Everyone loses some hair
every day. Losing up to 100 hairs a day is normal.
But if hair
loss runs in your family, you could lose a lot more hair. With this kind of hair loss, you may
end up with bald spots if you are a man. If you are a woman, you may find that the hair on the top of your head is slowly thinning. About half of all
people have this type of hair loss by around age 50.
Although hair loss is fairly common, it can be a tough
thing to live with, especially when it changes how you look. But there are ways
you can treat your hair loss.
What causes hair loss?
Common causes of hair loss
Family history. In most cases, hair loss is
inherited, which means it's passed down from one or both of your parents. This
is called male-pattern or female-pattern hair loss.
including physical stress from surgery, illness, or high
Chemotherapy, which is powerful
medicine that destroys cancer cells.
Damage to your hair from
pulling it back too tightly, wearing tight braids or ponytails, or using
curling irons or dyes.
Age. You grow less hair as you get
older. Hair also gets thinner and tends to break more easily as you age.
Poor diet, especially not getting enough protein or
Your symptoms will depend
on what kind of hair loss you have.
If your hair is thinning, it
happens slowly over time, so you may not notice the hairs falling out. If your
hair is shedding, then clumps of hair fall out. You may lose hair all over your
scalp, which is called general hair loss. Or you may lose hair only in one
area, which is called focal hair loss.
With inherited hair loss,
men usually get bald spots around the forehead or on the top of the head, while
women have some thinning all over the scalp, but mostly on the top of the head.
Since your hair has a lot to do with your
appearance, losing it may cause you to have lower self-esteem if you don't like
how you look. This is especially true in women and teens.
How is hair loss diagnosed?
Your doctor will ask
you some questions, like how much hair you're losing, when it started, and
whether your parents have hair loss. He or she will look closely at your scalp
and hair loss pattern and may gently pull out a few hairs for tests.
If it's not clear what's causing you to lose your hair, your doctor may
do a blood test or look at a sample of your hair or scalp with a
How is it treated?
How you choose to treat your
hair loss depends on the cause. It also depends on your feelings. You may
decide that you need treatment, or you may not be worried about thinning hair
or baldness. The choice is up to you.
If hair loss is caused by something that won't last or can be treated, your hair is likely to grow back. For example, if an underactive thyroid is causing the problem, taking thyroid medicine may help. And most hair lost during chemotherapy will grow back after the treatment ends.
Hair loss that runs in the
family can be treated with medicines or hair
transplant surgery. Some people choose to wear hairpieces, like wigs or toupees (say
"too-PAYZ"). Finding different ways of styling your hair, like dyeing or
combing, also can help.
If hair loss is caused by something you can control,
like stress or medicines, you can treat it by getting rid of the cause.
When you are deciding about treatment, think about these
Which treatment is most likely to work?
long will it take?
Will it last?
What are the side
effects and other risks?
How much will it cost, and will insurance
Will your hair grow back?
When your hair loss is
inherited, your hair won't grow back naturally. Treatment can help some hair
grow back and prevent more from falling out, but you probably won't get all
your hair back. And treatment doesn't work for everyone.
medicines, stress, or hair damage cause you to lose your hair, it often will
grow back after you take away the cause. If this doesn't help, you may need
If you're unhappy with how hair loss makes you
look, treatment may help you feel better. It's natural to want to like the
way you look.
Losing a lot of
hair (more than 100 hairs a day) can be caused by
inherited factors, disease, stress, medicines, injury, aging, or hair care.
Inherited hair loss
The most common cause of hair
genetics—you inherit the tendency to lose hair from
either or both of your parents. This is called male-pattern hair loss or
female-pattern hair loss. The medical term for this type of hair loss is
In this type of
hair loss, your
genes affect how your hair grows. They trigger a
sensitivity to a class of hormones called
androgens, including testosterone, which causes
hair follicles to shrink. Hair follicles are the openings that hair grows from.
Shrinking follicles produce
thinner hair and eventually none at all. Men generally develop bald spots on
the forehead area or on the top of the head, while women often have thinning of the hair on the top of the head. About half of all people have
inherited hair loss by about 50 years of age.
Mental stress or physical stress, such as recent surgery,
illness, or high fever. You may have a lot of hair loss 1 to 3 months
after severe physical or emotional stress. Your hair usually will grow back
within a few months.
Hair styling and products. Pulling your hair back too
tightly or wearing tight braids or ponytails can cause hair loss. You may lose
hair around the edge of the hairline, especially around the face and forehead.
Using curling irons or dyes a lot can also result in hair loss. Hair
usually grows back when you stop doing these things.
Age. As you age, your hair tends to break more easily, and hair
follicles do not grow as much hair.
Poor nutrition, especially lack of
iron in the diet. Hair returns after you change your
diet to get enough of these nutrients.
Alopecia areata, an
autoimmune disease in which your immune system attacks
hair follicles, resulting in round hairless patches on any area of the
scalp or body. Severe cases involve many bald patches of hair or complete loss
of hair on the scalp or body, although in some cases there is hair thinning
without distinct patches of baldness. The hair loss usually is not permanent. Hair grows back within 1 year for many people.
Diseases, such as
syphilis, or cancer. Hair may grow back on its own,
although you may also need treatment.
Side effects of
medicines or medical treatments, such as blood
thinners (anticoagulants) or
chemotherapy. Hair usually grows back after you stop
using the medicines or when the treatment is over.
Trichotillomania, a compulsive behavior in which a
person pulls hair out of the scalp, eyelashes, or eyebrows. There is usually
mounting tension before pulling and a feeling of relief afterward.
Trichotillomania often results in noticeable hair loss.
the scalp, including scarring.
Changes in hormone levels. Childbirth, taking birth control
pills, or changes in a woman's
menstrual cycle can affect the hair growth cycle and
cause hair loss. Hair usually will grow back.
Hair loss can
occur as thinning, in which you may not notice hair falling out, or as
shedding, in which clumps of hair fall out.
In the most common
type of hair loss, inherited hair loss (androgenetic alopecia), men tend to lose hair on the front hairline and forehead and
on top of the head. Eventually, only hair around the ears, the sides, and the back
of the head remains. Women with this condition typically have gradual
thinning throughout the scalp, but mostly on the top of the head.
Other causes of hair loss may also show distinct
patterns. For example, conditions such as
trichotillomania (compulsively pulling at the hair) or
alopecia areata (in which the immune system attacks
hair follicles) result in obvious patches of hair loss, while stress and some
medicines result in clumps of hair falling out.
Because hair is an
important part of appearance, hair loss can also result in loss of self-esteem
and feeling unattractive, especially in women and teens.
Inherited hair loss
About half the population have some hair loss by about 50
years of age. Men may start losing hair between the ages of 15 and 25, and women are more likely to start losing hair between the ages of 25 and 30, or in some cases, after menopause.1
With inherited hair loss (androgenetic alopecia), men tend to lose hair on the front hairline and temples
and on top of the head. Eventually, they may go completely bald.
Women generally lose less hair than men, but they have a similar pattern of hair loss. Women may have slight, moderate, or even severe hair loss, but they don't usually lose all their hair.
Alopecia areata is
hair loss caused when the immune system attacks
hair follicles, where hair growth begins. It usually starts with one or more
small, round, smooth bald patches on the scalp, and can progress to total scalp
hair loss or complete body hair loss. It often begins in childhood. The hair
usually grows back within 1 year. But hair loss in alopecia areata can come and go—the hair often will grow back over several months in one area but will fall
out in another area.
With hair loss caused by stress,
disease, medicines or medical treatments, clumps of hair may fall out. But after the cause is stopped, the hair usually
grows back, although sometimes treatment may be needed.
What Increases Your Risk
Factors that increase the
hair loss include:
Genetics (inherited tendency). If one or both of your parents have hair loss, it is likely
that you will also.
Hair loss is
diagnosed through a medical history and physical exam. Your doctor will
ask you questions about your hair loss, look at the pattern of your hair loss,
and examine your scalp. He or she may also tug gently on a few hairs or pull
The most common cause of hair loss—inherited hair
recognized. Men tend to lose hair from the forehead area and top of the head
with normal amounts of hair on other areas of the scalp. Women tend to keep their front hairline, but have thinning of the hair on the top of the head.
Hair loss history
To determine the cause of your
hair loss, your doctor may ask you about:
Characteristics of your hair loss. Is your
hair thinning, with your scalp becoming more visible, but your hair is not
noticeably falling out? Or is your hair shedding, with lots of hair falling
How long your hair loss has been occurring. How long has it
been since you had your normal amount of hair?
Your family history
of hair loss. Does your mother or father, brother or sister, or any other
relative have hair loss? If so, what caused their hair loss?
hairstyling habits. Has your hair become fragile from pulling it too tight or
from other hairstyling habits? Have you had any chemical treatments to your
hair, such as permanents (perms) or bleaching? Do you use a blow-dryer that may
be too hot? Is a curling iron damaging your hair?
illness. Have you had any skin rashes, such as
Medicines you are
taking. Are you taking blood thinners (anticoagulants)
or medicines for
depression, or heart problems? Have you had any
Your diet. Are you
iron in your diet?
If the reason for your hair loss is not
clear, your doctor may do tests to check for a disease that may be causing your
hair loss. Tests include:
Hair analysis. Your doctor will take a sample of your
hair and examine it under a microscope. A scalp sample might also be
Hair loss in women is more difficult to diagnose than
it is in men because the pattern of hair loss is not as noticeable as it is in
diagnose hair loss usually is not done in women with mild to moderate hair thinning who are otherwise healthy. But in women who have irregular
menstrual cycles, continued episodes of
acne, or too much body hair (hirsutism), testing for a
class of hormones called
testosterone, is sometimes done.
How you treat hair loss depends on the cause. You may decide not to treat hair loss if it doesn't bother you.
Some people choose to treat
hair loss with medicines or hair
transplant surgery. Others choose to wear hairpieces (wigs or toupees) or use
different methods of hair styling (dyeing or combing).
If a disease, medicine, or stress is the cause, then treating the
disease, changing medicines, or managing stress
may stop the hair loss.
Treatment for hair loss may help you feel better about how you look. But some medicines may have harmful side effects, and surgery
may carry certain risks.
Inherited hair loss
Treatment for inherited hair
loss aims to prevent
hair loss, promote hair growth, and cover bald areas of the scalp. But
treatment is not successful for everyone, and you should not expect to regrow a
full head of hair.
Minoxidil. Minoxidil (Rogaine) is
available without a prescription and is sprayed on and/or rubbed into the scalp
twice a day.
Finasteride. Finasteride (Propecia) is available by
prescription and is taken once a day in pill form.
Surgery includes hair transplants and procedures such as scalp reduction and scalp flaps.
Hairpieces and hair products
Cosmetic approaches to hair loss include:
Hairpieces are made from human or synthetic hair that is implanted into a nylon
netting. Hairpieces may be attached to the scalp with glue, metal clips, or
tape. Hair weaving, which involves sewing or braiding pieces of long hair into
existing hair, is not recommended because it may cause permanent hair loss.
Using certain hair care products and styling
techniques. Hair care products or perms may make hair appear thicker. Dyes may
be used to color the scalp. But continual use of perms or dyes may result in
more hair loss.
Other concerns with hair loss
cause often stops hair loss, and hair grows back. In some cases, other treatment
occurs when the
immune system attacks hair follicles, where hair
growth begins. Because hair often grows back within a year, you may decide
not to have treatment. Understanding the come-and-go nature of hair loss with
this condition can help you make the best treatment decision. Children and
teens may need counseling to help them adjust to the hair loss.
Women with inherited hair loss who wish to take birth
control pills should use a pill type that does not add to hair loss, such as a
norgestimate or desogestrel.2
Success of treatment
How successful your treatment
is depends on your expectations and the cause of hair loss. Treatment for hair
loss caused by an illness, medicine, or damage to the hair usually is more
successful than treatment for inherited hair loss.
Home treatment for
hair loss includes hair care and hairstyling
techniques that may help you cover thinning or bald spots on the scalp. This
may be easier for women because inherited hair loss causes a general thinning that
is usually not as severe as it is in men. Hair sprays, dyes, and perms can help
make the hair appear fuller.
Hair care products
In women with inherited hair loss,
hair care and the occasional use of grooming products, hair sprays, hair color,
teasing, permanents, or frequent washing won't increase hair loss. But if
your hair loss is caused by hair care, then perms and dyes may contribute to
more hair loss.
Skin cancer protection
For both men and women, hair thinning and baldness
increase the risk of sunburn and skin cancer on the scalp. When in the sun,
wear a hat or use a sunscreen with an SPF of 30 or more to prevent sun damage
to the scalp.
hair loss can slow thinning of hair and increase
coverage of the scalp by growing new hair and enlarging existing hairs. But
they need to be taken regularly. If you stop the medicine, hair loss returns. Do not expect to regrow a full head of hair. Hair coverage
is improved on the top of the head, but not on the forehead area.
Corticosteroids injected into the scalp. The corticosteroid is
injected many times about
1 cm (0.4 in.) apart every 4 to
6 weeks. This is the most common treatment in adults and is best used for
treating patchy hair loss.
Corticosteroid ointments or creams you put on the
scalp. Corticosteroids may be used along with
injected steroids or with other medicines such as minoxidil
Corticosteroids you take by mouth (oral). Although this
does result in hair growth, it is rarely used because of the side effects of
Surgery to cover bald areas of the scalp may
be used to treat
hair loss. If successful, surgery may be a permanent
treatment for hair loss.
The most common types of surgery to treat hair loss
Hair transplant surgery. During this surgery, your doctor will move small grafts (pieces
of skin with hair follicles) from areas of your scalp with full hair to areas
of your scalp that are bald or thinning. The grafts may include single hairs or
up to 30 hairs in one graft. This is the most common type of surgery used to
treat hair loss.
Scalp reduction. Scalp reduction involves removing
large areas of bald scalp from the head. Sections of the scalp with growing
hair are then stretched and sewn together to fill in the bald
Scalp flaps. Scalp flaps involve moving a large section of
scalp containing hair from the side and back of the head to a bald area. One
side of the flap remains attached to the scalp as the section of scalp with
hair is moved to cover a bald area. The complication rate of this procedure is
higher than other procedures because of bleeding, scarring, and infection after
What to think about
Surgery may be a more permanent
solution than medicines to treat hair loss, but it is expensive, it involves
surgical risks, and there is a chance that not all hair follicles will remain
Other treatment for
hair loss includes:
Wearing hairpieces. Hairpieces are made from
human or synthetic hair that is implanted into a nylon netting. Hairpieces may
be attached to the scalp with glue, metal clips, or tape. But hair weaving, which involves
sewing or braiding pieces of long hair into existing hair, is not recommended because it may cause permanent hair loss.
care products and styling techniques. Hair care products or perms may make hair
appear thicker. Dyes may be used to color the scalp.
Laser phototherapy combs. These combs use low levels of light to increase hair growth on the scalp. They are designed for use at home.
Counseling, if hair loss is caused by compulsive pulling of your hair (trichotillomania).
Other Places To Get Help
American Academy of Dermatology
National Alopecia Areata Foundation
Whiting DA (2006). Disorders of hair. In DC Dale,
DD Federman, eds., ACP Medicine, section 2, chap. 13.
New York: WebMD.
Habif TP, et al. (2011). Hair and nail diseases. In Skin Disease: Diagnosis and Treatment, 3rd ed., pp. 562–589. Edinburgh: Saunders.
Hague J, Berth-Jones J (2010). Alopecia areata. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 31–35. Edinburgh: Saunders Elsevier.
Other Works Consulted
Kestenbaum TM (2010). Diseases affecting the hair. In JC Hall, ed., Sauer's Manual of Skin Diseases, 10th ed., pp. 337–347. Philadelphia: Lippincott Williams and Wilkins.
Wolff K, Johnson RA (2009). Disorders of hair follicles and related disorders. In Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 6th ed., pp. 962–986. New York: McGraw-Hill.
ByHealthwise Staff Primary Medical ReviewerAdam Husney, MD - Family Medicine Specialist Medical ReviewerE. Gregory Thompson, MD - Internal Medicine
How this information was developed to help you make better health decisions.