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Genetic and Hormonal Factors
Androgenetic alopecia, commonly known as male or female pattern baldness, represents the most prevalent cause of hair loss worldwide. This hereditary condition affects both men and women, though it manifests differently in each gender. In men, hair loss typically begins with a receding hairline and crown thinning, while women experience diffuse thinning across the top of the scalp.
The condition results from sensitivity to dihydrotestosterone (DHT), a hormone derived from testosterone. Hair follicles sensitive to DHT gradually shrink over time, producing progressively thinner and shorter hair strands until they eventually stop producing hair altogether. This process can begin as early as the late teens or early twenties.
Medical Conditions
Various medical conditions can trigger significant hair loss. Thyroid disorders, both hyperthyroidism and hypothyroidism, commonly cause hair thinning by disrupting the natural hair growth cycle. Autoimmune conditions like alopecia areata cause the immune system to attack hair follicles, resulting in patchy hair loss that can progress to complete baldness.
Polycystic ovary syndrome (PCOS) affects many women and can lead to hormonal imbalances that cause hair thinning on the scalp while promoting unwanted hair growth elsewhere. Iron deficiency anemia, particularly common in women, can also contribute to hair loss by reducing the oxygen-carrying capacity of blood to hair follicles.
Lifestyle and Environmental Factors
Physical and emotional stress can trigger telogen effluvium, a condition where hair prematurely enters the resting phase of the growth cycle. This type of hair loss typically occurs two to three months after a stressful event, such as surgery, severe illness, significant weight loss, or major life changes.
Nutritional deficiencies play a crucial role in hair health. Insufficient protein intake, low iron levels, and deficiencies in vitamins like B12, D, and biotin can all contribute to hair thinning and loss. Crash diets and eating disorders often result in temporary but noticeable hair loss due to inadequate nutrition.
Medications and Treatments
Numerous medications can cause hair loss as a side effect. Chemotherapy drugs are well-known for causing temporary but complete hair loss, as they target rapidly dividing cells, including those in hair follicles. Blood thinners, antidepressants, blood pressure medications, and high doses of vitamin A can also contribute to hair thinning.
Hormonal medications, including some birth control pills and hormone replacement therapy, may trigger hair loss in susceptible individuals. Additionally, medications used to treat arthritis, gout, and heart problems have been associated with hair loss in some patients. It's important to discuss potential side effects with healthcare providers when starting new medications.
Physical Trauma and Hair Practices
Traction alopecia results from excessive pulling or tension on hair strands over extended periods. This condition commonly affects individuals who frequently wear tight hairstyles such as ponytails, braids, buns, or hair extensions. The constant tension gradually weakens hair follicles and can lead to permanent hair loss if the practices continue.
Excessive heat styling, chemical treatments like perms and relaxers, and aggressive brushing can damage hair shafts and follicles. Trichotillomania, a psychological condition involving compulsive hair pulling, can also result in noticeable hair loss and requires professional intervention to address both the physical and mental health aspects.
Age and Natural Changes
As we age, hair naturally becomes thinner, grows more slowly, and may change in texture and color. The hair growth cycle gradually slows down, with hair spending more time in the resting phase and less time actively growing. This natural aging process affects both men and women, though the extent and pattern can vary significantly between individuals.
Hormonal changes during menopause can accelerate hair loss in women due to declining estrogen levels. Similarly, hormonal fluctuations during pregnancy and postpartum can cause temporary hair loss, though hair typically returns to normal within several months after delivery. Understanding these natural changes helps distinguish between normal age-related hair changes and conditions requiring medical attention.