Hair loss, clinically known as alopecia, may be caused by a number of different factors. The most common type of hair loss is a medical condition known as androgenetic alopecia, commonly called hereditary hair loss or male/female-pattern baldness. Roughly 80 million men and women in the United States have this type of hair loss, where gender-pattern hair loss by the age of 50 affects about half of males and a quarter of females.
As mentioned above, androgenetic alopecia is to the most common type of hair loss. Androgenetic alopecia is caused by an increased production of the hormone dihydrotestosterone (DHT). High levels of DHT may result in dormant apocrine hair growth. Evidence has shown that hair loss may be also caused by: certain hair styles/hair products (traction alopecia), stress/anxiety, diet, medication, radiation therapy/chemotherapy, trichotillomania, fungal infections, illness, and certain medical conditions (e.g. anemia). Other forms of alopecia include: alopecia areata (can cause complete hair loss in otherwise healthy people), cicatricial (scarring) alopecia, and central centrifugal cicatricial (scarring) alopecia.
Hair loss may be observed as: gradual thinning, bald patches, or complete baldness. Some people with alopecia areata may also lose their eyelashes. Androgenetic alopecia in women causes thinning that begins at the center of the scalp, and in men androgenetic alopecia first presents as a receding hairline.
We will begin by asking for relevant information; for example, if the hair loss happened suddenly or gradually; current medication list; known allergies; and whether you have been dieting. Women may be asked about their periods, pregnancies, and menopause. We may meticulously observe your scalp where at times perform a scalp biopsy. This type of biopsy is where a piece of the scalp is removed for further analysis. In other circumstances, we may pull out a few hairs in order to gather more concrete evidence. We may also scan the hair on the rest of your body to see whether there is too little or too much on those areas. Occasionally blood tests are ordered in diagnosing a specific type of alopecia.
Just as there are many causes, there are many treatments for hair loss. Treatments available without a prescription include: Minoxidil (i.e. Rogaine) and special brushes, combs, and other hand-held devices that emit a laser in the hopes of stimulating hair growth. Prescription medications such as Finasteride [keeps the body from making dihydrotestosterone (DHT)] have been shown to reduce hair loss where studies found that Finasteride slowed hair loss in most (~88%) of men. If hair loss is caused by inflammation, we may opt to inject a corticosteroid in the hopes of reducing this inflammation. For more aggressive approaches to manage or reverse alopecia, we may use one or more of the following procedures: hair transplantation, scalp reduction, scalp expansion, and scalp flaps.