San Diego Hair Loss (Alopecia) Disorders

At any given time, hairs on the scalp and body are constantly falling out and being replaced. Approximately 90% of the hair on the scalp is in the growth phase, while approximately 1-2% are in the shedding phase. Hair grows at a rate of just over 1 cm per month. The normal number of hairs lost from the scalp is 40-120 per day. Thinning of scalp hair is due to increased hair shedding, a decrease in hair replacement, or both. There are numerous causes of hair loss, and most of these conditions are treatable.

Hereditary Hair Loss

Androgenetic alopecia or hereditary thinning of the hair is the most common cause of hair loss is present to varying degrees in greater than 50% of the population. This condition can be inherited from either the mother`s, father`s or both sides of the family. Women with this trait develop thinning hair of the frontal scalp in a diffuse fashion, but do not become completely bald. Men with androgenetic alopecia typically have receding hairlines of the frontal scalp. Hereditary hair loss can begin in one`s teens, twenties, or thirties. While there is no cure, medical and surgical treatments are available that may benefit certain individuals, including:

Minoxidil, a foam or solution applied to the scalp twice a day, which can be used by men and women
Finasteride, an oral prescription medication for men which blocks the formation of the active male hormone in the hair follicle
Hair restoration surgery

Alopecia Areata

Alopecia areata is an autoimmune condition in which the CD4 T cells of the immune system attack components of the hair follicle. The condition is common, occurring in nearly 2% of the population, affecting individuals of all ages, but mostly children. Affected persons are usually otherwise healthy. This disease causes smooth, round patches of hair loss affecting the scalp and/or other body hair including eyebrows and eyelashes. Rarely it can result in complete loss of scalp and body hair. In most cases the hair regrows spontaneously. Available treatments help to stimulate hair re-growth. Treatments include:

cortisone injections in the scalp where the hair loss occurred
topical corticosteroids
topical sensitizing chemicals such as squaric acid or DPCP
tar-based ointments

Telogen Effluvium

A severe, acute illness and other factors can cause many hairs to shift from the growth (anagen) phase to the resting (telogen) phase of the hair growth cycle, to produce a dramatic and diffuse shedding of the hair (effluvium). In most cases, telogen effluvium usually resolves in a few months on its own. Causes of telogen effluvium include:

High Fever, Severe Infection such as Influenza
Major Surgery/Chronic Illness
Thyroid Disease
The post-partum state
Discontinuation of birth control pills

Chemical Treatments

Many men and women use chemical treatments on their hair, including: dyes, tints, bleaches, straighteners, and permanent chemicals. Excessive heat applied to the hair can also cause hair breakage. These treatments can cause the hair to become fragile and break, particularly if used too frequently. If hair becomes brittle from chemical treatments, it is best to discontinue use of these agents until the hair is allowed to grow out.

Trichotillomania (Hair Pulling)

Trichotillomania is most common in children, though it may occur in adulthood as well. Individuals may unconsciously pull on their hair, resulting in unusual patterns of hair loss on the scalp, eyebrows or eyelashes. This may simply represent a bad habit, but occasionally may be a sign of a more serious psychological problem.

Other Causes of Hair Loss Include:

Iron deficiency anemia
Thyroid disorders
Malnutrition (insufficient protein intake)
Chemotherapeutic agents, other medications
Fungal infections (tinea capitis)
Trauma to the hair follicle including use of tight braids (traction alopecia)
Rare scarring conditions of the scalp (cicatricial alopecia)