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September 2, 2010
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Hair Loss in Men and Women

Medical Authors: Nili N. Alai, MD, FAAD, and Alan Rockoff, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Hair Loss and Stress

Is there a correlation between hair loss and stress?

Learn whether stress causes hair loss.Medical Author: Melissa Conrad Stöppler, MD
Medical Editor: William C. Shiel Jr., MD, FACP, FACR

Both emotional and physical stress (such as a serious illness or recovery from surgery) have been associated with hair loss. It is possible that stress induces hormonal changes that are responsible for the hair loss, since hair loss is a known consequence of other hormonal changes due to pregnancy, thyroid disturbances, or even from taking oral contraceptives.

Nervous habits, such as scalp rubbing or hair twisting or pulling may also be responsible for hair loss. These habits may be responses to psychological stress in some people and may be another cause of stress-related hair loss. Excessive hair-pulling is a form of impulse-control disorder medically referred to as trichotillomania.

Learn more about how stress may cause hair loss »


What are causes of hair loss?

There are many causes of scalp hair loss, and they do differ in men and women. This article will cover the common ones. Studies show that losing up to 100-150 hairs per day is normal. Human hair naturally grows in three phases: anagen, catagen, and telogen. Anagen is the active or growing phase. Catagen is a fairly short phase of the natural hair cycle during which hairs begin to break down. Telogen is the resting phase. The hairs that are shed daily are often in the resting or late phase in the hair cycle. Normally, about 10% of the scalp hairs are in the resting or telogen phase at any time. These hairs are not growing and are getting prepared for cyclic shedding.

In general, most hair loss is not associated with systemic or internal disease, nor is poor diet a frequent factor. Frequently, hair may simply thin as a result of predetermined genetic factors, family history, and the overall aging process. Many men and women may notice a mild and often normal physiologic thinning of hair starting in their thirties and forties. Other times, normal life variations including temporary severe stress, nutritional changes, and hormonal changes like those in pregnancy, puberty, and menopause may cause a reversible hair loss.

Notably, several health conditions, including thyroid disease and iron deficiency anemia, can cause hair loss. While thyroid blood tests and other lab tests, including a complete blood count (CBC), on people who have ordinary hair loss are usually normal, it is important to exclude underlying causes in sudden or severe hair loss. If you are concerned about some other underlying health issues, you may start by seeing your family physician, internist, or gynecologist for basic health screening. Dermatologists are doctors who specialize in problems of skin, hair, and nails and may provide more advanced diagnosis and treatment of hair thinning and loss. Sometimes a scalp biopsy may be taken to help in diagnosis of severe or unexplained hair loss.

Although many medications list "hair loss" among their potential side effects, drugs are also not overall common causes of thinning or lost hair. On the other hand, with cancer treatments and immune suppression medications including chemotherapy, hair loss is a very common side effect. Complete hair loss often occurs after a course of major chemotherapy for cancer. Usually, hair regrows after six to 12 months.



Next: How is hair loss classified? »

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Hair Loss

What is alopecia areata?

Alopecia areata is a hair-loss condition which usually affects the scalp. It can, however, sometimes affect other areas of the body. Hair loss tends to be rather rapid and often involves one side of the head more than the other.

Alopecia areata affects both males and females. This type of hair loss is different than male-pattern baldness, an inherited condition.

What causes alopecia areata?

Current evidence suggests that alopecia areata is caused by an abnormality in the immune system. This particular abnormality leads to autoimmunity. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune cells inside of the hair follicles where they are not normally present. What causes this is unknown. Alopecia are...

Read the Alopecia Areata article »








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