Losing roughly 100 hairs per day is considered normal, but large amounts of shedding or thinning hair should be evaluated by a dermatologist. Dermatologists specialize not only in the skin but in the management of conditions affecting the the hair and nails also and both men and women can be affected.
Male or female pattern hair loss is also known as androgenic alopecia. This is hair thinning that occurs commonly with age. It has a strong genetic component from both the mother or father’s side and can start even as early as 20 years of age. Typical pattern hair loss in women is a widened frontal part or thinning most noticeable on the frontal scalp. Treatment options include Rogaine, Spironolactone, Finasteride, Minoxidil, PRP and Hair Transplants. Most often combination therapies are needed.
Alopecia Areata is an autoimmune type of hair loss and presents with a sudden appearance of round or round patches of baldness anywhere on the scalp (or less often in beard area). Alopecia areata can have a variable presentation and hair can fall out and grow back at any time and seemingly without a pattern. This condition can be aggressive and total body hair lost can occur (alopecia universalis) and it is very difficult to regrow this hair. Much commonly, alopecia areata is fully reversible with steroid injections into the bald areas.
Traction alopecia can occur with chronic tension on the hair follicle depending on styling of hair. The typical presentation is a recession of the frontal and temporal hairlines. This hair loss often occurs in the African-American population as a result of braiding or tight extensions. Removing the tension on the hair follicle will stop the progression of damage, but it can be permanent.
Hair loss can occur due to an underlying medical condition such as thyroid disease, or anemia, can present immediately or with a slow progression. The medical abnormalities can be detected with simple blood work and can then be corrected with medications or supplements. The hair loss may take months or even longer to recover.
Telogen Effluvium is a hair loss that occurs after psychological or physiological stress. This can present after giving birth, or loss of a loved one but any significant stress on the body can induce this reaction. Essentially, the body focuses its attention elsewhere and forces a higher proportion of hairs into the shedding, or telogen, phase than is normally the case. These stressors include high fever, crash diet/sudden weight loss, medication change (including birth control pill), significant surgery, or significant emotional stress (such as divorce, death of a family member). This also presents with increased shedding and generalized thinning over the entire scalp. Once there has been a full recovery from the stressor, the hair loss may again take months or even a year to reverse. Medications are not needed in the treatment of this condition.
There are many other types of hair loss not included in the catergories above and an inperson consultation and workup may be necessary for treatment.