Hair Loss And Its Causes
Baldness or hair loss is typically something only adults need to worry about. But in a few cases, teens lose their hair, too — and it may be a sign that something's going on. Hair loss during adolescence can mean a person's sick or maybe just not eating right. Some medications or medical treatments, like chemotherapy treatment for cancer, also cause people to lose their hair. And people can even lose their hair if they wear a hairstyle that pulls on their hair for a long time, such as braids.
Losing hair can be stressful during a time when appearance really matters, but the good news is that hair loss that happens during the teen years is often temporary. Once the problem that causes it is corrected, the hair usually grows back.
Hair Basics
Our hair is made of a type of protein called keratin. A single hair consists of a hair shaft (the part that shows), a root below the skin, and a follicle, from which the hair root grows. At the lower end of the follicle is the hair bulb, where the hair's color pigment, or melanin, is produced.
Most people lose about 50 to 100 head hairs a day. These hairs are replaced — they grow back in the same follicle on your head. This amount of hair loss is totally normal and no cause for worry. If you're losing more than that, though, something may be wrong. The medical term for hair loss — losing enough hair that a person has visibly thin or balding patches — is alopecia.
If you have unusual hair loss and don't know what's causing it, it's a good idea to see your doctor. A doctor can determine why the hair is falling out and suggest a treatment that will correct the underlying problem, if necessary.
What Causes Hair Loss?
Here are some of the things that can cause hair loss in teens:
- Illnesses or medical conditions. Endocrine (hormonal) conditions, such as uncontrolled diabetes or thyroid disease, can interfere with hair production and cause hair loss. People with kidney disease and liver diseases and lupus can also lose hair. The hormone imbalance that occurs in polycystic ovary syndrome can cause hair loss in teen girls as well as adult women.
- Medications. Some medications that have hair loss as a side effect may be prescribed for teens. These include acne medicines like isotretinoin, and lithium, which is used to treat bipolar disorder. Diet pills that contain amphetamines can also cause hair loss. Chemotherapy drugs for cancer are probably the most well-known medications that cause hair loss, but some cancers including leukemia and lymphoma can cause hair loss even before treatment begins.
- Alopecia areata (pronounced: air-ee-ah-tuh). This skin disease causes hair loss on the scalp and sometimes elsewhere on the body. It affects 1.7% of the population, including more than 4 million people in the United States. Alopecia areata is thought to be an autoimmune disease, in which the hair follicles are damaged by a person's own immune system. (In autoimmune diseases, the immune system mistakenly attacks healthy cells, tissues, and organs in a person's body.) Alopecia areata usually starts as one or more small, round bald patches on the scalp and can progress to total hair loss, although total hair loss only happens in a small number of cases. Both guys and girls can get it, and it often begins in childhood. The hair usually grows back in 6 months to 2 years, but not always.
- Trichotillomania (pronounced: trik-o-til-uh-may-nee-uh). Trichotillomania is a psychological disorder in which people repeatedly pull their hair out, often leaving bald patches. It results in areas of baldness and damaged hairs of different lengths. People with trichotillomania usually need professional help from a therapist or other mental health professional before they can stop pulling their hair out.
- Hair treatments and styling. Having your hair chemically treated, such as getting your hair colored, bleached, straightened, or permed, can cause damage that may make the hair break off or fall out temporarily. Another type of baldness that results from hair styling can actually be permanent: If a person wears his or her hair pulled so tightly that it places tension on the scalp, it can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the hair follicles.
- Poor nutrition. Poor eating can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn't getting enough protein, vitamins, and minerals to sustain hair growth. Some teens who are vegetarians also lose their hair if they don't get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
- Disruption of the hair growth cycle. Some major events can alter the hair's growth cycle temporarily. For example, delivering a baby, having surgery, or getting anesthesia can temporarily stop the hair growth cycle. (Because the hair we see on our heads has actually taken months to grow, a person may not notice any disruptions of the hair growth cycle until months after the event that caused it.) This type of hair loss corrects itself.
- Male-pattern baldness. Among adults, particularly men, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-neh-tik) alopecia, also called male-pattern baldness. This condition is caused by a combination of factors, including hormones called androgens and genetics. In some males, the hair loss can start as early as the mid-teen years. It can also occur in guys who take steroids like testosterone to build their bodies.
If you see a doctor about hair loss, he or she will check your scalp and, in some cases, may take hair samples. You may also be tested for certain medical conditions that can cause hair loss.
If medication is causing hair loss, ask the doctor if a different drug can be substituted. If your hair loss is due to an endocrine condition, like diabetes or thyroid disease, proper treatment and control of the underlying disorder is important to reduce or prevent hair loss. Using a product like minoxidil that can discourage hair loss and speed up hair growth also may be helpful. Alopecia areata can be helped by treatment with corticosteroids. And if a doctor finds that nutritional deficiencies are causing your hair loss, he or she may refer you to a dietitian or other nutrition expert.
Catastrophic Hair Loss
Hair loss can be the first outward sign that a person is sick, so it may feel scary. Teens who have cancer and lose their hair because of chemotherapy treatments go through a difficult time, especially girls.
It can help to feel like you have some control over your appearance when you're losing your hair. Try some of the many options for disguising hair loss — such as wearing wigs, hair wraps, hats, and baseball caps. For most teens who lose their hair, the hair does return — including after chemotherapy. And hair loss during chemotherapy is usually a sign that the treatment is working to destroy the cancer cells because you can see how it's working on the good cells (your hair!).
Taking Care of Your Hair
Eating a balanced, healthy diet is important for a lot of reasons, and it really benefits your hair. And don't forget to treat your hair well. For example, some doctors recommend using baby shampoo, shampooing no more than once a day, and lathering gently. Don't rub your hair too vigorously with a towel, either. Many hair experts suggest you consider putting away the blow-dryer and air drying your hair instead. If you can't live without your blow-dryer, try using it on a low heat setting.
Style your hair when it's dry or damp. Styling your hair while it's wet can cause it to stretch and break. And try to avoid teasing your hair, which can also cause damage. Finally, be careful when using chemicals — such as straighteners or color — on your hair.
What is the normal cycle of hair growth and loss?
The normal cycle of hair growth lasts for 2 to 6 years. Each hair grows approximately 1 centimeter (less than half an inch) per month during this phase. About 90 percent of the hair on your scalp is growing at any one time. About 10 percent of the hair on your scalp, at any one time, is in a resting phase. After 2 to 3 months, the resting hair falls out and new hair starts to grow in its place.
It is normal to shed some hair each day as part of this cycle. However, some people may experience excessive (more than normal) hair loss. Hair loss of this type can affect men, women and children.
What causes excessive hair loss?
A number of things can cause excessive hair loss. For example, about 3 or 4 months after an illness or a major surgery, you may suddenly lose a large amount of hair. This hair loss is related to the stress of the illness and is temporary.
Hormonal problems may cause hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This hair loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your hair loss.
Many women notice hair loss about 3 months after they've had a baby. This loss is also related to hormones. During pregnancy, high levels of certain hormones cause the body to keep hair that would normally fall out. When the hormones return to pre-pregnancy levels, that hair falls out and the normal cycle of growth and loss starts again.
Some medicines can cause hair loss. This type of hair loss improves when you stop taking the medicine. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants.
Certain infections can cause hair loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines.
Finally, hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.
Can improper care of my hair cause hair loss?
Yes. If you wear pigtails or cornrows or use tight hair rollers, the pull on your hair can cause a type of hair loss called traction alopecia (say: al-oh-pee-sha). If the pulling is stopped before scarring of the scalp develops, your hair will grow back normally. However, scarring can cause permanent hair loss. Hot oil hair treatments or chemicals used in permanents (also called "perms") may cause inflammation (swelling) of the hair follicle, which can result in scarring and hair loss.
What is common baldness?
The term "common baldness" usually means male-pattern baldness, or permanent-pattern baldness. Male-pattern baldness is the most common cause of hair loss in men. Men who have this type of hair loss usually have inherited the trait. Men who start losing their hair at an early age tend to develop more extensive baldness. In male-pattern baldness, hair loss typically results in a receding hair line and baldness on the top of the head.
Women may develop female-pattern baldness. In this form of hair loss, the hair becomes thin over the entire scalp.
Can my doctor do something to stop hair loss?
Perhaps. Your doctor will probably ask you some questions about your diet, any medicines you're taking, whether you've had a recent illness and how you take care of your hair. If you're a woman, your doctor may ask questions about your menstrual cycle, pregnancies and menopause. Your doctor may want to do a physical exam to look for other causes of hair loss. Finally, blood tests or a biopsy (taking a small sample of cells to examine under a microscope) of your scalp may be needed.
Is there any treatment for hair loss?
Depending on your type of hair loss, treatments are available. If a medicine is causing your hair loss, your doctor may be able to prescribe a different medicine. Recognizing and treating an infection may help stop the hair loss. Correcting a hormone imbalance may prevent further hair loss.
Medicines may also help slow or prevent the development of common baldness. One medicine, minoxidil (brand name: Rogaine), is available without a prescription. It is applied to the scalp. Both men and women can use it. Another medicine, finasteride (brand name: Propecia) is available with a prescription. It comes in pills and is only for men. It may take up to 6 months before you can tell if one of these medicines is working.
If adequate treatment is not available for your type of hair loss, you may consider trying different hairstyles or wigs, hairpieces, hair weaves or artificial hair replacement.