PEOPLE shed hair all the time; it's a normal part of everyday life, however annoying it may be. Fortunately, most times the triggers are temporary and may resolve on their own. However, when hair begins to fall out, medical internist Dr Samantha Nicholson-Spence said that this usually indicates that there is a more complex issue at hand, primarily in the form of an underlying health condition.
“Hair falling out is a non-specific symptom; the fact is there are many potential triggers for someone's hair falling out as it can be a little difficult to identify a single causative factor,” Dr Nicholson-Spence said.
She pointed out that hair loss stems from one of two things — a genetic predisposition, or based on a reaction to a trigger which can range from something like a vitamin deficiency to a chronic medical condition such as lupus.
She sheds light on some of these triggers, and shares how they contribute to hair loss:
Alopecia (Primary hair loss disease)
“There are several primary hair loss diseases such as alopecia areata, which causes “shiny” baldness because there is a destruction of hair follicles. It can cause baldness from head to toe,” Dr Nicholson-Spence said. In other instances, she explained that the hair follicles may shrink over time, resulting in the growth of hair that is much finer in texture every growth cycle. This type of alopecia is usually a direct result of the disease; however, hair loss may be as a result of secondary triggers such as a hormone imbalance, as in the case hyperandrogenism (too much testosterone in a woman) or an underactive or overactive thyroid. In the third case of alopecia, patients tend to develop Telogen Effluvium (less coarse hair). It is also characterised by excessive daily hair loss, especially when the hair is washed and brushed — the trigger is usually from some form of internal disruption.
Conditions of the scalp
Scalp conditions such as dandruff, seborrheic dermatitis or cradle cap as it is referred to when it occurs in children, can also result in hair loss. She said that especially in children, since they usually have finer texture hair, parents may notice some balding much sooner than they would see in adults.
Physical and emotional stresses are major hair loss triggers — this can be anything from childbirth to a car accident or a period of sadness and depression. These events can cause significant shock to the hair cycle reprogramming, and skip over the growth and rest stage going straight into the shedding phase resulting in Telogen Effluvium. The effects of this extended period of shedding, according to Dr Nicholson-Spence, is usually noticed within a few months of the traumatic event. She said that the issue usually resolves as the body repairs itself.
“HIV tends to cause fine hair, which subsequently thins and falls out. Some people call it 'pretty hair' because it's less coarse; however, the correct terminology is Telogen Effluvium. In HIV, though, it can precede your diagnosis so when we see Telogen Effluvium we often consider HIV,” Dr Nicholson-Spence said. She, however, cautioned that it is not diagnostic of HIV since this can be seen in several other illnesses like lupus or even in people after major surgeries.
Some ways of styling hair such as braiding, weaving, tight cornrows, bleaching, using hair glue, hot irons, overbrushing, and other ways of vigorous styles over a period of time can also cause your hair to fall out as well as cause damage or scarring to the hair follicles. Consistently doing these hairstyles may cause traction alopecia, which may lead to permanent hair loss. Dr Nicholson-Spence recommends more protective styles and generally less stress on the hair for a healthier mane.
Hair products such as dyes, relaxers, perms and other chemicals used in the hair can cause damage to the hair and scalp while others may result in irritation. Dr Nicholson-Spence explained that this sometimes results in hair thinning. Hair may also become drier, weaker and more susceptible to breakage and fall out even after a single use of these chemicals.
Rapid weight loss
When you lose weight rapidly, Dr Nicholson-Spence said that this can be stressful for the body, even if you are overweight. With weight loss, she said that it is always best to achieve this gradually because the stress associated with the rapid fluctuation in body mass index may send a signal to your hair follicles to move into an inactive stage. This may result in Telogen Effluvium and consequent hair loss.
From too much Vitamin A to deficiency of zinc as well as other nutritional diseases such as anorexia, bulimia and malnutrition, Dr Nicholson-Spence said that one symptom of a nutritional imbalance is some amount of hair loss. She explains that it is quite common for a person to develop hair and scalp problems because the nutrition contained in what we eat or do not eat can significantly impact the structure of hair and hair follicles as well as its growth.
The medication that you are taking might be helping you to keep well, but Dr Nicholson-Spence said that sometimes it may also be the culprit behind your hair loss. Some classes of medication, including blood thinners, some blood-pressure tablets, cancer medication and some non-steroidal anti-inflammatory drugs often result in hair loss.
Dr Nicholson-Spence said that while hair loss is a telltale sign of some medical conditions, some illnesses are often far gone before you begin to lose hair. Hopefully by this time, in the case of serious illnesses, the disease would have already been discovered.