Did you know the human scalp contains approximately 100,000 to 150,000 hair follicles? There are many causes of thinning hair and/or hair loss. Hair loss may occur due to disorders of hair cycling, inflammatory conditions that damage hair follicles, or inherited or acquired abnormalities in hair shafts. It’s an extremely distressing time for any woman who starts to notice these changes. Our hair can be a huge part of our identity and self-image.
Causes range from how we style our hair (tight ponytails/braids- anything that puts prolonged traction on the hair follicle can cause “traction Alopecia”), to diet, stress and autoimmune conditions (when your immune system “attacks” your own body). Through this article, I’ll explain some of the causes, and what to do if you or someone you know is experiencing hair loss.
Firstly, the major dividing lines for the various forms of hair loss are the distinction between scarring alopecia, nonscarring alopecia, and structural hair disorders.
Traction alopecia results from the prolonged pull of the hair follicle. Traction from braids or hair weaves is most commonly detected along the frontal and temporal (near the temples) hairlines. Repeated dying of the hair can also cause significant damage. As much as we love dying our hair it’s important to be mindful not to overdo it with chemicals, heat and processing.
Extreme weight loss and poor diet can also cause notable hair thinning and loss. Maintaining a healthy diet and a healthy weight are important for hair health. But of course sometimes we can do all of the “right” things and still be unhealthy in some way; I guess it’s important to just do our best and give ourselves the best shot.
Medical conditions like a long-standing iron deficiency, an underactive thyroid gland or Polycystic Ovarian Syndrome (PCOS) can also be at play. Furthermore, skin conditions like lupus, dermatitis, fungal skin infections and psoriasis that affect the scalp can have deleterious and dramatic effects on our hair. Female pattern hair loss is also seen and tends to happen in older age; it’s not only men who are affected.
Episodes of major psychological stress can have very real physical manifestations and hair loss is one of them. Furthermore, women with hair loss experience feelings of negative body image, poor self-esteem, less of a sense of control over their lives, and it very much impacts on their quality of life. In an age where hair extensions are deemed to be a normal part of female grooming, it’s little wonder that hair loss is so upsetting.
Trichotillomania is another psychological consideration. It’s a condition in which individuals repeatedly pluck hairs from the scalp or other hair-bearing areas. Ask your doctor about local support groups or psychological supports that may be available locally to help.
Some medicines can result in thinning hair or hair loss so it’s always useful to review any over-the-counter or prescription medicines you’re taking. We’re all quite aware that chemotherapeutic agents can cause hair loss but other more routine medicines can too – some acne and blood pressure medicines, for example, can cause hair loss.
There are many subtypes of alopecia but alopecia areata is likely the most common form of alopecia in which an autoimmune process (immune system attaching the body) contributes to the loss of hair on the scalp or other areas. Hair loss tends to occur in patches. Occasionally, alopecia areata progresses to loss of all scalp or body hair. In alopecia areata the follicle is not damaged so there is potential for the hair to grow back.
Visit your doctor
Your GP will be able to make an assessment of your hair loss and consider the cause based on the pattern of hair loss, your past medical history, your family history and your blood test results. Your doctor will ask about the rate and progression of the hair loss, the location and pattern and the extent of your hair loss. Other symptoms such as tiredness, irregular periods or itchiness will also be explored.
Your GP will do some blood tests to rule out reversible causes like an underactive thyroid or low iron level but oftentimes referral to a dermatologist for further inspection and assessment is required. They can look at the hair under a microscope to reach a formal diagnosis and start treatment where necessary. Whether or not the hair will grow back depends on the underlying cause and whether or not the hair follicle is permanently damaged or not. If you’re worried at all about your hair make an appointment with your GP who can help.
As always, don’t suffer in silence. Chat to your GP.