Determining the Cause of Your Hair Loss

1. See your doctor to rule out a medical condition. Several medical conditions can either temporarily or permanently interfere with normal hair growth and development. Some of these medical conditions include the following:

• Iron deficiency anemia.
• Thyroid conditions.
• Deficiencies in zinc, vitamin D, and possibly the B vitamin group.
• Hormonal level alterations of androgen, testosterone, and estrogen-derived hormones.
• Autoimmune disease.
• Major psychological stress.
• Physical trauma.
• Scalp infections and skin disorders.
• Diabetes.
• Lupus.
• Trichotillomania.
• Extreme weight loss, or extreme change in diet.
• Severe infection accompanied by a high fever.

2. Treat the medical condition. Medical conditions can lead to either temporary or permanent problems with hair loss.

• With the help of your doctor, and possibly healthcare professionals that practice in specialty areas, treating the underlying medical condition may resolve your hair loss problem.
• Your doctor will need as much information as possible about your hair loss problem, so be prepared to discuss this issue in depth. Be prepared to describe when it began, any significant life events that occurred just prior to the problem, steps you have taken to resolve it, and how much distress the hair loss is causing you.
• If an underlying medical condition is discovered, specialists that may be part of your treatment may include endocrinologists, dermatologists, nutritionists, and psychiatrists.

3. Understand how your hair grows. Many of the medical conditions listed interfere with one of the three phases of hair growth.

• The anagen phase is the period when your hair is actively growing. About 85% of your hair is in the anagen, or growing phase, at any given time.
• The catagen phase is a short period of time, about two weeks in durations, that allows the follicle to regenerate. Hair growth is halted during the catagen phase.
• The telogen phase is considered the resting phase of hair growth, and lasts for two to four months. At the end of this phase the hair falls out. Most people normally lose about 100 hairs each day due to the hair that is in the telogen phase.
• Many medical conditions encourage hair to enter the telogen phase. This may cause as many as 300 hairs to be lost each day. The medical term for excessive hair loss during this phase is telogen effluvium.

4. Realize that telogen effluvium is often temporary. Many medical conditions that cause hair to move into the telogen phase can be treated.

• Since your hair remains in the telogen phase for several months, your hair loss may not occur immediately after the event that triggered it. This would include physical trauma and severe emotional stressors.

5. Review your medications with your doctor. Many medications can cause temporary hair loss.

• Do not alter your medications for any reason. Talk with your doctor about your concerns. If you feel a medication is causing your hair loss, your doctor may be able to help by either adjusting the dose or prescribing a similar medication to take its place.
• Some medications that are known to contribute to hair loss include lithium, warfarin, heparin, and levodopa.
• Drugs that are classed as beta-blockers can also cause hair loss. Examples of medications in this class include propranolol, atenolol, and metoprolol.
• Amphetamine derivatives can cause hair loss. Examples of amphetamine medications include amphetamine salts, most commonly recognized by the brand name Adderall®, dextroamphetamine, and lisdexamfetamine.
• Chemotherapy medications, such as doxorubicin, commonly cause sudden and complete hair loss, as does radiation therapy associated with cancer treatment.

6. Consider the role of genetics. Having family members that developed hair loss are an indicator that you may also be susceptible.

• The most common pattern of genetically-induced hair loss involves losing hair at any earlier than normal age, losing hair more quickly than normal, and an overall thinning of hair in women.
• There is an incidence of about 21% of hair loss in women that is passed on genetically.