| What Is Baldness? |
It 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.
Anyone — including men, women and children — can experience hair loss. But baldness typically refers to excessive hair loss from your scalp and can be the result of heredity, certain medications or an underlying medical condition.
The medical term for hair loss is alopecia. The most common type is known as androgenetic alopecia or pattern baldness. It's typically permanent and can be attributed to heredity. In fact, about 95 percent of hair loss from the scalp is due to your inheritance.
Another type of alopecia, known as alopecia areata, is usually temporary. It affects approximately 2 percent of the population and can involve hair loss on the scalp or the body. Its specific cause is unknown.
No matter what causes baldness, the results can be traumatic. That may be why hair-growth schemes are among the most common medical scams. A quick Web search using the key word baldness turns up a multitude of wonder cures and treatments. But many products marketed to reverse baldness avoid regulation by the Food and Drug Administration (FDA) because they aren't considered drugs.
Still, FDA approved medications and surgical procedures are available to treat baldness. Before pursuing any of these options, be sure to talk with your doctor about the cause and best possible treatments for your hair loss.
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| Signs and Symptoms |
If you have androgenetic alopecia, you may experience hair loss as early as your teen years. For men, this type of baldness is typically characterized by hair loss that begins at the temples and the 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, baldness 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 4- to 5-year growth stage at any given time. The other 10 percent is in a 2- to 3-month resting phase, after which it is shed. Most people shed 50 to 100 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 balding. Heredity also affects the age at which you begin to lose hair and the speed, pattern and extent of your baldness.
Alopecia areata is classified as an autoimmune disease, but the cause of it is unknown. In fact, people who develop this type of baldness are generally in good health. A family history of alopecia areata makes you more likely to develop it. Unlike androgenetic alopecia, hair will generally grow back. But it may take several years.
Other causes of temporary hair loss include:
- Disease. Diabetes, lupus and thyroid disorders can cause hair loss.
- Poor nutrition. If you get inadequate protein or iron in your diet or are poorly nourished
in other ways, you can experience hair loss. Fad diets, crash diets and certain illnesses, such as
bowel disease or 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. If you are undergoing chemotherapy or radiation therapy, you may
develop alopecia. After your treatment ends, your hair typically will begin to regrow.
- Recent high fever, severe flu or surgery. You may notice you have less hair 4 weeks to 3
months after an illness or surgery. These conditions cause hair to shift rapidly into a resting phase,
meaning you'll see less new hair growth. A normal amount of hair typically will appear after the
growth phase resumes.
- Infancy. Newborn babies often lose hair during the first few months of life. This baby hair
is eventually replaced by more permanent hair. It's also common for babies from 3 to 6 months of age
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 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.
- Scalp infection. Infections such as ringworm can invade the scalp and cause changes on the skin's surface, which can lead to hair loss. Once infections are treated, hair generally returns. Ringworm, a fungal infection, can usually be treated with a topical or oral antifungal medication.
| 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 currently approved by the FDA for treatment of alopecia 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. Many more
people experience a slower rate of hair loss. Minoxidil is available in a 2 percent solution and in a
5 percent solution.
New hair resulting from minoxidil use is often thinner and lighter in color than previous hair. Sometimes this regrown hair resembles baby 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 insignificant results within 6 months, your doctor may recommend discontinuing use. Side effects can include some dryness and 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. Like minoxidil, positive results may take several
months. Stop treatment if you don't see any results after 12 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 has not proved to be effective for women and is not approved for use by women. In fact, it poses significant danger to women of childbearing age. If you're a pregnant woman, then don't even handle crushed or broken finasteride tablets because absorption of the drug may cause serious birth defects in male fetuses.
Neither minoxidil nor finasteride is indicated for nonhereditary baldness or hair loss due to illness or childbirth. These drugs also are not approved for use by children or adolescents. - Cortisone (Cortone). Injections of cortisone into the scalp can be used to treat alopecia
areata. Treatment is usually repeated monthly and generally involves only mild discomfort during the
injections. Cortisone pills are sometimes prescribed for extensive hair loss due to alopecia areata.
- Anthralin (Drithocreme, Micanol). Available as either a cream or an ointment, anthralin is a synthetic, tarry substance that you apply to the 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 mild cases of alopecia areata.
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. A very small group of people who undergo these procedures experience chronic head pain afterward. There's a slight risk of infection. 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 baldness 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 your greatest challenge in losing your hair is to cope 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.