April 10, 2011— -- Everyone loses hair. It happens during your morning shower, while you're blowing it dry, or when you give it a quick brush—and that's normal. "On average, we lose fifty to a hundred hairs a day," says Francesca Fusco, MD, a New York City dermatologist who specializes in hair loss. "That's just hair going through its cycles, and there will be a new one to replace it." But hair loss may be a sign of a more serious medical condition that needs an evaluation by a dermatologist and possible treatment. Here are nine causes of hair loss and how to deal with them.
Telogen effluvium is a phenomenon that occurs after pregnancy, major surgery, drastic weight loss, or extreme stress, in which you shed large amounts of hair every day, usually when shampooing, styling, or brushing. It can also be a side effect of certain medications, such as antidepressants, beta-blockers, and nonsteroidal anti-inflammatory drugs. During telogen effluvium, hair shifts faster than normal from its growing phase into the "resting" phase before moving quickly into the shedding, or telogen, phase.
The symptoms: Women with telogen effluvium typically notice hair loss 6 weeks to 3 months after a stressful event. At its peak, you may lose handfuls of hair.
The tests: There are no tests for telogen effluvium, but your doctor may ask you about recent life events and look for small "club- shaped" bulbs on the fallen hair's roots. The bulbs mean the hair has gone through a complete cycle of growth, suggesting that the cycle may have sped up due to stress.
What you can do: In some cases, such as pregnancy or major surgery, you may have to bide your time until the hair loss slows. If medication is the culprit, talk to your doctor about lowering your dosage or switching drugs. If it's stress-related, do your best to reduce anxiety.
Hereditary Hair Loss
Hair loss that is genetic is known as androgenetic alopecia and, according to the American Academy of Dermatology, is the most common cause of hair loss. The gene can be inherited from either your mother's or father's side of the family, though you're more likely to have it if both of your parents had hair loss.
The symptoms: Women with this trait tend to develop thinning at the hairline behind the bangs, says Pamela Jakubowicz, MD, a dermatologist at Montefiore Medical Center in New York City. The condition develops slowly and may start as early as your 20s. You may be vulnerable if your mother also has this pattern of thinning. In some cases, the hair loss may be diffuse, meaning it's spread across the entire scalp.
The tests: Your dermatologist will examine the pattern of hair loss to determine if it's hereditary and may order blood work to rule out other causes, Dr. Jakubowicz says. A biopsy of your scalp is sometimes done to see if the hair follicles have been replaced with miniaturized follicles, a surefire sign of hereditary hair loss.
What you can do: Slow the hair loss by applying minoxidil (Rogaine) to the scalp twice a day. The drug works on both women and men, although women should use a lower-strength formula to prevent unnecessary side effects. Women should not use minoxidil if they are pregnant or nursing. Men may be treated with finasteride (Propecia), an oral medication.
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