Finding hair in your brush is normal: We shed. But if a person starts losing an unusual amount of hair, it can be cause for concern.
Losing hair normally doesn’t have much effect on your appearance or warmth, as your head has plenty more to make up for the daily loss. But there may be a more significant reason for your hair loss when you start seeing your scalp or bald spots.
When you think of hair loss, you may think of the genetic factors, such as male pattern baldness. Hormones, thyroid problems, and other diseases can all cause hair loss too.
So, what are these various causes, and how do you know if they’re to blame for your excessive shedding?
Women may lose hair following childbirth or while in menopause. Women who have hormonal imbalances can have hair loss.
Aside from genetic male pattern baldness, men can lose hair as their hormonal composition changes with age. Hair loss is caused by your follicles’ response to the hormone dihydrotestosterone (DHT).
Perhaps one of the most common hormone-related causes for hair loss is a thyroid problem. Both too much thyroid hormone (hyperthyroidism) and too little (hypothyroidism) can lead to hair loss. Treating the thyroid disorder can often reverse the hair loss.
Physical and psychological stress can cause hair loss. Surgery, high fevers, and blood loss can cause enough stress to result in excessive shedding. Childbirth can result in hair loss for several months after delivery.
As for psychological stress, the link is less well-defined. However, many people have reported losing hair at times of extreme mental stress or anxiety. And hair loss for other reasons can still be stressful.
The causes of physical stress are often temporary, and the hair loss subsides as the body heals.
You can combat mental stress with lifestyle changes, such as:
- daily exercise
- proper nutrition
- meditation and other stress management strategies
- removing known stressors from your life
Pharmaceuticals can come with a long list of side effects, including hair loss. Chemotherapy is the most well-known cause, but others include:
- thyroid medications
- some oral contraceptives
- beta-blockers
- anticonvulsants
- antidepressants
- anticoagulants
These medications affect people differently and may not cause hair loss in everyone.
Zinc and iron deficiency are the most common nutritional links to hair loss. But some evidence indicates that low intakes of the following vitamins and nutrients could also be to blame:
- fats
- vitamin D
- vitamin B-12
- vitamin C
- vitamin A
- copper
- selenium
- biotin
Lupus is an autoimmune disease that can cause hair loss. Generally, the hair loss is patchy and accompanied by lesions on the scalp.
Many other medical conditions can lead to abnormal balding, including:
- renal failure
- inflammatory bowel disease (IBD)
- liver disease
- diabetes
Skin conditions such as psoriasis and dermatitis can occur on the scalp and interfere with hair growth. Infections such as ringworm of the scalp and folliculitis can also cause hair loss.
Dihydrotestosterone (DHT) is made from testosterone by an enzyme called 5-alpha reductase. It can also be made from DHEA, a hormone more common in women. DHT is found in skin, hair follicles, and the prostate. The actions of DHT and the sensitivity of hair follicles to DHT is what causes hair loss.
DHT also acts in the prostate. Without DHT, the prostate doesn’t develop normally. With too much DHT, a man can develop benign prostate hypertrophy, also known as an enlarged prostate.
It’s not the amount of testosterone or DHT that causes baldness; it’s the sensitivity of your hair follicles. That sensitivity is determined by genetics. The AR gene makes the receptor on hair follicles that interact with testosterone and DHT. If your receptors are particularly sensitive, they are more easily triggered by even small amounts of DHT, and hair loss occurs more easily as a result. Other genes may also play a part.
Age, stress, and other factors can influence whether you experience hair loss. But genes play a significant role, and men who have close male relatives with MPB have a much higher risk of developing MPB themselves.
Several methods of treating MPB and FPHL involve interfering with testosterone and DHT’s actions. Finasteride (Propecia) is a drug that inhibits the 5-alpha reductase enzyme that converts testosterone to DHT. It’s dangerous to use in women who may become pregnant, and there may be sexual side effects of this drug on both men and women.
Another 5-alpha reductase inhibitor called dutasteride (Avodart) is currently being looked at as a potential treatment for MPB. It’s currently on the market for treatment of an enlarged prostate.
Other treatment options that don’t involve testosterone or DHT include:
- minoxidil (Rogaine)
- ketoconazole
- laser treatment
- surgical hair follicle transplant
Talk with your doctor about your concerns and the potential causes for your hair loss. They can recommend a treatment that’s right for you.
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