Alopecia (Hair Loss)

Alopecia is the absence or slowing of hair growth in an area of the body where hair formerly grew. It may be caused by physical damage to the hair itself or to the hair follicles, but it is most often the result of changes in the natural growth cycle of hair. In some types of alopecia, the growth cycle is disrupted by some temporary situation such as a chemical imbalance or stress. However, the vast majority (95 percent) of cases of hair loss in both men (male pattern baldness) and women (female diffuse baldness) are genetic in origin. This is called androgenetic alopecia.

Signs and Symptoms

What Causes It?

Androgenetic alopecia is caused by a genetic tendency for certain hair follicles to produce a substance that reacts with male hormones. As you get older, this reaction eventually causes the follicle to shut down. Female diffuse baldness progresses more slowly than male pattern baldness because of the small amount of male hormones in a woman's body. A hormone imbalance may make the problem worse.

Temporary hair loss may result from any shock to the body's systems, including starvation, systemic infection, childbirth, thyroid or immunologic disorders, drugs (especially chemotherapy for cancer), or stress. Hair follicles can be destroyed permanently by scarring from burns, severe scalp infections, X-ray therapy, or skin disorders. Damage may also result from tight hairstyles over a long period of time, chemical treatments such as hair coloring or permanents, or the habitual pulling out of the hair. A fungal condition called tinea capitis ("ringworm of the scalp") also results in hair loss. The causes of alopecia areata, or patchy hair loss, are not well understood. It tends to happen in times of stress.

What to Expect at Your Provider's Office

If the cause of your hair loss is uncertain, your provider may suggest thyroid function tests or a blood test to rule out immune system problems. A biopsy, in which a small sample of scalp tissue is taken to be examined microscopically, is occasionally recommended.

Treatment Options

Appropriate treatment options depend upon the type of alopecia. Aggressiveness of the treatment depends on the patient's attitude and must be weighed against potential side effects. In many temporary forms of alopecia, the condition will begin to normalize without treatment. Surgery may be indicated for highly motivated patients with male pattern baldness for whom medical therapies are contraindicated or ineffective. Options include hair transplants, scalp reduction, and strip or flap grafts.

Drug Therapies

Surgical and Other Procedures

Surgical options include hair transplants, scalp reduction, and strip or flap grafts.

Complementary and Alternative Therapies

These therapies have limited success in treating male pattern baldness.

Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Physical Medicine
Stress reduction techniques can increase blood flow to the scalp.

Therapeutic massage increases circulation and reduces stress. Scalp massage using essential oils of rosemary, lavender, sage, thyme, and cedarwood may be helpful in increasing circulation. Add 3 to 6 drops of essential oil to 1 tbsp. of jojoba or grapeseed oil. Massage into scalp daily.

Special Considerations

A small percentage of men using finasteride may experience a decreased sex drive or difficulty in achieving an erection.

If you are pregnant, postpone treatment until after your baby is born.


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