What causes hair loss? — The most common cause of hair loss is a condition called "androgenetic alopecia." This condition is also known as "male-pattern baldness" when it happens in men and "female-pattern hair loss" when it happens in women.
Androgenetic alopecia can look different in men and women. Men often develop bald areas on the front and the top of the scalp. Women often have thinning hair on the top of the scalp, but usually do not lose all of the hair there (figure 1).
Another common cause of hair loss is called "alopecia areata." This type of hair loss happens when the body's infection-fighting system gets confused and starts to attack the parts of the skin where hair grows. People with alopecia areata might have small round spots or larger areas of hair missing.
There are many other reasons for hair loss. Some medical conditions and even some medicines can also cause hair loss.
Should I see a doctor or nurse? — See your doctor or nurse if you are bothered by your hair loss, or if:
You are not sure why you are losing your hair
Your hair loss occurs suddenly
You also have itching or pain on your scalp
You also don't feel well or feel very tired
Are there tests I should have? — Most people with hair loss do not need tests. But your doctor or nurse might do tests to make sure your hair loss is not caused by a hormonal problem or another medical condition.
How is hair loss treated? — That depends on what type of hair loss you have.
If your hair loss is caused by a health problem, treating that problem can help. Other types of hair loss are treated in many different ways. Examples include medicines that go on the scalp, medicines that are given as shots into the scalp, and medicines that come in pills. Sometimes surgery is used to treat people with areas of hair that cannot grow back.
Androgenetic alopecia – These are examples of medicines that might help to stop hair loss in people with androgenetic alopecia:
•Minoxidil (brand name: Rogaine) – This medicine is used in men and women. You can buy it without a prescription. It comes in a liquid or foam that you put on your head.
•Finasteride (brand name: Propecia) – This medicine is meant for men. Doctors sometimes also give it to women who have been through menopause (meaning they have stopped having periods). It comes in a pill, and you need a prescription to buy it.
•Spironolactone (brand name: Aldactone) – This medicine might help some women who do not have good results with minoxidil. It is not safe to use during pregnancy. The medicine comes in a pill, and you need a prescription to buy it.
Alopecia areata – These are some examples of medicines that can help regrow hair in people with alopecia areata:
•Medicines called steroids – These can be given as shots, or applied directly to the scalp (for example, as a liquid, gel, foam, lotion, or cream). The medicine slows or stops the immune response that causes alopecia areata. These are not the same as the steroids some athletes take illegally.
•A treatment called "topical immunotherapy" – A dermatologist usually gives this type of treatment. The doctor puts a special medicine that causes a mild allergic reaction on the spots of hair loss. You usually need many treatments to see if topical immunotherapy will work.
What if I am upset about my hair loss? — Losing your hair can be very tough. If you feel sad or anxious because of your hair loss, speak to your doctor or nurse. He or she can help you get the support you need.
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This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15436 Version 6.0
Release: 28.2.2 - C28.105
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