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Your Hair and Your Health

Posted 4/5/2018 by UHBlog

Although hair loss is a common condition and usually is hereditary, sometimes it could indicate a medical problem. If you're concerned about why your hair is thinning out, talk to us.

Smiling middle-aged man enjoying the outdoors

The American Academy of Dermatology (AAD) says it's normal to lose about 50 to 100 hairs every day. It's usually not a big deal, because about the same number of hairs grow back to replace them. If they don't, it's most likely the result of hereditary hair loss--a condition that AAD says affects about 80 million American men and women.

But not always.

“Some hair loss can be the result of a medical problem,” says internal medicine specialist Martina Ferraro, DO, MBA. “Especially in females, abnormal hair loss can be distressing, but knowing that there may be a treatment can be reassuring.”

According to Dr. Ferraro, some common causes of hair loss for both men and women include:

  • Hereditary hair loss. “Androgenetic” hair loss – also known as male and female pattern baldness – is probably the most common cause of hair loss in men and women, Dr. Ferraro says. Women who are starting to experience hereditary hair loss probably have already seen predictable signs in their mothers’ thinning hair. A predictor for guys is their mom’s father.
    The first symptoms tend to show around the hairline, and the condition can be diagnosed with a biopsy of the scalp. Treatments includes topical minoxidil (Rogaine) for both men and women and oral Finasteride for men.
  • Telogen effluvium. A condition triggered by stress, telogen effluvium often causes hair loss one to three months after a stressful life event.
    “An event can range from getting married to having a baby to having surgery,” she says. “Hair loss is usually abrupt and the pattern is diffuse. Some patients can lose handfuls of hair, but in most cases the hair loss improves with time.”
  • Alopecia areata is an autoimmune disorder in which the immune system attacks the hair bulbs. The cause is unknown but may be triggered by illness and stress, Dr. Ferraro says. The onset is usually gradual, but the hair loss typically occurs in round patches that can be quite large.
    “Diagnosis and treatment is done by a dermatologist who can inject topical steroids into the scalp,” she says.

Hair loss may also be a shared symptom of other medical conditions in the body. Among them are:

  • Thyroid dysfunction. Although hypothyroidism – an underactive thyroid – is most commonly associated with hair loss, an overactive thyroid (hyperthyroidism) can also have the same effect, Dr. Ferraro says. Because the thyroid is responsible for the body's metabolism, underactivity can result in weight gain, dry skin and constipation along with reduced hair growth. An overactive thyroid can result in weight loss, a rapid heartbeat or diarrhea.
    “The condition can also take a toll on a person's hair,” Dr. Ferraro says. “Your doctor can test your thyroid and treat the condition.”
  • Iron deficiency anemia occurs with blood loss. It can be checked with blood tests, such as a complete blood count and iron stores (ferritin). Along with hair loss, symptoms can include fatigue and feeling cold.
  • Polycystic ovarian syndrome is a condition in which the ovaries produce too much male hormone.
    “It can result in less hair on the head and more in other places, such as the face,” Dr. Ferraro says. “A blood test for hormones can be diagnostic and treatment includes oral contraceptives and other anti-androgens.”
  • Systemic lupus erythematosus is an autoimmune disorder in which the body attacks normal tissue. Dr. Ferraro says lupus can present many symptoms besides hair loss, including joint aches, rashes and fatigue. It can be diagnosed with a blood test for antibodies and treated by a rheumatologist.
  • Heart disease. “Some studies are showing there may be a relationship between male pattern baldness at the crown of the head and heart disease,” Dr. Ferraro says. “This may be explained by loss of circulation or possibly by increased levels of testosterone that are linked to heart disease. The risk of heart disease for men with high cholesterol and severe baldness may be as much as three times greater than the risk of men with high cholesterol and no baldness. This finding could lead to early and aggressive risk modification for heart disease in both men and women.”
  • Skin disorders, like tinea capitis, seborrheic dermatitis and psoriasis can lead to hair loss, Dr. Ferraro says. Symptoms usually include intense itching. Treatment includes systemic antifungals, medicated shampoo and creams.
  • Some medications. Hair loss can also be a side effect of medications – most notably many types of chemotherapy – but also some blood thinners, beta blockers, antidepressants and anti-inflammatories.
    “A discussion with your doctor can identify potential medication causes,” Dr. Ferraro says. “In some cases, Minoxidil may help during the regrowth period.”

Another reason for hair loss can be the result of physical damage.

“Trichorrhexis nodosa is caused by excessive heat and chemicals, such as when you use a hair dryer or flat iron or have your hair colored or permed,” Dr. Ferraro says. “Trichotillomania is caused by pulling or twisting of the hair, which usually occurs in patients with anxiety or an underlying psychiatric disorder. This is sometimes treated with antidepressants and cognitive behavior therapy.”

Most causes of hair loss can be treated or controlled if they don't go away on their own, Dr. Ferraro says.

“For many conditions, biotin supplements combined with a vitamin B complex that contains B1, B2, B3, B6 and B12 may help with hair thinning and loss. If you are experiencing hair loss that is more excessive than normal, you can talk to your doctor to discuss possible causes and treatments.”

Martina Ferraro, DO, MBA is an internal medicine specialist at University Hospitals Sheffield Primary Care. You can Request an Appointment with Dr. Ferraro or any other doctor online.

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