Other Causes of Hair Loss


There are a number of causes of hair loss and many important environmental factors which can speed up the hair loss process.

As stated under male and female hair loss, the most common form of hair loss is androgenetic alopecia; hair loss due to the interaction of hormonal and genetic influences.  Androgenetic alopecia will account for the majority of male hair loss cases and slightly fewer female cases of hair loss.

There are a number of other potential causes of hair loss which can be explored.


Traction Alopecia

Traction alopecia is a form of alopecia caused by the pulling force and stress applied to your hair follicles when styling your hair.  The most common form of traction alopecia comes from males and females whom tie their hair back tightly against their scalp in a pony tail or braids style.


Telogen Effluvium

Telogen effluvium is a form of alopecia caused by an interruption in the hairs normal growth cycle.  The condition is characterised as a diffuse loss of hair density as follicles shed their hairs and then enter a dormant phase of growth.  This condition is usually onset by a sudden shock, stress, chronic illness or medications amongst other less common causes.  Telogen effluvium can be an acute (sudden) or chronic (long term) condition which causes the follicles to enter the telogen phase of the growth cycle. 

Telogen effluvium is typically self correcting and many sufferers will see their hair loss reversed over a period of time.  Permanent or chronic telogen effluvium is less common but reversal of the loss is less likely.


Unnatural Chemical Use

The human body is constantly polluted by foreign objects which affect our ability to function properly.  The function of hair follicles is not an exception to this. 

Our interaction with unnatural elements can be split in to topical substances and internal substances.

Topical substances applied to the skin or scalp may interfere with the hair follicles DNA and as such can be further deleterious to the follicles genetic sensitivity.  The use of dyes, styling products and thickening products can all denature the DNA and cell nucleus of the hair follicle.  This will affect the cells ability to create proteins which are essential in creating DNA strands and hair shafts from the follicle.

Internal substances which affect the bodies natural androgen levels will affect the rate of hair loss.  The role of Testosterone in adrogenetic alopecia is significant as it is the by-product, DHT, which binds to the hair follicle and destroys the cells nucleus. 

Testosterone can be increased through the use of a number of performance enhancing drugs used by athletes and regular gym users.  Supplements such as anabolic steroids, amino acids and creatine all assist in providing the body with additional stamina and energy.  This will allow the user to perform over and above their natural ability, thus raising the level of testosterone produced.  Increased Testosterone results in increased DHT and increased hair loss.


Autoimmune Disorders

 An autoimmune disorder can be explained as your body mistakenly identifying cells as foreign cells and attacking them.  A person with an autoimmune disorder will have an overactive immune response which spills over to cells and tissue normally present in the body.  The body’s normal response to any foreign invader (i.e. a virus) is to attack the intruder with white blood cells, however, if the body incorrectly identifies your own cells as foreign cells and attacks them, this is known as an autoimmune response.  This condition is not exclusive to hair loss but hair loss is common as the body attacks the hair follicles and surrounding tissue having wrongly identified them as foreign bodies.


Environment

The environment in which you live can make a significant impact on the speed of your hair loss.  Factors such as heat, humidity, pollution, water quality, air quality and diet can impact on your hair loss by speeding up the rate of shedding.  The scalp provides an environment for the hair to grow and any factor which is deleterious to the scalp quality will affect overall hair growth.

All the above factors can cause the scalp to become dry, damaged, manipulated or stressed and as such will provide an unsuitable environment for optimal hair growth.


Diet-related Hair Loss

Protein: There are a number of nutritional deficiencies that can cause hair loss by altering your hair's structure or hair cycles. Among these, protein deficiency is one of the most common. Your hair is composed mostly of proteins, the same materials that your nails are composed of. If your food does not provide you with enough protein then both your nails and your hair may be negatively affected. Protein is found in common foods like meats, poultry, fish, beans and dairy products. If a protein-deficient diet persists then your hair will go into a premature resting stage and will start to fall out within a few months. Unfortunately, many people simply do not eat well, or they become caught up in some fad diet. The kinds of things to watch out for are poor eating habits that lack in protein, vegetarian diets, or fad diets that restrict the amount of protein you consume.


Iron: Another possible cause of diet-related hair loss is a low level of iron in your blood, which might result from an inadequate amount of iron in your diet. Foods that are common sources of iron include potatoes, dried beans, liver, beef, fortified cereals, raisins, spinach and broccoli. An inadequate amount of iron in your blood may also result from some difficulty your body has in absorbing iron, which is commonly linked with the condition anemia.


Vitamin A:

Another nutrient that can affect your hair is vitamin A, which can be found in whole eggs, milk and liver. Both an inadequate and an excessive amount of vitamin A can cause hair loss. Too little of this vitamin can result in a condition called hyperkeratosis. It occurs in your hair follicles and in the sebaceous glands (the small glands in your skin that secrete oil into your hair) and it can complicate hair growth. Conversely, too much vitamin A can prevent proper keratinisation (the process by which a protein called keratin builds your hair and nails), resulting in a kind of hair loss referred to as 'toxic alopecia'.


Other nutritional deficiencies that can affect your hair growth include deficiencies of: essential fatty acids, zinc, copper and vitamin C. Fortunately, the damage done to hair by this type of diet-related hair loss is only temporary and can be corrected by simply improving your diet. Your dietary history is one of the first things a medical doctor who specializes in skin and hair would ask when assessing your hair loss problem. Before considering anything else, you should assess your own diet in relation to any hair loss problems you may be experiencing.


Drug-related Hair Loss

Many prescription drugs can cause varying degrees of hair loss for some people. It is likely that you have seen cancer patients who have lost hair after undergoing chemotherapy. In fact, most cancer-fighting drugs cause hair loss. In addition, close to 300 more commonly employed drugs are known to be associated with hair loss.


Drugs commonly associated with hair loss:
  • Birth control pills
  • Heart disease and high blood pressure pills, especially beta
  • blockers and ace inhibitors, like captopril
  • Blood thinners, like heparin
  • Drugs for gout and arthritis, like allopurinol
  • Antidepressants, like lithium carbonate
  • Diet drugs, like phentermin
  • Cancer-fighting drugs
  • Hormone replacement therapy
  • Drugs used to treat Parkinson's Disease, like Levadopa
  • Performance-enhancing steroids
  • Acne medications derived from vitamin A, like isotretinoin
  • Anti-inflammatories, like naproxen
  • Cholesterol-lowering drugs
  • Anti-convulsants
  • Anti-fungals
  • Drugs used to treat thyroid disorders
  • Ulcer medications, like Pepcid Dermatologists always ask about drug histories, in addition to your dietary history, before diagnosing hair loss problems. Even drugs that are not currently associated with hair loss may cause you to lose hair, so you should take your drug consumption history into consideration no matter what.

Fortunately, drug-related hair loss is easily treated by simply discontinuing use of the drug causing the hair loss. There are usually several drug options to treat every condition, so you should be able to find an alternative that does not cause you to lose your hair.


Disease-related Hair Loss

There are dozens of diseases and conditions that can result in some type of hair loss. In this section, I will outline the major classes of diseases that cause hair loss, the kind of hair loss that they cause and possible treatments that are available.

Since so many common ailments and conditions can cause you to lose hair, your recent and long-term health history is one of the first things a medical doctor would question when assessing a case of hair loss. You should also question your own medical history to determine if disease is a factor in your own hair loss. Skin diseases of the scalp

There are a number of different conditions that can affect the scalp and cause varying degrees and types of hair loss. These include: infections like syphilis and ringworm; infestations like pediculosis, which is caused by lice; inflammatory diseases like folliculitis; genetic diseases like Darier's disease and other syndromes of the skin like psoriasis. The hair loss in each case is usually only partial and can be treated.


Ringworm: Ringworm is a contagious disease that is caused by the infection of fungus. It results in small, scaly patches on the skin and, when it occurs on the scalp, is also followed by a loss of hair. It can be treated effectively with a topical solution.


Darier's disease: Darier's disease is a genetic disorder characterized by dark, crusty patches on the skin, sometimes containing pus, which results in the hair becoming rough and dry with patches of baldness.


Psoriasis: Psoriasis is a chronic skin disease characterized by scaling and inflammation. It is a disorder of the immune system that occurs when cells in the outer layer of the skin reproduce faster than normal and pile up on the skin's surface. The hair loss is reversible with treatment.

Telogenic and anagenic alopecias To understand this type of hair loss, you first need to be familiarized with the hair growth cycle. All human hairs go through a natural cycle beginning with growth, called the anagen phase, followed by a period of rest, called the telogen phase, and ending with the hair falling out. When only the hairs that belong in a particular phase fall out, we call this either anagenic alopecia or telogenic alopecia. Dozens of factors can cause either of these alopecias, including stress, chronic diseases and nutritional deficiencies. Many of these different factors send anagen hairs prematurely into the resting stage and result in excessive shedding months after. This is called telogenic alopecia. In this section we will discuss some of the more common telogenic and anagenic syndromes.


Loose anagen syndrome: This condition generally affects young, Caucasian blonde girls, although anyone is susceptible. The characterizing symptom is the ability of anagen hairs (hairs that are in the anagen, or growth, stage of the hair cycle) to be pulled out easily and painlessly. In children ages 2 to 5 years with loose anagen syndrome, the hair is usually unable to grow past the ears, though the density is otherwise unremarkable and the hair is not particularly fragile otherwise. Treatment is usually unnecessary because although loose anagen hair grows slowly, it does grow and if it is accidentally pulled out, it grows back quickly. Pregnancy and childbirth: The stress of childbirth, similar to that of a severe fever or chronic illness, can prematurely push anagen hairs into the resting stage, resulting in excessive shedding some months later. Hormonal changes that occur during pregnancy also play a part in this telogenic alopecia. The slight hair loss should fix itself within 6 to 12 months.

Alopecia Areata Hair loss may sometimes affect otherwise healthy people with good eating habits, no notable diseases or injuries to the scalp that can explain such a loss of hair. When this occurs, it is referred to as 'alopecia areata'. This unpredictable but common disease affects 1.7 per cent of the world's population. Although it can affect men and women of all ages, onset most often begins in childhood.

In most cases, the hair falls out in round patches all over the scalp and body. In some extreme and rare cases, the hair loss may lead to a complete loss of hair all over the head and body. Alopecia areata that causes complete hair loss of the scalp is called 'alopecia totalis' and when it causes hair loss over the whole body it is called 'alopecia universalis'. It is believed that alopecia areata is caused by the immune system unexpectedly, and usually temporarily, attacking the hair follicles, causing them to fall out and preventing re-growth in some cases. However, it is not known why this occurs.

Cases of alopecia areata usually disappear on their own and never occur again. If this type of hair loss persists, however, medical treatment is a possibility. Various steroids, Propecia, Rogaine, and various immunogens (drugs that interfere with the immune system) have been found to be effective in combating alopecia areata.

Although alopecia areata is not life threatening, it is so dramatic in its effects that it often damages the mental and emotional states of its victims. For this reason, many support groups have been established to help people cope with alopecia areata. You can find a local support group in most countries around the world by contacting the National Alopecia Areata Foundation via their website at www. alopeciaareata.com.


Thyroid diseases Your thyroid gland resides in your neck and is responsible for producing hormones that are involved in many of your body's functions, your metabolism in particular, making its proper functioning vital to your overall health. H ypothyroidism occurs when your thyroid is underactive, meaning it is producing inadequate amounts of hormones. When this occurs, there is a slight shedding of the hair on the scalp, and possibly of the armpits and pubic area.

An under-active thyroid gland may become enlarged due to a bombardment of thyroid-stimulating-hormones (TSH) produced by the pituitary gland, which occurs in order to entice the thyroid to produce more hormones. The result is the creation of 'goiter'.

The most common cause of hypothyroidism is a previous (or ongoing) inflammation of the thyroid gland that leaves a large percentage of the gland's cells damaged or dead. This kind of inflammation is most likely the result of autoimmune thyroiditis, which is caused by the patient's own immune system. Hypothyroidism may also be caused by certain medical treatments that, indirectly or directly, affect the thyroid gland.

The hair loss that results from thyroid disease can be reversed by treating the condition that is affecting the thyroid gland. There are many other symptoms of thyroid disease, including fatigue, weakness, weight gain, dry skin, intolerance to the cold, constipation, memory loss, muscle aches and/or depression. The proper functioning of your thyroid gland is very important and is worth seeing a medical doctor if you think you may be experiencing some or all of these symptoms.


Psychiatric and psychological diseases The most common type of psychological condition that can cause hair loss is stress. Excessive stress can cause telogenic alopecia, which is described above. Anorexia nervosa: Anorexia nervosa occurs when someone restricts their diet to such a degree that there are nutritional, endocrinal and psychological impairments. The hypocaloric diet (meaning there is an insufficient amount of calories being ingested) may result in a loss of hair. This may also be accompanied by an increase in lanugo (the fine, light hairs that cover the body) on the face, trunk and arms.

Cancer-related hair loss Neoplasic alopecias: This term refers to hair loss that results from cancer spreading from one area of the body to the scalp. The word 'neoplasic' comes from the word 'neoplasm', which means 'tumor'.

The susceptibility of the scalp to neoplasic alopecia is higher for women with breast cancer and for men with lung cancer in particular, as opposed to other types of cancer. It is believed that mucines, a certain kind of protein created by breast and lung carcinoma, degenerate the cells of the outer root sheath of the hair follicle. However, not all cases of breast or lung cancer will cause hair loss. Ovarian and adrenal tumors are also likely to cause hair loss. Both types of tumors can cause hyperandrogenism, which is the excessive production of androgens (male hormones). Androgens are known to play a key role in male and female pattern baldness. Once the tumor has been removed, however, the hair loss should go away. Cancer-fighting drugs: Most cancer-fighting drugs, like chemotherapy, attack the body, including the hair follicles, and cause considerable hair loss. The hair should grow back after the treatment has stopped.


SAHA syndrome SAHA syndrome is a skin condition that only affects women and is caused by hyperandrogenism, which is the excessive production of male hormones (androgens) and which occurs in the whole body (cases of hyperandrogenism affecting only particular parts of the body are considered different conditions).


The four main symptoms of this syndrome make up the acronym 'SAHA ': seborrhea, acne, hirsutism and alopecia. These four manifestations appear in this order, although not all women suffer from all of them. All sufferers of SAHA syndrome do experience seborrhea, however. Seborrhea is a skin condition characterized by inflammation, dry or oily scaling, crustiness and/or itching. It is so called because of the excessive production of 'sebum' (the oily secretion of the skin) that causes the condition. The acne associated with the syndrome is considered part of the condition because the increased sebum production that causes acne in this case is caused by androgenic action. Hirsutism, the third symptom, is the excessive growth of male-pattern hair in women, also caused by an increase in androgens.

The hair loss that accompanies SAHA syndrome is also caused by excessive amounts of androgens and results in typical female pattern baldness. A uniform clearing of the scalp of the crown occurs, though total alopecia is unlikely and the frontal hairline remains intact.

Treatment of SAHA syndrome includes several drug options, including the use of antiandrogens and estrogens (female hormones).

Hair loss due to external in juries to the scalp Hair loss commonly occurs as a result of something as simple as physical stress being put on the hair, the destruction of the hair follicles themselves or excessive amounts of hair being pulled out of the scalp. In these cases, we say that the hair loss is due to 'external injuries to the scalp' as opposed to a skin disease or disorder.


Cicatricial Alopecias Hair loss may occur due to the destruction of the hair follicle. In this case, the skin of the scalp is somewhat like scar tissue and is therefore unable to produce hair, meaning that the hair loss is permanent and the only option is surgical treatment.

This destruction of the hair follicles can result from mechanical, physical or chemical trauma (which may include the use of acids, chronic traction, electrical or thermal burns, or freezing), as well as tumors, special skin diseases or severe infections such as syphilis. The destroyed hair follicles may not necessarily cover the entire scalp, depending on the method and type of damage. Again, the only option for this kind of hair loss is surgical treatment.


Trichotillomania Hair loss among children can occur as a result of a usually unrecognized behavioral disorder known as trichotillomania. It is characterized by uncontrollable hair pulling, similar to impulsive disorders such as pyromania or kleptomania. The disorder usually appears in males at the age of 8 and in females at the age of 12 and has a prevalence of about one per cent.

Sufferers of trichotillomania generally spend about one hour per day pulling their hair out. This can last for a few seconds or minutes, or it may last for prolonged periods of time. Some may try to resist the urge, while some are unaware of its occurrence, pulling hair absent-mindedly while driving, reading or watching television.

While the disorder itself is a stressful condition, the hair loss that results is an unfortunate additional complication that affects many children and teenagers psychologically and emotionally. The hair loss that occurs is usually focused on the scalp, but it may also occur among the eyebrows, eyelashes and pubic region. Hair loss is usually patchy, irregularlyshaped and occurs most often on the side of the body that coincides with the person's predominant hand. Most sufferers of trichotillomania are likely to feel embarrassed about the disorder and may try to hide their hair loss, prolonging diagnosis and complicating treatment.


Treatment for trichotillomania involves behavioral therapy and/or medication. Possible drugs include mood stabilizers, anxiolytics (drugs that work on the central nervous system to relieve anxiety), neuroleptics (also known as antipsychotics) and topical agents including steroids. However, behavioral therapy has been found to be more effective than drug therapy, especially if the hair pulling has only been occurring for less than 6 months and because there are no clear guidelines for how drugs should be used to treat trichotillomania. With therapy, sufferers of trichotillomania can overcome this disorder and resume their normal lives without worry of uncontrollable urges or hair loss.


Hair loss due to poor hair care The effects of poor hair care on hair loss are significant. Unfortunately, there are many styling habits and treatments that are bad for the overall health of your hair and that promote hair loss. Hairstyles that require unusual pulling, dying or conditioning may severely stress the natural workings of your hair and may lead to unusual balding.

When a high degree of physical stress is constantly being put on the hair for styling purposes, hair loss may occur. This condition is referred to as 'cosmetic alopecia'. It is usually caused by the constant use of curlers, brushes and other tools used to style hair as well as hairstyles that pull the hair. The alopecia appears as a slight shedding of the hair and occurs because the strain that the hair is put under leads to reduced blood flow in the capillaries at the bottom of the hair follicles. The hair's growth is stunted and eventually leads to a slight loss of hair a few months later. This usually affects the triangular areas above and in front of the ears, though it is dependant on the direction in which the hairstyle is aimed. It is also possible to damage the hair follicles and or the scalp itself with the constant use of chemicals used to curl or dye the hair. In most cases of cosmetic alopecia, the reduced blood flow that causes the hair loss disappears after the pressure is removed, although the shedding may take a few months to return back to normal.