Hair Loss

Introduction

Although hair loss is mainly an aesthetic problem, it can be extremely distressing, taking a toll on the sufferer’s self-esteem. There are many causes of hair loss, including:

  • Androgenetic alopecia – more commonly known as male or female pattern hair loss.
  • Alopecia areata – a patchy hair loss that might be due to an autoimmune disorder.
  • Traction Alopecia – caused by tight hairstyles such as cornrows and hair braids. This form of hair loss will resolve itself once hair styling habits are changed, if the problem is addressed early enough.
  • Telogen Effluvium – a type of hair loss caused by a shock to your body. This might include medication, stress, illness and childbirth.
  • Trichotillomania – a compulsive disorder in which the sufferer pulls out his own hair, eyebrows or eyelashes.

In this article, we will be focusing primarily on male and female pattern baldness (androgenetic alopecia).

Signs & Symptoms

For males, hair starts at the hairline, creating a receding hairline and forming an M-shape with a Willow’s Peak (the sharp point in the middle). Later, the hair at the crown will start to thin out too. Eventually, the patient might only have a rim of hair around the back and sides of the head.

The pattern of hair loss for females is very different. Hair loss starts on the crown, progressing to a widening of the centre parting. A further decrease in hair density might occur, with the bald areas gradually moving forward.

When to Seek Medical Attention

You should only attempt to self- treat androgenetic alopecia and not the other forms stated. See a doctor if:

  • Your hair loss is sudden
  • Your hair loss is patchy
  • There are signs of swelling on the scalp
  • You notice rashes on any other body parts
  • There are nail changes
  • If self-medication does not help your pattern baldness and you are bothered by it

Causes

Male pattern hair loss is caused by a genetic sensitivity of hair follicles to dihydrotestosterone (DHT), formed when testosterone is broken down. The causes of female pattern loss are not known, although it has been suggested that estrogens, a female hormone, might play a role in female pattern hair loss.

Factors that predispose you to hair loss are:

  • Gender – Androgenetic alopecia occurs in males more often than females
  • A family history of pattern baldness
  • Age – The older you are, the more likely it is for you to suffer from pattern baldness. Also, female pattern hair loss tends to worsen after menopause.

Treatment options

You do not need to treat androgenetic alopecia if it does not bother you.

If you would prefer to control it however, treatment works best when you start early. Minoxidil in a topical application is approved for treatment of hair loss and is available from your pharmacy. The exact mechanism of action is unknown, but it seems to increase blood circulation, stimulate inactive hair follicles and increase the size of your hair follicle. Minoxidil is available in three strengths – 2, 3 and 5%, with women typically starting on 2% and men on 5%. This medication is to be used long term, and patients who stop using minoxidil after results have been achieved will notice their hair loss problems returning back to pre-treatment condition.

Finasteride is a prescription oral medication indicated for male pattern baldness. It works by blocking the conversion of testosterone to DHT, a hormone which is thought to be responsible for male pattern hair loss. Some doctors would prescribe finasteride together with topical minoxidil.

For patients who do not respond to oral treatments, a doctor can determine your suitability for a hair transplant. This is a surgery in which a strip of scalp is removed from the back of the head, divided and then grafted onto the areas required.

 

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