Why is my hair falling out?

Hair loss is a common concern I see in my practice! There are many reasons why someone might notice that their hair is thinning, so it’s always important to look into these different factors and to do some investigation!

Causes of Hair loss

 

stress

Hair loss caused by stress more often shows up as generalized thinning. This can be due to prolonged periods of physical, mental or emotional stress!

So how does stress cause hair loss? There was a study done on mice that found a stress hormone called corticosterone, which is similar to cortisol was responsible for putting hair follicle stem cells into an extended resting phase.

 

genetics

Hair loss can be hereditary and it is the most common cause of hair loss. This is a genetic condition that causes hair follicles to shrink and eventually stop growing. In females you may notice overall thinning or a widening part, where males most often have a receding part or thinning on the top of the head. There are medications that can help slow down the hair loss and may even help with regrowth!

 

autoimmune

Alopecia Areata is an autoimmune condition which can cause hair loss to show up in patches. It most commonly affect the scalp, however it can show up in other areas of the body that grow hair. People can also sometimes notice burning or itchiness on the patches too!

 

hormones

  • PCOS. A common reason for hormonal hair loss is a condition called polycystic ovarian syndrome (PCOS). PCOS can cause symptoms of high androgens, such as thinning hair on the scalp, hair growth on the upper lip or chin and cystic acne. PCOS is a complex syndrome that can look different in every person diagnosed with it. Click here to read a blog I wrote on PCOS for Get Joni.

  • Hypothyroid. This is when your thyroid gland is not producing enough thyroid hormone. Symptoms of a low thyroid include: thinning and brittle hair, constipation, fatigue, and weight gain.

  • Postpartum hair loss. Most people will notice hair shedding after giving birth due to falling estrogen levels. This can happen on average for 6 months and it peaks around 4 months after birth! Postpartum hair loss will grow back over time!

 

infection

Skin infections like Tinea capitis can cause hair loss in patches along with dry scaling, redness, and itchiness. The hair will grow back after the fungal infection is treated!

 

nutrient and mineral deficiencies

It’s a good idea to rule out any vitamin and mineral deficiencies like vitamin D, iron, zinc and biotin. There are clinical signs for these deficiencies and you can get blood work done to see if they are in sub-optimal ranges.

 

Medications

Medications may affect hair follicles by either causing abrupt hair loss within days to weeks of taking the medication (anagen effluvium) or by putting hair follicles in premature rest (telogen effluvium), where hair loss is more noticeable 2 to 4 months after starting a new medication. For example, some antidepressants have a higher risk of hair loss vs. others. Talk to your prescribing Doctor if you feel that your hair loss is due to a medication you are taking. It’s possible that there could have been another hair loss trigger when you started the medication, such as stress! It is never a good idea to stop your prescribed medications without talking to a healthcare professional.

 

Treatment

Effective treatment for hair loss is going to depend on what is causing the hair loss! A treatment plan could include anything from correcting nutritional deficiencies to trying out different well researched medications. I am always happy to investigate these different causes and to discuss all of your options so that you can make a well informed decision on your hair health goals! Click the button below to book your initial appointment!

 

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references

Choi, S., Zhang, B., Ma, S. et al. Corticosterone inhibits GAS6 to govern hair follicle stem-cell quiescence. Nature 592, 428–432 (2021). https://doi.org/10.1038/s41586-021-03417-2

Etminan, Mahyara; Sodhi, Mohitb; Procyshyn, Ric M.c; Guo, Michaela; Carleton, Bruce C.d,e,f Risk of hair loss with different antidepressants, International Clinical Psychopharmacology: January 2018 - Volume 33 - Issue 1 - p 44-48 doi: 10.1097/YIC.0000000000000191

Prasad, S., De Souza, B., Burns, L. J., Lippincott, M., & Senna, M. M. (2020). Polycystic ovary syndrome in patients with hair thinning. Journal of the American Academy of Dermatology, 83(1), 260–261. https://doi.org/10.1016/j.jaad.2020.01.075

Thom E. Stress and the Hair Growth Cycle: Cortisol-Induced Hair Growth Disruption. J Drugs Dermatol. 2016 Aug 1;15(8):1001-4. PMID: 27538002.

Tosti, A., Misciali, C., Piraccini, B.M. et al. Drug-Induced Hair Loss and Hair Growth. Drug-Safety 10, 310–317 (1994). https://doi.org/10.2165/00002018-199410040-00005

Krista Lowe