Everyone loses some hair every day. Losing up to 100 hairs a day is normal.
But if hair loss runs in your family, you could lose a lot more hair. With this kind of hair loss, you may end up with bald spots if you are a man. If you are a woman, you may find that the hair on the top of your head is slowly thinning. About half of all people have this type of hair loss by around age 50.
Although hair loss is fairly common, it can be a tough thing to live with, especially when it changes how you look. But there are ways you can treat your hair loss.
Common causes of hair loss include:
Your symptoms will depend on what kind of hair loss you have.
If your hair is thinning, it happens slowly over time, so you may not notice the hairs falling out. If your hair is shedding, then clumps of hair fall out. You may lose hair all over your scalp, which is called general hair loss. Or you may lose hair only in one area, which is called focal hair loss.
With inherited hair loss, men usually get bald spots around the forehead or on the top of the head, while women have some thinning all over the scalp, but mostly on the top of the head.
Since your hair has a lot to do with your appearance, losing it may cause you to have lower self-esteem if you don't like how you look. This is especially true in women and teens.
Your doctor will ask you some questions, like how much hair you're losing, when it started, and whether your parents have hair loss. He or she will look closely at your scalp and hair loss pattern and may gently pull out a few hairs for tests.
If it's not clear what's causing you to lose your hair, your doctor may do a blood test or look at a sample of your hair or scalp with a microscope.
How you choose to treat your hair loss depends on the cause. It also depends on your feelings. You may decide that you need treatment, or you may not be worried about thinning hair or baldness. The choice is up to you.
If hair loss is caused by something that won't last or can be treated, your hair is likely to grow back. For example, if an underactive thyroid is causing the problem, taking thyroid medicine may help. And most hair lost during chemotherapy will grow back after the treatment ends.
Hair loss that runs in the family can be treated with medicines or hair transplant surgery. Some people choose to wear hairpieces, like wigs or toupees (say "too-PAYZ"). Finding different ways of styling your hair, like dyeing or combing, also can help.
If hair loss is caused by something you can control, like stress or medicines, you can treat it by getting rid of the cause.
When you are deciding about treatment, think about these questions:
When your hair loss is inherited, your hair won't grow back naturally. Treatment can help some hair grow back and prevent more from falling out, but you probably won't get all your hair back. And treatment doesn't work for everyone.
When medicines, stress, or hair damage cause you to lose your hair, it often will grow back after you take away the cause. If this doesn't help, you may need other treatment.
If you're unhappy with how hair loss makes you look, treatment may help you feel better. It's natural to want to like the way you look.
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Losing a lot of hair (more than 100 hairs a day) can be caused by inherited factors, disease, stress, medicines, injury, aging, or hair care.
The most common cause of hair loss is genetics—you inherit the tendency to lose hair from either or both of your parents. This is called male-pattern hair loss or female-pattern hair loss. The medical term for this type of hair loss is androgenetic alopecia.
In this type of hair loss, your genes affect how your hair grows. They trigger a sensitivity to a class of hormones called androgens, including testosterone, which causes hair follicles to shrink. Hair follicles are the openings that hair grows from.
Shrinking follicles produce thinner hair and eventually none at all. Men generally develop bald spots on the forehead area or on the top of the head, while women often have thinning of the hair on the top of the head. About half of all people have inherited hair loss by about 50 years of age.
Different types of hair loss may have different causes. Common causes of hair loss include:
Other causes of hair loss include:
Hair loss can occur as thinning, in which you may not notice hair falling out, or as shedding, in which clumps of hair fall out.
In the most common type of hair loss, inherited hair loss (androgenetic alopecia), men tend to lose hair on the front hairline and forehead and on top of the head. Eventually, only hair around the ears, the sides, and the back of the head remains. Women with this condition typically have gradual thinning throughout the scalp, but mostly on the top of the head.
Other causes of hair loss may also show distinct patterns. For example, conditions such as trichotillomania (compulsively pulling at the hair) or alopecia areata (in which the immune system attacks hair follicles) result in obvious patches of hair loss, while stress and some medicines result in clumps of hair falling out.
Because hair is an important part of appearance, hair loss can also result in loss of self-esteem and feeling unattractive, especially in women and teens.
About half the population have some hair loss by about 50 years of age. Men may start losing hair between the ages of 15 and 25, and women are more likely to start losing hair between the ages of 25 and 30, or in some cases, after menopause.1
With inherited hair loss (androgenetic alopecia), men tend to lose hair on the front hairline and temples and on top of the head. Eventually, they may go completely bald.
Women generally lose less hair than men, but they have a similar pattern of hair loss. Women may have slight, moderate, or even severe hair loss, but they don't usually lose all their hair.
For both men and women, inherited hair loss must be treated early for hair to regrow.
Alopecia areata is hair loss caused when the immune system attacks hair follicles, where hair growth begins. It usually starts with one or more small, round, smooth bald patches on the scalp, and can progress to total scalp hair loss or complete body hair loss. It often begins in childhood. The hair usually grows back within 1 year. But hair loss in alopecia areata can come and go—the hair often will grow back over several months in one area but will fall out in another area.
With hair loss caused by stress, disease, medicines or medical treatments, clumps of hair may fall out. But after the cause is stopped, the hair usually grows back, although sometimes treatment may be needed.
Factors that increase the risk of hair loss include:
If you have alopecia areata, you are more likely to have permanent hair loss if:
Call your doctor if:
Health professionals who can give you advice and treatment on hair loss include:
Hair transplant surgery is usually done by:
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Hair loss is diagnosed through a medical history and physical exam. Your doctor will ask you questions about your hair loss, look at the pattern of your hair loss, and examine your scalp. He or she may also tug gently on a few hairs or pull some out.
The most common cause of hair loss—inherited hair loss—is easily recognized. Men tend to lose hair from the forehead area and top of the head with normal amounts of hair on other areas of the scalp. Women tend to keep their front hairline, but have thinning of the hair on the top of the head.
To determine the cause of your hair loss, your doctor may ask you about:
If the reason for your hair loss is not clear, your doctor may do tests to check for a disease that may be causing your hair loss. Tests include:
Hair loss in women is more difficult to diagnose than it is in men because the pattern of hair loss is not as noticeable as it is in men.
Testing to diagnose hair loss usually is not done in women with mild to moderate hair thinning who are otherwise healthy. But in women who have irregular menstrual cycles, continued episodes of acne, or too much body hair (hirsutism), testing for a class of hormones called androgens, including testosterone, is sometimes done.
How you treat hair loss depends on the cause. You may decide not to treat hair loss if it doesn't bother you.
Some people choose to treat hair loss with medicines or hair transplant surgery. Others choose to wear hairpieces (wigs or toupees) or use different methods of hair styling (dyeing or combing).
If a disease, medicine, or stress is the cause, then treating the disease, changing medicines, or managing stress may stop the hair loss.
Treatment for hair loss may help you feel better about how you look. But some medicines may have harmful side effects, and surgery may carry certain risks.
Treatment for inherited hair loss aims to prevent hair loss, promote hair growth, and cover bald areas of the scalp. But treatment is not successful for everyone, and you should not expect to regrow a full head of hair.
Surgery includes hair transplants and procedures such as scalp reduction and scalp flaps.
Cosmetic approaches to hair loss include:
Treating the cause often stops hair loss, and hair grows back. In some cases, other treatment is needed.
Hair loss caused by cancer treatment requires special care: Use mild shampoos. Do not use a hair-dryer.
Alopecia areata occurs when the immune system attacks hair follicles, where hair growth begins. Because hair often grows back within a year, you may decide not to have treatment. Understanding the come-and-go nature of hair loss with this condition can help you make the best treatment decision. Children and teens may need counseling to help them adjust to the hair loss.
Medicines, such as corticosteroids, can be used to treat alopecia areata.
Women with inherited hair loss who wish to take birth control pills should use a pill type that does not add to hair loss, such as a norgestimate or desogestrel.2
How successful your treatment is depends on your expectations and the cause of hair loss. Treatment for hair loss caused by an illness, medicine, or damage to the hair usually is more successful than treatment for inherited hair loss.
Avoiding certain medicines, reducing stress, getting adequate protein and iron in your diet, and using hairstyles that don't damage your hair may reduce or prevent hair loss.
Inherited hair loss (androgenetic alopecia) cannot be prevented.
Home treatment for hair loss includes hair care and hairstyling techniques that may help you cover thinning or bald spots on the scalp. This may be easier for women because inherited hair loss causes a general thinning that is usually not as severe as it is in men. Hair sprays, dyes, and perms can help make the hair appear fuller.
In women with inherited hair loss, hair care and the occasional use of grooming products, hair sprays, hair color, teasing, permanents, or frequent washing won't increase hair loss. But if your hair loss is caused by hair care, then perms and dyes may contribute to more hair loss.
For both men and women, hair thinning and baldness increase the risk of sunburn and skin cancer on the scalp. When in the sun, wear a hat or use a sunscreen with an SPF of 30 or more to prevent sun damage to the scalp.
Medicines for hair loss can slow thinning of hair and increase coverage of the scalp by growing new hair and enlarging existing hairs. But they need to be taken regularly. If you stop the medicine, hair loss returns. Do not expect to regrow a full head of hair. Hair coverage is improved on the top of the head, but not on the forehead area.
Medicines often used to treat inherited hair loss include:
Surgery to cover bald areas of the scalp may be used to treat hair loss. If successful, surgery may be a permanent treatment for hair loss.
The most common types of surgery to treat hair loss include:
Surgery may be a more permanent solution than medicines to treat hair loss, but it is expensive, it involves surgical risks, and there is a chance that not all hair follicles will remain healthy.
Other treatment for hair loss includes:
- Whiting DA (2006). Disorders of hair. In DC Dale, DD Federman, eds., ACP Medicine, section 2, chap. 13. New York: WebMD.
- Habif TP, et al. (2011). Hair and nail diseases. In Skin Disease: Diagnosis and Treatment, 3rd ed., pp. 562–589. Edinburgh: Saunders.
- Hague J, Berth-Jones J (2010). Alopecia areata. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 31–35. Edinburgh: Saunders Elsevier.
Other Works Consulted
- Kestenbaum TM (2010). Diseases affecting the hair. In JC Hall, ed., Sauer's Manual of Skin Diseases, 10th ed., pp. 337–347. Philadelphia: Lippincott Williams and Wilkins.
- Wolff K, Johnson RA (2009). Disorders of hair follicles and related disorders. In Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 6th ed., pp. 962–986. New York: McGraw-Hill.
Primary Medical Reviewer Adam Husney, MD - Family Medicine
Specialist Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Current as ofMarch 12, 2014
Current as of: March 12, 2014
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