Pete, 49, has a family history of hair loss. His father and grandfather had receding hairlines in their thirties. Tiffany, 53, is suffering from significant stress at work and has noticed she is losing clumps of hair from her scalp following a total hysterectomy a month ago. The cause of hair loss determines what the treatment will be.
Both patients will experience hair loss without scarring, but will have different treatment options.
Male pattern baldness
The most common type of hair loss without scars is known as androgenetic alopecia, also known as male pattern baldness or female pattern baldness.
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In men, it is characterized by a gradual thinning of the hair on the crown and frontal part of the scalp.
Similarly, hair loss in women usually affects the crown and frontal areas of the scalp.
In contrast, hair loss in women is more diffuse than in men. Rarely do women develop completely bald patches.
Several reasons for female pattern baldness may be related to aging, hormonal changes, a family history of hair loss or male or female pattern baldness, or certain medications.
Both men and women can take Minoxidil (also known as Rogaine). It is applied directly to the scalp and is available without a prescription.
To know if it is effective, you must continue to use the Minoxidil for at least four to six months.
It is important to note that Minoxidil treatment should be continued indefinitely. If you stop using it, any hair that has been retained or grown back will be lost.
As with any medication, there are side effects. Topical Minoxidil can cause redness or irritation of the scalp, resulting in itching.
Another option for men is Finasteride (brand name: Propecia), a prescription drug that comes as a pill. It can be used dsolo or with Rogaine.
Because of the side effects, most of the patients prescribed Propecia are male and Finasteride cannot be safely used during pregnancy.
In female patients, spironolactone is a prescription drug that comes as a pill. Due to its effects on hormones, spironolactone is not used in men and should not be used during pregnancy.
Stress-related hair loss
A second type of hair loss without scars is telogen effluvium. It can be associated with stress, medications, thyroid disease, or after giving birth.
This type of temporary hair loss can be caused by a stressor or a change in your body.
Both men and women can develop telogen effluvium with no apparent cause between the ages of 30 and 60.
Usually, Telogen Effluvium appears on the top of your head and it usually does not affect the hairline or cause complete baldness. However, in some severe cases, it can affect your eyebrows and body hair.
What is alarming for patients is that Telogen Effluvium sheds heavily and has rapid hair loss. Hair loss in men and women, on the other hand, is slowly thinning.
Although Telogen Effluvium does not affect your physical health, it can affect you psychosocially and psychologically.
Finally, alopecia areata is a form of non-scarring hair loss that can range from mild to severe.
Most patients with alopecia areata have only a few circular patches of hair loss on the scalp or body. Some others may experience a more extensive involvement of hair loss.
When the cases are mild, traditional treatments like steroid injections can be given to the hair loss areas.
In more severe cases, there are multiple options to try, such as taking prednisone for six weeks or taking a new class of medications called JAK inhibitors. Although hair loss has decreased during the use of the medication, it will continue to fall out when the treatment is stopped.
In short, losing your hair can be frustrating and devastating. While it’s normal and not uncommon to lose hair as you age, it can erode your self-esteem and confidence as society reinforces the message that a youthful appearance is more attractive with a full head of thick hair. Unfortunately, people who experience hair loss may struggle with low self-esteem or other body image issues.
If you are struggling with the depression, anxiety, or stress of losing your hair, talk to a health care professional who is knowledgeable about the diagnosis and treatment of hair loss.
Susan Hammerling-Hodgers, a member of the National Psoriasis Foundation, is PA-C (Certified Physician Assistant) and MPAS (Master of Physician Assistant Studies) and works at Brevard Skin and Cancer at the Merritt Island, Titusville, and Rockledge offices.
This article originally appeared on Florida Today: Causes and Treatments for Thinning Hair in Men and Women