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alopecia

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Hair loss

Alternative Names
hair loss, baldness

Definition
Alopecia is the medical name for baldness or hair loss. 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 from male-pattern baldness. Many other conditions can cause hair loss, however. Treatment depends on the type and cause of baldness.

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.

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 treatment of the head, usually to treat cancer
  • infections, such as a fungal infection of the scalp or a sexually transmitted disease called syphilis
  • trauma to the hair or scalp, which may include certain hair styles that constantly pull on the hair, such as tight braids
Certain diseases can also cause the condition: 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 syphilis can prevent some cases of hair loss. Early replacement of low iron or thyroid levels may also prevent some cases. Many cases cannot be prevented, but may respond to treatment.

How is the condition diagnosed?
The affected person usually notices the hair loss. A medical history and physical examination often make the doctor suspect a certain cause. Some methods used to diagnose the cause of hair loss include:
  • Scraping the affected area to collect hairs may be done. The hairs can be examined with a microscope or analysed by a laboratory to look for certain causes of hair loss.
  • A biopsy of the skin may be done in some cases. A biopsy involves taking a small piece of skin with a special tool. The piece of skin is sent to a laboratory for testing.
  • Blood tests may also be done to check for certain diseases.
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 depend on the cause of hair loss. For example, cancer is a very rare cause of hair loss that could possibly lead to death.

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. 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.

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 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
Other treatments may be used for other causes. Some people choose no treatment at all. Wigs or other artificial hair replacement can also be used if desired.

What are the side effects of the treatments?
All medications may cause side effects. For example, finasteride may cause impotence, or making a man unable to have an erection. Antibiotics may cause allergic reactions or stomach upset. Other side effects depend on the drug used.

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 doctor can frequently examine the area of hair loss to see if treatment is effective. Other monitoring depends on the cause of the hair loss.

Author: Lynn West, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request


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