More than 80 percent of men and nearly half of women will experience significant hair loss during their lifetime. For many people, hair loss begins well before middle age. Dermatologist Jerry Shapiro, M.D., a world-renowned expert and leading authority on hair loss at the Ronald O. Perelman Department of Dermatology at NYU Langone College, discusses the causes and treatments for this incredibly complex problem. I will explain the law.
It’s not just about age
A typical scalp contains approximately 100,000 to 150,000 hairs. Typically, 50 to 100 pieces are shed each day once the growth cycle is complete. “When hair loss exceeds growth, the result is alopecia (the medical term is alopecia),” Dr. Shapiro explains. The most common type in both men and women occurs when the follicles become overly sensitive to hormones and worsen. As a result, the growing season is shortened and eventually growth stops. Alopecia becomes more prevalent as we age, but by the age of 30, one in four men will suffer from alopecia.
Physical and mental stress may play a role
Alopecia causes 95 percent of hair loss in men and approximately 40 percent in women. However, hair loss can have many other causes. Some people suffer from autoimmune diseases that cause scattered patches of hair loss. Hair loss can also be caused by abnormal stress. “I call these the three Bs: bereavement, bankruptcy, and separation,” says Dr. Shapiro. Other causes include chemotherapy, pregnancy, menopause, anabolic steroids, smoking, high doses of vitamin A, and some prescription drugs. The same goes for forcibly pulling your hair or putting it in a tight ponytail. “If you notice a lot of hair growing in places you don’t usually see, like your pillow, see your doctor,” advises Dr. Shapiro.
Diagnosis may require some investigation
Diagnosis begins with a detailed patient medical history, possible triggering events, and a list of relatives with hair loss. Next is a scalp examination. The dermatologist may pull the hair to see how many hairs break, or use equipment to examine the hair under a microscope without removing it. Doctors may order blood tests to check people for signs of skin disorders or hormonal problems (such as excessive facial hair in women).
Treatment includes medications and surgery
If hair loss is caused by a medical condition, the hair will often regrow once the underlying problem is resolved. There are two FDA-approved medications for male pattern baldness. For female pattern baldness, there is only one. However, the most effective and only permanent treatment is hair transplantation. A dermatologist harvests healthy hair follicles from areas of dense growth and transplants them where needed. Hansjorg Wiss Plastic Surgery Department at New York University Langone offers a less invasive approach that uses air pressure and suction to remove hair follicles rather than incisions. Dr. Shapiro says, “The results can be dramatic.”
