Symptoms, causes, diagnosis and treatment of baldness

treatment of baldness
A receding hairline does not simply mean less hair. It is a disorder that can be caused by many different factors. Losing your hair can have a serious psychological impact on many people, both men and women. But what causes a receding hairline? Will it keep getting worse? Is there any kind of treatment that works?

How does hair loss present?

Receding hairline can affect men or women, but it is more common in men. Hair loss is usually related to aging, but many younger people also experience hair loss.

Hair loss presents itself differently in each person.

Progression of hair loss in men

Having a receding hairline doesn't always mean a person will be completely bald later on, but it can be an early sign of a condition called male pattern baldness (also called androgenetic alopecia or AGA).

There is usually a distinct pattern that occurs when a man loses his hair. This is different in women, who commonly experience weight loss. However, in men, the loss usually occurs in progressive steps that can include:
  1. a receding hairline that appears to be uneven
  2. a noticeable "M" shape appears at the hairline
  3. hair loss on the top of the back of the head (resulting in a bald spot)
  4. the area involving the hairline meets the bald spot (resulting in larger areas of hair loss)
  5. complete baldness on top (the only remaining hair appearing around the sides and back of the head)

Hair loss and receding hairline in women

In women, the pattern of hair loss is usually very different from that of men. Women generally do not experience the typical hair loss that commonly occurs with male pattern baldness.

Eighty percent of men of European descent are affected by hair loss by the time they are 80 years old.

When it comes to women, 40% have visible hair loss by the time they reach their 40s, according to the American Academy of Dermatology.

Women can have a receding hairline; however, it is not usually associated with female pattern baldness.

Conditions that can cause a woman to have a receding hairline may include:

  • Frontal Fibrosing Alopecia: This is characterized by slowly progressive hair loss and scarring of the scalp near the forehead. There is no cure for this condition, but medications that slow hair loss can be effective in some cases.
  • Traction Alopecia: This is gradual hair loss resulting from constant pulling (of hair pulled back into a ponytail, pigtails, or braids).

"For women, the first sign of hair loss they often notice is a widening of their part or their ponytail is smaller," said dermatologist Mary Gail Mercurio, MD, FAAD, associate professor of dermatology and director of the dermatology residency program at the University of Rochester in Rochester, New York.

Signs that hair loss may be problematic

Hair loss is an everyday occurrence that occurs as part of a normal cycle for most people; it is normal to lose approximately 100 hairs a day. The hair falls out slowly and gradually, then new hair grows back. But some circumstances may indicate the possibility that hair loss is problematic.

Also, excessive concern about hair loss may indicate that it is best to speak with a health care provider about your concern.

Causes

In a receding hairline, the hair begins to fall out as a result of damage to the hair follicles. Under normal circumstances, as hair naturally reaches its mature stage, strands fall out and are replaced by new ones. But when hair follicles are damaged, there is a risk of scarring and a risk that the hair will no longer grow back.

Genes are the most common cause of male and female pattern baldness (also known as androgenic alopecia).

According to the Mayo Clinic, hair loss is usually related to one or more factors, including:

  • Genetics
  • Hormonal changes (due to pregnancy, menopause, thyroid, or other hormonal problems)
  • Medical conditions (such as alopecia areata, infectious diseases, ovarian tumors, or other conditions)
  • Scalp infections
  • Drugs or supplements (such as cancer or arthritis drugs, or drugs for gout, heart problems, high blood pressure, or depression)
  • Radiation therapy
  • Surgeries
  • Pregnancy
  • Miscarriage
  • Stress (a stressful event can cause hair loss, but this is usually temporary)

Additionally, other factors that can cause a receding hairline include:

  • Excessive styling (involving the use of heat from hair dryers or curling irons)
  • Hairstyles that pull hair very tight (such as braids)
  • Hot oil or permanent hair treatments
  • Poor diet (lack of adequate protein)
  • Autoimmune disorders
  • Tumors (rarely)

Physical or emotional stress

Stress can be a major causal factor related to hair loss. The name for stress-induced hair loss is telogen effluvium. The condition results in the loss of large amounts of hair each time it is combed or shampooed.

Telogen effluvium may not be noticeable until long after a stressful event is over. It can take up to eight months before the hair loss disappears. Hair loss due to stress is usually temporary, but can become chronic (long-term) in some cases.

Hair Loss Prevention

There are some preventative measures that can be taken to prevent hair loss, according to the Mayo Clinic, these include: avoiding hairstyles that pull on the hair (such as braids, braids, ponytails, or buns), avoiding pulling, constant rubbing, or twisting the hair, using a wide tooth comb and gently brushing or combing the hair, and avoiding harsh chemical treatments on the head, such as perms or hot oil treatments.

Additionally, helpful measures include avoiding the use of hot rollers and curling irons (and other heat styling methods), avoiding medications or supplements that can cause hair loss when possible, quitting smoking, protecting hair from prolonged exposure direct sunlight (or other types of ultraviolet light) and wearing a cooling cap (for those receiving chemotherapy, this may reduce the risk of hair loss from chemotherapy).

Keep in mind that if the cause of a person's hair loss is hereditary, it cannot be prevented.

Diagnosis

Hair loss can be diagnosed and treated by a dermatologist. Diagnosis may include a detailed family history for clues as to whether the condition runs in families, a "pull test" to determine how easily hair falls out, a scalp biopsy (removal of a small sample of tissue from the scalp ) to evaluate the tissue for scalp conditions and a blood test to check for medical conditions that could cause hair loss (such as thyroid disease).

Treatment

Treatment of hair loss depends on the cause. If a condition such as thyroid disease is causing a person to lose their hair, treatment would involve addressing the underlying cause: the thyroid problem.

If an immune disorder (such as alopecia areata) is the cause of hair loss, steroid injections into the scalp may help.

Rogaine (Minoxidil)

Rogaine (minoxidil) is commonly used to slow hair loss or, in some cases, to reverse it. Keep in mind that Rogaine is usually only effective in reducing the hairline that is associated with male pattern baldness and may not work for other types of hair loss. Additionally, Rogaine is known to be more effective at restoring hair in small batches, rather than very large areas of the scalp, so early use of Rogaine will likely produce the best results.

Other Types of Treatment

Other treatment options may include a drug called Propecia (aimed at promoting hair growth). This drug can have some serious side effects, including a possible increased risk of prostate cancer. (However, this is controversial); it is exclusively for men because it involves blocking DHT from testosterone (a male hormone). DHT is believed to inhibit hair growth in men. It also has controversial associations with depression and sexual side effects.

Platelet Rich Plasma (PRP) therapy for hair loss is a three-step medical treatment in which a person's blood is extracted, processed, and then injected into the scalp. This therapy has been used for problems such as healing injured tendons, ligaments, and muscles.

Surgical hair restoration (involves a transplant of the hair follicles) is another option some choose, as well as laser therapy (which can help reduce male pattern baldness), taking Dritho-Scalp (a prescription drug that promotes new hair growth). some people) and corticosteroids (a prescription medicine that reduces inflammation around hair follicles, allowing them to grow new hair). Of course, be sure to check with your health care provider before beginning any medication or supplement regimen.

Biotin, a supplement often touted as improving hair loss, is in fact not supported by data.

Essential oils are also often used (preliminary studies have shown that lavender oil and peppermint oil may be as effective as Rogaine for hair growth).

Studies

A study on the effectiveness of Rogaine (minoxidil) treatment for male pattern baldness found that topical treatment with 5% minoxidil was more effective than either 2% minoxidil or placebo for regrowth of new hair. In fact, the men grew 45% more hair at week 48 than those who used 2% topical minoxidil.

Another study found that mice treated with peppermint essential oil had clear signs of hair growth. A 2016 mouse model study revealed similar results when mice were treated with lavender oil. Although human studies are required to support these claims, these 2 essential oil studies may offer preliminary information to support those seeking a natural treatment for hair loss.

Psychological toll of hair loss

The emotional reaction to hair loss can be very significant. In fact, many studies and surveys have been conducted to assess the impact hair loss has on emotional health. One such survey of 2,000 men in the United States found that there may be a strong association between a man's work identity and his hair.

In the Hair Census, as many as eight out of 10 men surveyed reported that the appearance of their hair was important and made them look professional and feel confident.

A dermatologist spokesperson told BBC News: "Researchers say hair loss is a common disorder and can cause considerable damage to emotional health, including loss of self-esteem and confidence."

A Word From Verywell

Although having a receding hairline commonly causes considerable concern for both men and women, many people have found that it's not totally hopeless. There are new medical treatments and procedures on the horizon that can help slow down the receding hairline process. Consulting with a dermatologist or other health care provider can help a person with a receding hairline fully understand the cause of the condition and gain a clear picture of available treatment options.


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