Is your hair falling out? Is it growing in places that it shouldn’t? While some hair loss or growth can be normal, there are a variety of medical conditions or specific life changes that can lead to abnormal hair loss or growth.
Let’s talk about what changes in your hair might mean for you and your health.
First things first: What is abnormal?
The human head has approximately 80,000 to 150,000 strands of hair. Although it’s normal to have periods of hair growth and hair loss, abnormal changes to your hair can often be important clues to your health.
Remember that what is normal for your friends and coworkers might not be normal for you, and vice versa.
The definition of what is “normal” must also consider race and ethnicity. For example, most Asian and Native American women have little body hair, while Middle Eastern and Mediterranean women (on average) have greater quantities of body hair.
So, just remember that what is normal for your friends and coworkers might not be normal for you, and vice versa.
With that in mind, let’s dive into a few of the most common ways your hair can be an indicator of your overall wellbeing.
The average person loses anywhere from 50 to 150 hairs per day, so hair loss is not an immediate cause for concern. If you don’t shampoo your hair daily, you may notice more hair loss at one time due to manual dislodging of hairs that would have otherwise been progressively shed over time.
Patches of hair loss or bald spot
Is there one focal area of hair loss? This is referred to as Alopecia areata, an autoimmune process in which hair loss occurs in patches. A dermatologist can use steroids to help the area regrow hair. Contact your doctor to arrange a dermatology referral.
Stress-induced hair loss
If you have been undermajor physical, emotional or psychological stressors and are losing hair, you may have a condition called Telogen Effluvium. This is diffuse hair loss that occurs two to three months after a stressful event. Your hair growth should return to normal within a few months after removal of the offending stress, but it’s a good idea to talk to your doctor if you are experiencing severe stress.
You may want to ask yourself these questions to see what’s going on underneath the surface.
- Have you changed your diet by restricting calories or protein?
- Have you taken any new drugs, or had recent illness or surgery?
- Are you under personal stress?
- Have you recently given birth?
Hair loss in men
Many men experience hair loss as they age. This type of hair loss is slowly progressive and is distributed typically on the crown of the head and forehead. It is usually due to genetic factors passed down from the maternal DNA. This can be treated with over-the-counter remedies or certain prescription medications if needed.
Hair loss in women
As women age and hormones change, many women develop hair thinning on the front and crown of the head like male pattern hair loss. This can be due to hormone imbalances or excess androgens such as testosterone. If you have been prescribed a hormone replacement therapy that includes testosterone, you may develop this type of hair loss as a side effect.
Check with your doctor about how to maintain normal levels of testosterone and estrogen as you age to avoid this type of hair loss.
This is a disorder in which people repeatedly pluck hairs from their scalp or other areas of the body. It is usually irregular and bizarre in shape. This is a psychological disorder that can be treated with counseling. If you find yourself compulsively plucking out hairs, your doctor can help.
Hair breakage is called Traction Alopecia. The good news is, hair breakage usually is not due to an underlying medical concern. Common causes of this are tight hair braids or ponytails, and excessive use of heated hair styling tools. Avoid use of very hot hair dryers, curlers or straighteners, and allow your hair to dry naturally and relax at night without the use of hair bands.
When hair is thinning throughout the entirety of your scalp, you may want to talk to your doctor to rule out hormonal imbalance, anemia or vitamin deficiencies.
Vitamins like biotin are helpful in maintaining healthy hair.
If you are trying to lose weight and have made significant dietary restrictions, you may be losing hair due to nutrient deficiencies or lack of enough protein and calorie requirements to maintain hair growth. It is important to maintain a healthy well-balanced diet, including fruits and vegetables, adequate protein intake and plenty of water. These actions can help you feel your best and keep your hair healthy.
Vitamins like biotin are helpful in maintaining healthy hair. Biotin can be found in egg yolks, liver, soybeans and yeast-containing products.
Dry, dull or brittle hair
If your hair has become dry and coarse, or you have developed brittle nails, you may want to talk to your doctor. These are common signs of a condition called hypothyroidism, an autoimmune disorder of the thyroid gland that is treated with thyroid hormone replacement medication.
Check with your doctor about screening for abnormal thyroid function.
Excess female facial hair
Hair growth on the chin, jawline or upper lip area is called hirsutism. This affects between 5 and 10 percent of women of reproductive age and is usually influenced by hormones called androgens like testosterone from the ovaries or dehydroepiandrosterone sulfate (DHEAS) from the adrenal glands.
Excess androgens can cause hair growth on the upper lip, chin, breastbone, upper abdomen, back and buttocks. It can also lead to hair loss on the scalp. Common causes of this include:
- Hormone replacement therapy
- Polycystic ovarian syndrome (PCOS): You may need blood work and an ultrasound to determine if you have PCOS.
- Obesity: Weight loss can also be helpful to regulate hormones back to a natural cycle.
Dandruff or flaky, itchy scalp
If you have thick development of dried skin that is hard to scrub off, you may have Seborrheic Dermatitis, or dandruff. This is often an allergic reaction to certain soaps or shampoos but is a type of eczema that can easily be treated by removal of the offending agent.
Most dermatologists recommend using a soap or shampoo low in fragrances or added chemicals, as this may be irritating to your scalp. It can be treated with a selenium sulfide shampoo or prescription ketoconazole shampoo.
When to talk to your doctor about your hair
Anything sound familiar? If you’re worried about abnormal changes to your hair or scalp, consult your doctor. They can help you determine if this is a natural process due to external stressors or if there is an underlying condition behind your symptoms.
Your doctor will likely review your allergies, medication list and diet, and potentially check blood work for things like anemia, vitamin deficiency, thyroid disorders or hormonal abnormalities.
But before you panic, take a deep breath. Chances are, any changes to your hair are probably caused by natural processes or normal life stressors and not a reason for you to worry.
Don’t have a primary care physician? Find one near you.
About the author
Brighton Miller, DO, is a family medicine physician on the medical staff at Baylor Scott & White All Saints Medical Center – Fort Worth. Make an appointment with Dr. Miller today.