Hair loss: Causes and treatments

When I started losing my hair three years ago, I was mortified. I starting wearing baseball hats (never a good look) and avoided cameras. Every day became a bad hair day. It never occurred to me to go to the doctor. I assumed there was no cure for this sudden “shedding” — if there was one, somebody would be a millionaire, right? — but mainly I just didn’t want to draw any unnecessary attention to my lack of hair. Turns out time spent hiding my condition would have been better spent at the doctor’s office. Losing hair isn’t just a guy thing. There are more than a hundred causes of hair loss for women, and according to Jeff Donovan, a dermatologist and hair loss specialist at Sunnybrook Health Sciences Centre in Toronto, nearly all women will experience some type of hair loss in their lifetime. Determining whether you’re losing an abnormal amount of hair can be tricky since we shed anywhere between 50 to 100 hairs daily. But if you’re leaving clumps in your hairbrush or waking up to a pillowcase strewn with hair, book a visit with your doctor. When I finally did, I was diagnosed with a thyroid condition and started taking medication. It helped curb the hair loss, but I never did get back all my curly locks. In the end, I was fitted with a postiche, a custom hairpiece that clips onto the hair.

• The technical term for hair loss is alopecia. It can appear as anything from an overall thinning to complete baldness.You can lose hair for any number of reasons, like low iron levels, polycystic ovarian syndrome or lifestyle triggers like excessively restrictive diets. Getting checked by a doctor is the only way to rule out more serious underlying diseases like lupus or anemia. However, if a cause isn’t found by your GP, you should get a referral to a dermatologist.
• The three most common types of hair loss are androgenetic alopecia (genetic hair loss), telogen effluvium (an umbrella term describing excessive hair shedding with various causes, including stress) and alopecia areata (an autoimmune disease).
• The most successful treatments are ones that deal with the underlying problem when possible. If hair loss is a result of low iron levels, iron supplements can be prescribed. If it’s a result of a fungal infection, the problem will be addressed with medication.
• Occasionally, certain medications like antidepressants or beta blockers can cause hair loss. If so, substitutions can usually be made by your doctor. For androgenetic hair loss, topical minoxidil (a common brand is Rogaine) may be prescribed. This can stop hair loss 30 to 40 percent of the time, and may even improve hair density. Other treatments include oral antiandrogen pills or hair transplants. There may not be a “cure” for this type of hair loss, but these options can help prevent further shedding. If hair loss is due to alopecia areata, common treatments include steroid injections, diphencyprone (a topical treatment) and sulfasalazine pills, cyclosporine pills or methotrexate pills.
• Wigs and other non-surgical hair systems are practical solutions, and these aren’t your grandma’s wigs either. You can buy clip-on systems like a postiche (starting at $2,200) or a hair integration system, where your own hair is pulled through a cap and integrated with hairs that match yours (starting at $3,500, with maintenance fees to consider).

A version of this article appeared in our September 2012 issue with the headline “Hair today, gone tomorrow,” p. 42.