Hair loss

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Hair follicle

Ringworm, tinea capitis - close-up

Alopecia areata with pustules

Alopecia totalis - back view of the head

Alopecia totalis - front view of the head

Alopecia, under treatment

Trichotillomania - top of the head

Folliculitis, decalvans on the scalp

Overview

Treatment

Hair loss

Alternative Names:

Loss of hair; Alopecia; Baldness
Home Care:

Hair loss from menopause or childbirth often returns to normal 6 months to 2 years later.

For hair loss caused by illness (such as fever), radiation therapy, or medication use, no treatment is necessary. The hair will usually grow back when the illness has ended or the therapy is finished. A wig, hat, or other covering may be desired until the hair grows back.

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For hair loss due to heredity, age, and hormones, the topical medication Rogaine (minoxidil) can be helpful for both male and female pattern baldness. Expect to wait 6 months before you see results. The oral medication Propecia (finasteride) is effective in some men. This medicine can decrease sex drive. When either medication is stopped, the former baldness pattern returns.

Hair transplants performed by a physician is a surgical approach to transferring growing hair from one part of the head to another. It is somewhat painful and expensive, but usually permanent.

Hair weaves, hair pieces, or changes of hair style may disguise hair loss. This is generally the least expensive and safest approach to hair loss. Hair pieces should not be sutured to the scalp because of the risk of scars and infection.

Call your health care provider if:

Call your doctor if:

You are losing hair in an atypical pattern.
You are losing hair rapidly or at an early age (for example, teens or twenties).
You have any pain or itching associated with the hair loss.
The skin on your scalp under the involved area is red, scaly, or otherwise abnormal.
You have acne, facial hair, or menstrual irregularities.
You are a woman and have male pattern baldness.
You have bald spots on your beard or eyebrows.
You have been gaining weight or have muscle weakness, intolerance to cold temperatures, or fatigue.

What to expect at your health care provider's office:

A careful medical history and examination of the hair and scalp are usually enough to diagnose the nature of your hair loss.

Your doctor will ask detailed questions such as:

Are you losing hair only from your scalp or from other parts of your body as well?
Is there a pattern to the hair loss like a receding hair line, thinning or bald areas on the crown, or is the hair loss throughout your head?
Have you had a recent illness or high fever?
Do you dye your hair?
Do you blow dry your hair? How often?
How often do you shampoo your hair?
What kind of shampoo, hair spray, gel, or other product do you put on your hair?
Have you been under unusual stress lately?
Do you have nervous habits that include hair pulling or scalp rubbing?
Do you have any other symptoms like itching, flaking, or redness of your scalp?
What medications do you take, including over the counter drugs?

Diagnostic tests that may be performed (but are rarely needed) include:

Microscopic examination of a plucked hair
Skin biopsy (if skin changes are present)

Ringworm on the scalp may require the use of an oral drug, such as griseofulvin, because creams and lotions applied to the affected area may not get into the hair follicles to kill the fungus.

Treatment of alopecia areata may require topical or injectable steroids or ultraviolet light.

References:

Habif TP. Clinical Dermatology. 4th ed. St. Louis, Mo: Mosby, Inc. 2004:844-845.

Rakel P, ed. Conn?s Current Therapy 2005. 57th Ed. Philadelphia, PA: WB Saunders; 2005: 897.