Hair loss is an issue that affects many people worldwide. While some causes are genetically predetermined, hair loss can also be linked to medical problems or other external factors. As a medical professional who specializes in treating this condition, it’s important for me to stress the importance of understanding these different root causes—and what steps you may need to take as part of your treatment plan. In this blog post, I will address common questions about some of the potential sources and explanations behind thinning hair or complete baldness in adults.
Hair loss, medically known as alopecia, refers to excessive thinning or shedding of our scalp locks. It’s estimated that by age 50 more than half of all men (and 40 percent of women) are affected by some degree of pattern baldness or other forms of hair loss – making it an extremely common affliction among adults.
What we consider “normal” levels if existing and falling strands can vary drastically between different individuals but generally speaking, losing anywhere from 30-150+ hairs per day falls within what doctors refer to as normal shedding range and is nothing out of the ordinary. However, when hair loss exceeds these thresholds then seeing your endocrine provider is worthwhile to evaluate you for medical conditions causing alopecia.
Despite certain hair products claiming they stop balding due to age, there isn’t much research backing up those claims. Genetic predispositions become more likely with each year we grow older. Men’s patterned hairlines commonly don’t begin receding until ages 25–35 while women often start seeing signs at around 40 years old onward. Genetics plays a large role overall but age is one factor worth considering if someone notices “odd” changes in their scalp beyond typical shedding which could improve with lifestyle adjustments such as regular exercise and proper nutrition.
The most common type of hereditary hair loss is called Androgenetic Alopecia (male-pattern baldness). Women rarely achieve full baldness like men do when this condition occurs but instead gradually thin out on the top portion of their scalp, the temples and the crown of the head. Genetic susceptibility of hair follicles to androgens likely plays a role in this type of hair loss. Medications to block androgens can help to treat this condition.
There are a number of endocrine disorders associated with hair loss. Polycystic ovary syndrome is a very common cause of hair loss in women and results from excessive male hormones (androgens) being produced by the ovaries and adrenal glands. Thyroid disorders such as hyperthyroidism (an overactive gland), hypothyroidism (under inactive lobe) are also very common endocrine conditions associated with alopecia. Cushing’s syndrome is a rare condition where your body makes too much cortisol, which causes hair loss. High levels of psychological stress also increase cortisol, thus explaining the link between anxiety and depression and hair loss. Pituitary diseases, endometriosis, and nutritional deficiencies such as B12, vitamin D and iron deficiencies may also play a role in hair loss.
Autoimmune diseases like Rheumatoid Arthritis or Lupus where body’s immune system mistakenly begins attacking their own tissues, thus aggravating the scalp’s susceptible follicles leading noticeable clumps being lost. The immune system can attack the hair follicle itself causing patches of bare skin called alopecia areata. This may respond to topical treatments of injections of steroids into the affect area by a dermatologist.
Other Medical Conditions
Severe illness including surgery, infection, extreme weight loss and the post-partum period are often associated with hair loss. COVID-19 infection is associated with hair loss. Medications such as steroids or cancer chemotherapy can cause hair loss as well. Treating the underlying condition often results in improvement in this type of alopecia.
Although exciting new treatments to improve hair loss have been developed, it is always important to have an appropriate medical evaluation to rule out medical causes of alopecia before embarking on any hair restoration treatment plan for optimal results.