Scalp Hair Loss – Causes of Balding in Men and Women

Most of us are concerned about hair – its color, texture, length or bulk. However, our greatest concern often arises when there is loss of hair. It is a common concern for both men and women. Hair loss is a natural process that occurs very slowly everyday but is almost never noticed since the lost hairs are constantly replaced by the growth of new hairs. However, there is a point where the hair loss can become visible.

What is balding?

Balding is partial or complete hair loss on the scalp. It may refer to just one area of the scalp, like hair loss only on the top of the scalp. Sometimes it involves the entire scalp. Hair loss can also occur on multiple areas of the body simultaneously although the term balding is reserved for varying degrees of hair loss on the scalp. There are many different types of hair loss and patterns by which it occurs as well a host of causes.

Sometimes the hair loss is temporary and hair growth restores once the underlying cause is restored or the cycles of growth shift. At other times hair loss may be permanent and the follicles cannot be stimulated to restore hair growth. Although balding is common in males, it can also occur in females. Some of the causes of hair loss in males and females may occur for different reasons.

Causes of Hair Loss

Hair growth is a influenced overall health and any condition that severely impairs health can result in hair loss even if the condition/disease does not involve the scalp. Some of the more common causes of balding in both men and women has been discussed below. It is important to consult with a doctor, and preferably a dermatologist or trichologist, to identify the exact cause of balding.

Male Pattern Baldness

Androgenetic alopecia is the most common cause of baldness in males. It is due to a combination of genetic factors and androgen (male sex hormone) levels although other factors may also be at play. This type of balding can also occur in women and is then referred to as female pattern baldness. It tends to be more common in postmenopausal women but may also affect women earlier in life, even during their fertile years of life.

Read more on androgenetic alopecia.

Autoimmune Hair Loss

Alopecia areata is a type of hair loss which appears to be due to autoimmune factors. The immune system targets and attacks th hair follicles, leading to damage of the follicles and a cessation of hair growth. This results in patchy hair loss with total loss of hair on a circumscribed area of the scalp. However, the hair follicle damage is usually not permanent. Both men and women are affected.

Dormant Hair Follicles

Telogen effluvium is a condition where the hair follicles in a certain area remains in the resting phase (telogen) for a prolonged period of time. The exact reason why this phase becomes prolonged is unclear but is often associated with psychological or emotional stress. Pregnancy, childbirth, nutritional deficiencies, severe trauma and infections, major surgery, medication, heavy metal toxicity, hypothyroidism and other chronic diseases may also be triggers.

Fungal Infection (Ringworm)

A fungal infection of the scalp, known as tinea capitis, is a common type of dermatophyte infection. It is also referred to as scalp ringworm. The fungal infection can occur inside the hair shaft or outside the shaft. Hair loss may occur but it is not always permanent unless there is scarring of the scalp, usually with secondary bacterial infections. Antifungal treatments can resolve the infection and hair growth may then be restored.

Read more on scalp ringworm.

Underactive Thyroid

Another common cause of hair loss is hypothyroidism (underactive thyroid). It can arise for a number of different reasons, ranging from infections to autoimmune diseases affecting the thyroid gland. The low thyroid hormone levels affects all cells in the body to varying degrees, including the cells of the hair follicles. Hypothyroidism is more common in females therefore hair loss due to an underactive thyroid gland appears more common in women.

Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a condition where cysts arise in the ovaries and is associated with elevated levels of androgens (male sex hormones) in women. PCOS is believed to affect as many as 1 in 10 women of childbearing age and is one of the most common causes of infertility.  Despite scalp hair loss, abnormal hair growth can occur on other parts of the body like facial hair in women.

Pregnancy and Childbirth

Some women may experience hair loss during pregnancy or just after childbirth. While this is often associated with the hormonal changes during and after pregnancy, there may be other pregnancy and childbirth-associated cause of hair loss. This include nutritional deficiencies, pregnancy-related thyroid conditions, psychological stress, postpartum depression and other conditions.

Oral Contraceptives and Other Drugs

The oral contraceptive (birth control pill) is possible cause of hair loss in some women, usually with a family history of balding. Hair loss can also occur as a side effect of various other drugs, including certain medication used for arthritis, chemotherapy (cancer drugs), depression, heart disease (including blood thinners) and high blood pressure. It may also be observed with excess vitamin A intake.

Nutritional Deficiencies

Healthy hair growth is dependent on proper nutrition and deficiencies may result in hair loss. While this can be seen with prolonged nutritional deficiencies, sometimes a sudden and even short-term disruption in nutrition can affect hair growth. The latter may be observed with extreme fasting and dieting. It is more likely to affect growth if proper nutrition is not restored after the period of fasting or dieting.

Hair Styling and Hair Care Products

Strain on the hair shafts and follicles may also result in hair loss. This can occur with tight hairstyles although it is not usually a permanent hair loss. Some hair care products may also contribute to hair loss. This is more likely to be seen with excessive or incorrect use of products to straighten hair or bleach/dye the hair as part of a color change. Hair dye allergies may be one of the reasons for this hair loss but only affects people who are sensitive to substances like PPD that are found within certain dyes.

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