Diseases & Conditions

Baldness - Hair Loss


Overview, Causes, & Risk Factors

Hair loss can occur as thinning hair or complete baldness. The hair loss may be on the head or any other part of the body that normally has hair, such as the eyebrows.

What is going on in the body?

There are many causes of hair loss. The most common form of hair loss is due to male pattern baldness, in which hair is lost from the front and top of the scalp. Other types of hair loss can create different patterns. Treatment depends on the type and cause of baldness.

What are the causes and risks of the condition?

Hair loss can be due to:

  • male pattern baldness, the most common type of hair loss, which is usually inherited from one of the parents
  • inflammation of the scalp, which can cause patchy hair loss and is often treatable
  • medications, such as chemotherapy
  • radiation therapy of the head, usually to treat cancer
  • infections, such as a fungal infection of the scalp or a sexually transmitted disease called Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();"> syphilis
  • trauma to the hair or scalp, which may include certain hairstyles that constantly pull on the hair, such as tight braids
  • Certain diseases can also cause the condition:

  • low levels of iron in the body, which may also cause anemia, or a low red blood cell count
  • hypothyroidism, which is a condition caused by low levels of thyroid hormones
  • systemic lupus erythematosus, a bodywide disease that attacks many organ systems
  • very rarely, cancer
  • Female pattern baldness usually causes thinning of the hair on the top and sides of the head. Some causes of female pattern baldness are:

  • stress, including emotional stress, surgery, illness, or rapid weight change
  • hormonal changes, including those caused by pregnancy, menopause, or use of oral contraceptives
  • hormonal imbalances, such as hypothyroidism, which is a low level of thyroid hormone
  • some medications, such as those used for gout and high blood pressure
  • high levels of vitamin A

  • Symptoms & Signs

    What are the signs and symptoms of the condition?

    The primary symptom is hair loss. Other symptoms can vary widely depending on the cause of the hair loss. Those with male pattern baldness have no other symptoms. The location of the hair loss also differs depending on the cause.


    Diagnosis & Tests

    How is the condition diagnosed?

    The affected person usually notices the hair loss. A medical history and physical exam often make the healthcare provider suspect a certain cause. Some methods used to diagnose the cause of hair loss include:

  • scraping the affected area to collect hairs. The hairs can be examined with a microscope or analyzed by a lab to look for certain causes of hair loss.
  • biopsy of the skin. A biopsy involves taking a small piece of skin with a special tool and sending it to the lab for testing.
  • blood tests to check for certain diseases

  • Prevention & Expectations

    What can be done to prevent the condition?

    There are medications available to prevent hair loss in men with a strong family history of the common type of baldness. Early treatment of fungal infections and Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();">syphilis can prevent some cases of hair loss. Early correction of low iron levels or hypothyroidism may also prevent some cases. Many cases cannot be prevented but may respond to treatment.

    What are the long-term effects of the condition?

    If not treated, hair loss can become severe. With male pattern baldness, this is the only long-term effect. Scarring of the skin can occur with certain causes of hair loss. Other long-term effects may occur, but they depend on the cause of the hair loss.

    What are the risks to others?

    Many cases of hair loss in children are due to fungal infections. These are fairly contagious and can be spread by close contact with other children or sharing combs or hairbrushes. Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();"> Syphilis, a sexually transmitted disease, is a rare cause of hair loss. Other forms of hair loss, which make up the majority of cases, are not contagious.


    Treatment & Monitoring

    What are the treatments for the condition?

    Treatment is directed at the underlying cause. Treatment may include:

  • medication for male pattern baldness, such as minoxidil and finasteride
  • antibiotics to treat a fungal or Treponema pallidum\ bacteria. Less often, syphilis is transmitted from a pregnant woman to her baby. This form of syphilis is known as \congenital syphilis.\ ',CAPTION,'Syphilis');" onmouseout="return nd();"> syphilis infection
  • stopping a medication that is causing hair loss
  • medication to treat an underlying condition, such as iron or thyroid hormone pills
  • medications applied to the area of hair loss to reduce inflammation
  • Some people may choose hair grafting, or hair transplantation, to cover areas of hair loss. There are several hair-grafting techniques, which involve taking pieces of scalp from hair-growing areas on the back or side of the head and placing them into slits on the balding areas.

    Wigs, hair weaves, toupees, and other hairpieces may be used to cover areas where hair is thin or absent. Other treatments may be used for other causes. Some people choose no treatment at all.

    What are the side effects of the treatments?

    All medications may cause side effects. For example, finasteride may cause erectile dysfunction in men. Antibiotics may cause rash, stomach upset, or allergic reactions.

    What happens after treatment for the condition?

    If treatment is successful, the hair loss stops. With male pattern baldness, treatment is often needed for life to prevent further hair loss. In some cases, treatment may allow the hair to grow back completely. Treatment may be needed for long periods of time if the underlying cause is a serious disease.

    How is the condition monitored?

    Both the affected person and the healthcare provider can frequently examine the area of hair loss to see if treatment is effective. Other monitoring depends on the cause of the hair loss. Any new or worsening symptoms should be reported to the healthcare provider.


    Attribution

    Author:Lynn West, MD
    Date Written:
    Editor:Ballenberg, Sally, BS
    Edit Date:01/30/01
    Reviewer:Eileen McLaughlin, RN, BSN
    Date Reviewed:07/27/01

    Sources

    Conn's Current Therapy, 1999, Rakel et al.