entire scalp or other parts of the body.

Treatment Option

The doctor will inject a corticosteroid into the scalp to treat alopecia areata. This is usually repeated monthly. New hair growth may be visible four weeks after the injection. Doctors sometimes prescribe oral corticosteroids such as prednisone for extensive hair loss due to alopecia areata.

Telogen Effluvium

This is essentially stress induced hair loss. About 3-4 months after a severely stressful event, such as an illness or major surgery, large amount of hair may be lost. The stress caused the hair follicles to cease the growing phase prematurely. This stress-induced hair loss is temporary and the hair usually grows back.

Hormonal problems

Abnormal thyroid function can lead to people losing their hair, as can imbalances in androgens (males hormones) and estrogen. For instance, anabolic steroids taken by athlete’s for performance enhancement can lead to premature hair loss. The correction of hormonal imbalances can, in some instances, return hair growth to normal.

Post-partum hair loss

Many women experience this 3-4 months after having a child. This hair loss is also related to hormonal changes due to pregnancy. Elevated levels of certain hormones during pregnancy lead to the hair follicles staying in growth phase longer than normal. When the hormones return to pre-pregnancy levels, those follicles enter the resting phase and start to fall out 3-4 months later.

Certain Medications

Some medicines, such as blood thinners (coumadin), anti-hypertensives, antidepressants and birth control bills can lead to excessive hair loss.. This type of hair loss usually improves when the medication is stopped.

Fungal infections

Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with anti-fungal medicines.

Traction Alopecia

Wearing tight pigtails or cornrows or using tight hair rollers, can pull on the hair and damage the hair follicle. This can lead to a type of hair loss called traction alopecia. The hair can grow back normally, if the pulling is stopped before scars develop.

If you have any further questions about hair loss or would like to schedule an appointment to discuss your treatment, please contact us.

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