What causes hair loss?
There are several possible underlying causes of hair loss. Some of these include:
- thyroid or autoimmune disorders
- lacking certain vitamins and minerals in your diet, such as iron
- female pattern hair loss, which might run in your family
- stress, fever or pregnancy
- certain medicines
- trauma (where the hair cells have been damaged, for example by hair straighteners or certain hair styles)
- inflammation of the scalp
By seeing your GP, you can rule out certain conditions that might be causing the problem.
Hair loss diagnosis
The first thing your GP may do is ask you questions about your hair loss. When did it start? How has it progressed – gradually or quickly? Is the hair loss in patches or all over your scalp? They’ll also ask about your skin, nails and general health, to help rule out possible causes.
Your GP may also examine your hair. Depending on what they find, they may do a blood test, again to look for underlying causes. For example, your GP might do a blood test for your thyroid gland. This is because thyroid disorders can both cause hair loss and be linked to problems with your immune system, which usually helps your body fight off illnesses. One type of hair loss, called alopecia areata, occurs more often in people with autoimmune conditions. These are conditions where your immune system turns against itself.
Your GP may also do a blood test to check your iron levels. Both iron deficiency and low thyroid hormone levels can be treated, so it’s worth seeing if your doctor thinks these might be the cause.
What treatments work for hair loss?
If you have low iron or thyroid deficiency
Low iron and low thyroid levels can cause your hair to become thinner and fall out more. If your blood tests confirm that you have low iron or thyroid levels, these can be increased through taking tablets. The hair loss should recover completely, although this may take a few months.
Another type of hair loss is alopecia areata, which causes patchy hair loss on the scalp. It’s caused by a problem with your immune system, which leads to inflammation affecting the hair follicles. It can be an unpredictable condition that’s difficult to treat, but fortunately, many people can expect their hair to grow back within a year. Your GP may suggest a referral to a dermatologist, who will discuss your treatment options with you.
Female pattern hair loss
Female pattern hair loss (or androgenetic alopecia) is the most common form of alopecia in women. It tends to show itself as spread out hair loss on the top of your head. It usually occurs in your 50s or 60s, much like male pattern hair loss in men.
Female pattern hair loss is different from other types of alopecia. It’s a genetic condition that’s caused by your hair follicles’ sensitivity to hormones called androgens. The hormone gradually makes the follicles smaller until they shrink and stop producing hair.
If you have female pattern hair loss, one treatment your GP might consider is minoxidil 5% solution, a topical lotion or foam that’s available over the counter. It’s not guaranteed, but it can promote regrowth, at least in the short term for some women.
The chances of successful treatment are higher if you start soon after the hair loss begins. But it will take three to six months of treatment to notice a difference, if it’s going to work for you. If the treatment does work, you should continue to use it, as stopping it will likely lead to rebound hair loss.
If there’s no response to minoxidil, your GP may refer you to a dermatologist.
Other types of hair loss include telogen effluvium, where your hair’s cycle of growth is disturbed. This can be linked to severe stress, some medicines, pregnancy or other short-term triggers. This condition is self-limiting, so your GP or dermatologist may not recommend any treatment other than trying to overcome the trigger that caused the hair loss.
Inflammatory scalp conditions
Hair loss can occur in association with skin diseases which affect the scalp, for example psoriasis, eczema or infection – some of which are treatable. However, sometimes the inflammation is so severe that it kills the hair follicles, causing scarring alopecia. In this case, the hair is unlikely to grow back. There are a few treatments that can be tried, such as topical corticosteroid creams or steroid injections, but the earlier you can see a doctor, the better.
Using straightening chemicals and hot combs can damage the hair, often permanently, leading to hair loss. Similarly, some hair styles which pull on the hair follicle can damage it, such as braids and hair extensions. Stopping these styling techniques can stop the condition worsening, but rarely lead to recovery of the hair loss.
How hair loss affects self-esteem
Many women with hair loss find negative perceptions of the condition by others to be most distressing.
Harriet, 50, who has suffered from female pattern hair loss since she was 25 years old, is so upset by other people’s reactions that she’s asked us not to use her real name.
She said: “Hair loss affects your self-esteem, especially when people try to look at your head subtly, but you know it’s noticeable. It makes me feel sad, but if I dwelled on it, I’d go into a spiral of depression. There’s nothing medically wrong with me, but it’s still very upsetting. The worst thing is when I go out. I can have on a lovely dress, makeup and earrings, but my hair is the one thing that lets me down.”
Fear of going totally bald is also a worry but, fortunately, it’s rare in women.
Support with hair loss
Hair loss isn’t life threatening or life-limiting, and for some women it’s enough to receive this assurance from a GP. Seeing a good hairdresser for styling and make-up advice may be helpful.
But if you’re struggling with your hair loss, your GP may refer you for counselling sessions. You could also try support groups, such as those run by Alopecia UK. You can also discuss with your GP where you can get hairpieces and wigs if you prefer to disguise your hair loss.
Harriet adds: “How you cope depends on the type of person you are. I can get stressed about my hair loss but other people are more care-free – or seem to be. I’ve found that asking family and friends to support can help. I also have a sympathetic hairdresser.”
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