What Causes Your Hair to Fall Out?

Hair loss (alopecia) is a common complaint that may be due to a wide variety of causes from medical conditions and hormones to genetics and aging. Hair loss may be temporary or permanent.

Hair loss can affect the scalp and hair on other parts of the body. Symptoms of hair loss include: 

• Receding hairline
• Bald patches
• Thinning hair
• Brittle hair
• Hair loss in the shower
• Body hair loss

Common causes of hair loss include:

• Genetics
  • Male pattern baldness
  • Female pattern baldness
• Hormones
  • Pregnancy 
  • Changes in birth control (going on or off hormonal birth control or changing contraception) 
• Extreme stress (called telogen effluvium)
  • Major events such as death of a loved one, divorce, moving, job loss
  • Hair loss often occurs a few months after the major stressful event and hair will grow back once stresses end
• Certain medications 
  • Medications to treat high blood pressure, cancer, arthritis, and depression may cause hair loss
• Dandruff or scalp psoriasis
• Harmful hair care practices
  • Chemical processing
  • Excessive brushing or teasing of hair
  • Application of excessive heat
  • Wearing tight braids (traction alopecia)
• Nutritional deficiencies
  • Deficiencies in iron, zinc, vitamin B3 (niacin), fatty acids, selenium, vitamin A, vitamin D, vitamin E, folic acid, biotin, and protein may cause hair loss
• Autoimmune diseases
  • Alopecia areata, in which the body’s immune system mistakenly attacks hair follicles
  • Thyroid disease
  • Rheumatoid arthritis
  • Sickle-cell anemia

The cause of hair loss is diagnosed with a physical examination of the scalp along with a history of symptoms. Tests that may be indicated to help determine the cause of the hair loss include: 

• Dermoscopy of the hair and scalp (trichoscopy) 
• Hair pull test 
• Examination of other parts of the body 
  • Depending on the disorder, additional hair, nail, skin, tooth, or other abnormalities may help with diagnosis

Treatment for hair loss depends on the cause. 

• Male and female pattern baldness
  • Minoxidil (Rogaine): available over-the-counter for men and women
  • Finasteride (Propecia): available by prescription, meant for men, though may be used in women who have been through menopause
  • Spironolactone (Aldactone): available by prescription, may help some women who do not have good results with minoxidil. It is not safe for use during pregnancy.
• Hormones
  • Hair loss due to pregnancy is temporary and hair will grow back on its own within a few months after giving birth
  • Volumizing shampoos and conditioners may help hair look fuller
• Extreme stress
  • Volumizing shampoos and conditioners may help hair look fuller
  • Different styling techniques may also help
• Certain medications 
  • Hair loss is usually temporary
  • Talk to your doctor about switching medications if the side effect is bothersome
  • Never stop taking a prescribed medication without firs talking to your doctor 
• Dandruff or scalp psoriasis
  • For dandruff: over-the-counter shampoos containing zinc pyrithione or exfoliating ingredients such as the classic Head & Shoulders Classic or Oribe Serene Scalp Anti-Dandruff Shampoo 
  • For scalp psoriasis: 
    • Medicine applied to the scalp
    • Medicated shampoos
    • Scale softeners
    • Injections
    • Light treatments
    • Biologics and other medicines 
• Harmful hair care practices
  • Don’t use hot tools for hair styling
  • Avoid harsh chemical processes 
  • Don’t brush hair aggressively 
  • Don’t wear a tight braided hairstyle for too long
• Nutritional deficiencies
  • Talk to a doctor about correcting nutritional deficiencies
  • In some cases, over-the-counter supplements may be sufficient and in other cases prescription supplementation or dietary changes may be needed
• Autoimmune diseases
  • For alopecia areata:
    • Steroids: injected or applied directly to the scalp (for example, as a liquid, gel, foam, lotion, or cream)
    • Topical immunotherapy
    • For other autoimmune conditions: treating the condition may help reduce or eliminate hair loss