The medical term for hair loss is alopecia. There are various types of alopecia and many causes. Depending on the pattern and chronology of your hair loss, your doctor may recommend certain tests to rule out serious medical conditions like autoimmune disease, metabolic and endocrine disorders and chronic illness or infection. An article published in American Family Physician (2003;68:93-102,107-108) reviews alopecia, including causes and medical treatment options.
The vast majority of hair loss is the type referred to as "male pattern baldness," or androgenetic alopecia, which is for the most part a benign, but psychologically bothersome condition. In men, the characteristic pattern of hair loss is along the front and sides of the head, while in women it involves central thinning. This type of hair loss in both men and women is usually genetic. However, in women, this type of hair loss may be due to hyperandrogenism (excess male hormones), and will be accompanied by other symptoms like hirsutism (hair distribution in a male pattern i.e. face and chest), menstrual problems, acne and infertility. In this case, the hormone irregularities are addressed. Minoxidil (Rogaine) is the recommended medical treatment if the hair loss is not advanced and not due to some other underlying condition. For men, finasteride (Propecia) and tretinoin (Retin-A) may also be prescribed. If advanced, medical doctors recommend hair pieces or transplant surgery.
Another type of hair loss is telogen effluvium in which overall loss of hair from the scalp is increased and may include pubic and axillary (under arms) areas. This type of hair loss usually has a precipitating event 3-4 months prior such as injury or stress, giving birth, high prolonged fever, serious infection or illness, hypothyroidism, severe dieting and malnutrition. It may also be due to various types of drugs including chemotherapeutic agents, anticoagulants, hormones and anticonvulsants. Resolving underlying causes or with time, this type of hair loss resolves.
Alopecia areata is complete hair loss from an area, and may include the whole scalp (alopecia totalis) or the entire body (alopecia universalis). Patients can be genetically predisposed. The hair loss is the result of an autoimmune reaction in the hair follicle. It may resolve in 6-12 months, but can recur. There may also be concurrent conditions like thyroid disorders, vitiligo and pernicious anemia. Immune modulating drugs and corticosteroid shots may be prescribed, but have poor response rates, especially with entire scalp or body hair loss. Other causes of hair loss include dermatophyte infection (tinea capitis), syphilis, trichotillomania (psychiatric disorder characterized by pulling out hair) and traction alopecia due to tight ponytails or braids.
Posted by Kristopher Foster on May 3, 2006 01:03 PM
