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WOMEN'S HEALTH

Hair/Nails/Skin• Corns and calluses • Nail fungus • Ingrown toenails •
Moles • Acne • Skin cancer • Psoriasis • Hair loss • Sweating and body
odor • Rosacea • Hives and angioedema • Athlete's foot •
Dermatomyositis • Dermatitis/Eczema • Cold sore • Scleroderma • Lice •
Common warts • Melanoma • Cellulitis • Scabies • Anal itching •
Dandruff • Impetigo • Boils and carbuncles • Psoriatic arthritis •
Ringworm of the body • Jock itch • Plantar warts • Folliculitis • Dry
skin • Actinic keratosis • CREST syndrome • Vitiligo

INFORMATION CENTERS:

Note: All links within content go to MayoClinic.com external linkDiseases
and Conditions Hair loss From MayoClinic.com
Special to CNN.com

Overview

Your hair loss may have started with a few extra hairs in the sink or
in your comb. But now you can't look in the mirror without seeing more
of your uncovered scalp.

Baldness typically refers to excessive hair loss from your scalp and
can be the result of heredity, certain medications or an underlying
medical condition. Anyone — men, women and children — can experience
hair loss.

The medical term for hair loss is alopecia. The most common type is
pattern baldness (androgenetic alopecia). It accounts for about 95
percent of hair loss from the scalp. It's typically permanent and can
be attributed to heredity. Another type of alopecia, alopecia areata,
can be temporary. It can involve hair loss on your scalp or your body.
Its specific cause is unknown.

Some people prefer to let their hair loss run its course untreated and
unhidden. Others may cover it up with hairstyles, makeup, hats or
scarves. You may also choose one of the medications and surgical
procedures that are available to treat hair loss. Before pursuing any
of these treatment options, talk with your doctor about the cause and
best possible treatments for your hair loss.

Signs and symptoms

Having androgenetic alopecia may mean you experience hair loss as
early as during your teen years. For men, this type of hair loss is
typically characterized by hair loss that begins at the temples and
crown. The end result may be partial or complete baldness. Women with
androgenetic alopecia usually have hair loss limited to thinning at
the front, sides or crown. Complete baldness rarely occurs in women.

With alopecia areata, hair loss usually occurs in small, round, smooth
patches. You may lose only scalp hair, or you may lose body hair as
well.

Causes

About 90 percent of the hair on most people's scalp is in a 2- to
6-year growth (anagen) stage at any given time. The other 10 percent
is in a 2- to 3-month resting (telogen) phase, after which time it is
shed. Most people shed 50 to 150 hairs a day. Once a hair is shed, the
growth stage begins again as a new hair from the same follicle
replaces the shed hair. New hair grows at a rate of approximately 1/2
inch each month.

Hair loss may lead to baldness when the rate of shedding exceeds the
rate of regrowth, when new hair is thinner than the hair shed or when
hair comes out in patches.

Androgenetic alopecia is caused by heredity. Although it's most common
among men, it can also affect women. A history of androgenetic
alopecia on either side of your family increases your risk of hair
loss. Heredity also affects the age at which you begin to lose hair
and the developmental speed, pattern and extent of your hair loss.

Alopecia areata is classified as an autoimmune disease, but the cause
is unknown. People who develop this type of hair loss are generally in
good health. Some scientists believe that some people are genetically
predisposed to develop alopecia areata and that a trigger, such as a
virus or something else in the environment, sets off the condition. A
family history of alopecia areata makes you more likely to develop it.
Unlike androgenetic alopecia, hair generally grows back. But you may
lose and regrow your hair a number of times.

Other causes of temporary hair loss include:

* Disease. Diabetes, lupus and thyroid disorders can cause hair
loss.

* Poor nutrition. Having inadequate protein or iron in your diet or
poor nourishment in other ways can cause you to experience hair
loss. Fad diets, crash diets and certain illnesses, such as eating
disorders, can cause poor nutrition.

* Medications. Certain drugs used to treat gout, arthritis,
depression, heart problems and high blood pressure may cause hair
loss in some people. Taking birth control pills also may result in
hair loss for some women.

* Medical treatments. Undergoing chemotherapy or radiation therapy
may cause you to develop alopecia. After your treatment ends, your
hair typically begins to regrow.

* Recent high fever, severe flu or surgery. You may notice you have
less hair three to four months after events such as an illness or
surgery. These conditions cause hair to shift rapidly into a
resting phase (telogen effluvium), meaning you'll see less new
hair growth. A normal amount of hair typically will appear after
the growth phase resumes.

* Infancy. Newborns often lose hair during the first several months
of life. This baby hair (vellus) is eventually replaced by more
permanent hair. It's also common for babies to lose a patch of
hair on the back of their heads from rubbing against mattresses,
playpens and car seats. Hair will grow back once a baby begins to
spend more time sitting up.

* Childbirth. Some women experience an increase in hair loss several
months after delivering a baby. This is because during pregnancy
the hair is shifted into an active growth state that then goes
back to baseline soon after delivery. This increased hair loss
usually corrects itself.

* Hair treatments. Chemicals used for dying, tinting, bleaching,
straightening or perming can cause hair to become damaged and
break off if they are overused or used incorrectly. Excessive
hairstyling or hairstyles that pull your hair too tightly also can
cause some hair loss. This is known as traction alopecia.

* Scalp infection. Infections such as ringworm can invade the hair
and skin of your scalp, leading to hair loss. Once infections are
treated, hair generally regrows. Ringworm, a fungal infection, can
usually be treated with a topical or oral antifungal medication.

* Type 1 diabetes

* Lupus

* Hypothyroidism

* Eating disorders

* Gout

* Depression

* High blood pressure (hypertension)

* Fever

* Influenza (Flu)

Treatment

Baldness, whether permanent or temporary, can't be cured. But
treatments are available to help promote hair growth or hide hair
loss. For some types of alopecia, hair may resume growth without any
form of treatment.

Medications
The effectiveness of medications used to treat alopecia depends on the
cause of hair loss, the extent of the loss and individual response.
Generally, treatment is less effective for more extensive cases of
hair loss.

The types of drugs for treatment of alopecia that are approved by the
Food and Drug Administration include:

* Minoxidil (Rogaine). This over-the-counter medication is approved
for the treatment of androgenetic alopecia and alopecia areata.
Minoxidil is a liquid that you rub into your scalp twice daily to
regrow hair and to prevent further loss. Some people experience
some hair regrowth or a slower rate of hair loss or both.
Minoxidil is available in a 2 percent solution and in a 5 percent
solution.

New hair resulting from minoxidil use may be thinner and shorter
than previous hair. But there can be enough regrowth for some
people to hide their bald spots and have it blend with existing
hair.

New hair stops growing soon after you discontinue the use of
minoxidil. If you experience minimal results within six months,
your doctor may recommend discontinuing use. Side effects can
include irritation of the scalp.

* Finasteride (Propecia, Proscar). This prescription medication to
treat male-pattern baldness is taken daily in pill form. Many
people taking finasteride experience a slowing of hair loss, and
some may show some new hair growth. Positive results may take
several months.

Finasteride works by inhibiting the conversion of testosterone
into dihydrotestosterone (DHT), a hormone that shrinks hair
follicles and is an important factor in male hair loss. Rare side
effects of finasteride include diminished sex drive and sexual
function. As with minoxidil, the benefits of finasteride stop if
usage is discontinued.

Finasteride is not approved for use by women. In fact, it poses
significant danger to women of childbearing age. If you're a
pregnant woman, don't even handle crushed or broken finasteride
tablets because absorption of the drug may cause serious birth
defects in male fetuses.

* Corticosteroids. Injections of cortisone into the scalp can treat
alopecia areata. Treatment is usually repeated monthly. Doctors
sometimes prescribe corticosteroid pills for extensive hair loss
due to alopecia areata. Ointments and creams can also be used, but
they may be less effective than injections.

* Anthralin (Drithocreme). Available as either a cream or an
ointment, anthralin is a synthetic, tarry substance that you apply
to your scalp and wash off daily. It's typically used to treat
psoriasis, but doctors can prescribe it to treat other skin
conditions. Anthralin may stimulate new hair growth for cases of
alopecia areata.

Surgical procedures
Hair transplants and scalp reduction surgery are available to treat
androgenetic alopecia. During transplantation a dermatologist or
cosmetic surgeon takes tiny plugs of skin, each containing one to
several hairs, from the back or side of your scalp. The plugs are then
implanted into the bald sections. Several transplant sessions may be
needed as hereditary hair loss progresses with time.

Scalp reduction, as the name implies, means decreasing the area of
bald skin on your head. Your scalp and the top part of your head may
seem to have a snug fit. But the skin can become flexible and
stretched enough for some of it to be surgically removed. After
hairless scalp is removed, the space is closed with hair-covered
scalp. Doctors can also fold hair-bearing skin over an area of bald
skin in a scalp reduction technique called a flap. Scalp reduction can
be combined with hair transplantation to fashion a natural-looking
hairline.

Surgical procedures to treat baldness are expensive and can be
painful. Possible risks include infection and scarring. If you're
interested in these procedures, consider only board-certified
dermatologists, plastic surgeons or cosmetic surgeons, and check local
and state medical boards for a record of patient complaints before
choosing a doctor.

If you would like an alternative to medical treatment for your hair
loss or if you don't respond to treatment, you may want to consider
wearing a wig or hairpiece. They can be used to cover either permanent
or temporary hair loss. Quality, natural-looking wigs and hairpieces
are available.

Coping skills

Chances are that the greatest challenge of losing your hair is coping
with the change in your appearance. You may be frustrated or upset by
other people's reactions or after trying various treatments with
little success. If you're having difficulty coping with baldness
caused by heredity, a medical condition or medical treatments, you may
find some of the following suggestions helpful:

* Learn about the cause of your baldness and treatment options. Be
wary of alternative treatments that have no proven track record or
may cause dangerous or unpleasant side effects.

* Educate those near to you. Your family and friends can be more
sympathetic if they understand the cause of your baldness or your
concerns about your looks. You may also learn that they are less
concerned about changes in your appearance than you are.

* Consider joining a support group. While support groups aren't for
everyone, they can be sources of information and comfort. Talking
with people who experience the same challenges or medical
conditions and learning how they cope can be reassuring.

* Hair loss: Cancer-related causes and how to cope

March 12, 2004

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Terms of Use.

© 2001 Planetree, Inc. All rights reserved.

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