Alopecia Hair Loss

Hair loss can occur as thinning hair or complete baldness. The hairloss may be on the head or any other part of the body that normally has hair,such as the eyebrows.

What is going on in the body?

There are many causes of hair loss. The most common form of hair loss is due tomale pattern baldness, in which hair is lost from the front and topof the scalp. Other types of hair loss can create different patterns. Treatmentdepends on the type and cause of baldness.

What are the causes and risks of the condition?

Hair loss can be due to:

• male pattern baldness, the most common type of hair loss, which is usuallyinherited from one of the parents
• inflammation of the scalp, which can cause patchy hair loss and is oftentreatable
• medications, such as chemotherapy
• radiation therapyof the head, usually to treat cancer
• infections, such as a fungal infection of the scalp or a sexually transmitted disease called Treponema pallidum \ bacteria.
• trauma to the hair or scalp, which may include certain hairstyles thatconstantly pull on the hair, such as tight braids

Certain diseases can also cause the condition:

• low levels of iron inthe body, which may also cause anemia, or a low red blood cell count
• hypothyroidism, whichis a condition caused by low levels of thyroid hormones
• systemic lupuserythematosus, a bodywide disease that attacks many organsystems
• very rarely, cancer

Female pattern baldness usually causes thinning of the hair on the top andsides of the head. Some causes of female pattern baldness are:

• stress, includingemotional stress, surgery, illness, or rapid weight change
• hormonal changes, including those caused bypregnancy, menopause, or use of oralcontraceptives
• hormonal imbalances, such as hypothyroidism, which is a low level of thyroid hormone
• some medications, such as those used for gout and high bloodpressure
• high levels of vitamin A

What are the signs and symptoms of the condition?

The primary symptom is hair loss. Other symptoms can vary widely depending onthe cause of the hair loss. Those with male pattern baldness have no othersymptoms. The location of the hair loss also differs depending on the cause.

How is the condition diagnosed?

The affected person usually notices the hair loss. A medical history andphysical exam often make the healthcare provider suspect a certain cause. Somemethods used to diagnose the cause of hair loss include:

• scraping the affected area to collect hairs. The hairs can be examined witha microscope or analyzed by a lab to look for certain causes of hair loss.
• biopsy of the skin. A biopsy involves taking a small piece of skinwith a special tool and sending it to the lab for testing.
• blood tests to check for certain diseases

What can be done to prevent the condition?

There are medications available to prevent hair loss in men with a strong family history of the common type of baldness. Early treatment of fungal infections and Treponema pallidum \ bacteria.

Early correction of low iron levels or hypothyroidism may also prevent some cases. Manycases cannot be prevented but may respond to treatment.

What are the long-term effects of the condition?

If not treated, hair loss can become severe. With male pattern baldness, thisis the only long-term effect. Scarring of the skin can occur with certaincauses of hair loss. Other long-term effects may occur, but they depend on the causeof the hair loss.

What are the risks to others?

Many cases of hair loss in children are due to fungal infections. These arefairly contagious and can be spread by close contact with other children orsharing combs or hairbrushes. Treponema pallidum\ bacteria. Other forms ofhair loss, which make up the majority of cases, are not contagious.

What are the treatments for the condition?

Treatment is directed at the underlying cause. Treatment may include:

• medication for male pattern baldness, such as minoxidil and finasteride
• antibiotics to treat a fungal or Treponema pallidum \ bacteria.
• stopping a medication that is causing hair loss
• medication to treat an underlying condition, such as iron or thyroidhormone pills
• medications applied to the area of hair loss to reduce inflammation

Some people may choose hair grafting, or hair transplantation, to cover areasof hair loss. There are several hair-grafting techniques, which involve takingpieces of scalp from hair-growing areas on the back or side of the head andplacing them into slits on the balding areas.

Wigs, hair weaves, toupees, and other hairpieces may be used to cover areaswhere hair is thin or absent. Other treatments may be used for other causes.Some people choose no treatment at all.

What are the side effects of the treatments?

All medications may cause side effects. For example, finasteride may causeerectile dysfunction inmen. Antibiotics may cause rash, stomach upset, or allergic reactions.

What happens after treatment for the condition?

If treatment is successful, the hair loss stops. With male pattern baldness,treatment is often needed for life to prevent further hair loss. In some cases,treatment may allow the hair to grow back completely. Treatment may be neededfor long periods of time if the underlying cause is a serious disease.

How is the condition monitored?

Both the affected person and the healthcare provider can frequently examine thearea of hair loss to see if treatment is effective. Other monitoring depends onthe cause of the hair loss. Any new or worsening symptoms should be reported tothe healthcare provider.