I’ve noticed my hair is thinning significantly lately, and I’m starting to get worried. I’m in my late 20s, and I’m not sure what’s causing this. I’ve heard everything from stress to vitamin deficiencies can contribute to hair loss. Could you elaborate on the common causes of hair fall, specifically focusing on differentiating between temporary shedding (like telogen effluvium) and more permanent forms of hair loss (like androgenetic alopecia)? Also, are there any lifestyle factors, like diet or hair styling practices, that I should be paying attention to that could be contributing to the problem? I’d also like to know if certain medical conditions or medications are often associated with increased hair shedding.

Answer

Common causes of hair fall can be broadly categorized into genetic factors, hormonal imbalances, medical conditions, medications, lifestyle factors, and infections.

Genetic Factors:

• Androgenetic Alopecia (Male or Female Pattern Baldness): This is the most common cause of hair loss and is genetically determined. It’s characterized by a receding hairline and thinning crown in men, and a general thinning all over the scalp in women. The condition is linked to dihydrotestosterone (DHT), a hormone derived from testosterone, which shrinks hair follicles over time, leading to shorter, finer hairs and eventually, no hair growth. The age of onset and pattern of progression vary depending on individual genetic predisposition.

Hormonal Imbalances:

• Pregnancy: Hormonal shifts during pregnancy often lead to thicker hair. However, after childbirth, estrogen levels drop, and many women experience temporary hair shedding (telogen effluvium).
• Menopause: Fluctuating hormone levels during menopause can also trigger hair thinning or loss. Lower estrogen levels can lead to increased levels of androgens (male hormones), contributing to androgenetic alopecia.
• Thyroid Disorders: Both hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) can disrupt hair growth cycles, leading to hair loss. Thyroid hormones are crucial for regulating metabolic processes, which affect hair follicle function.
• Polycystic Ovary Syndrome (PCOS): This hormonal disorder, common in women of reproductive age, is characterized by elevated androgens, which can cause hair thinning on the scalp and excessive hair growth elsewhere (hirsutism).
• Hormonal Contraceptives: Starting or stopping birth control pills or other hormonal contraceptives can sometimes trigger hair loss, especially in women predisposed to hormonal imbalances.

Medical Conditions:

• Alopecia Areata: This autoimmune condition causes the immune system to attack hair follicles, resulting in patchy hair loss. The hair loss can be sudden and may affect the scalp, eyebrows, eyelashes, and other body hair. Severity varies, with some individuals experiencing only a few small patches, while others experience complete hair loss (alopecia totalis) or loss of all body hair (alopecia universalis).
• Telogen Effluvium: This condition occurs when a significant number of hair follicles enter the telogen (resting) phase of the hair growth cycle at the same time, leading to excessive shedding. It’s often triggered by stress, illness, surgery, childbirth, or rapid weight loss.
• Traction Alopecia: This type of hair loss is caused by repeated pulling or tension on hair follicles, often from tight hairstyles like braids, ponytails, or extensions.
• Scarring Alopecia (Cicatricial Alopecia): This is a group of rare disorders that destroy hair follicles and replace them with scar tissue. It can result from various inflammatory conditions, such as lichen planopilaris, discoid lupus erythematosus, and folliculitis decalvans. The hair loss is typically permanent.
• Iron Deficiency Anemia: Low iron levels can contribute to hair loss, especially in women. Iron is essential for the production of hair cells.
• Nutritional Deficiencies: Deficiencies in other essential nutrients, such as biotin, zinc, protein, and fatty acids, can also lead to hair thinning or loss.
• Autoimmune Diseases: Conditions like lupus and rheumatoid arthritis can sometimes cause hair loss as part of their systemic effects.
• Seborrheic Dermatitis: This common skin condition can cause inflammation and scaling on the scalp, which can contribute to hair loss.

Medications:

• Chemotherapy Drugs: Many chemotherapy drugs used to treat cancer can cause significant hair loss (anagen effluvium) because they target rapidly dividing cells, including hair follicle cells.
• Blood Thinners (Anticoagulants): Medications like warfarin and heparin can sometimes cause hair shedding.
• Antidepressants: Certain antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), have been linked to hair loss in some individuals.
• Acne Medications: Some acne medications containing retinoids (like isotretinoin) can cause hair thinning.
• Beta-Blockers: These medications, used to treat high blood pressure and heart conditions, can sometimes lead to hair loss.
• Nonsteroidal Anti-inflammatory Drugs (NSAIDs): Prolonged use of NSAIDs like ibuprofen and naproxen has been associated with hair shedding in rare cases.
• Anabolic Steroids: These drugs can cause hair loss, particularly in individuals genetically predisposed to androgenetic alopecia.

Lifestyle Factors:

• Stress: High levels of stress, whether physical or emotional, can trigger telogen effluvium.
• Poor Diet: A diet lacking in essential nutrients can contribute to hair loss.
• Smoking: Smoking can damage hair follicles and reduce blood flow to the scalp, increasing the risk of hair loss.
• Excessive Alcohol Consumption: Excessive alcohol intake can interfere with nutrient absorption and overall health, potentially contributing to hair loss.
• Hairstyling Practices: Overuse of heat styling tools (hair dryers, curling irons, straighteners) and harsh chemical treatments (perming, relaxing, coloring) can damage hair and lead to breakage and hair loss.

Infections:

• Scalp Infections (e.g., Tinea Capitis): Fungal infections of the scalp can cause inflammation, scaling, and hair loss.
• Folliculitis: Inflammation of hair follicles, often caused by bacterial or fungal infections, can lead to hair loss.
• Syphilis: Secondary syphilis can cause a characteristic "moth-eaten" pattern of hair loss on the scalp.