In his monthly column, Dr. Herbert answers your questions related to health care matters. Submit your question to marylou@newfalconherald.com. It’s your chance to ask the doc.Question: I am a 51-year old woman and am experiencing hair loss. It has been primarily falling out in clumps at the follicles. Is this just stress or could it be something else?Stress is a common cause of hair loss, but there are many other medical causes. Many causes are treatable; therefore, it is important to fully evaluate any persistent hair loss.The medical term for hair loss is alopecia, and it is important to understand normal hair growth to understand its loss. Hair growth occurs in two phases: the growth phase and the resting phase. At any one time, approximately 90 percent of the hair on one’s head is in the growth phase and 10 percent is in the resting phase.The growth phase lasts several years, during which a hair will grow about one centimeter per month. After the growth phase, the hair enters the resting phase and remains there for several months. At rest, the hair will not grow, and it eventually falls out when a new hair grows in from the follicle. The average person sheds about 100 hairs a day. The thickness or thinness of one’s hair, as well as the perception of hair loss, is related to how many active hair follicles a person has, and how much time each follicle spends in the growth or resting phase.Stress can cause a common form of hair loss called telogen effluvium, where more hairs than normal enter the resting phase from the growth phase. In this form of alopecia, the hair thins over the entire scalp, rather than in patches. This condition is often caused by physical or psychological stress, such as a major illness, having surgery, or a stressful incident. The hair loss usually occurs several months after the event and is temporary. Although there is no effective treatment, the hair will come back as long as the illness or stress is resolved.Another cause of hair loss is alopecia areata, in which hair comes out in patches. It can range in severity from a single patch to multiple patches, which can run together to cause complete hair loss over time. It is an autoimmune disease, or one in which the body’s immune system incorrectly attacks the hair follicles, causing hair from those follicles to fall out. Patchy hair loss can also be caused by scalp infections, such as fungal infections or chronic skin conditions, like eczema. These conditions can usually be treated with creams, but must be done early. Once the skin becomes scarred, hair will not grow and the loss becomes permanent.Certain medications are known to cause hair loss. Most people are aware of the hair loss associated with chemotherapy medications, but it can also occur with some antidepressants, birth control pills, and blood thinners, among others. Certain vitamins, if taken in excess, can also cause hair loss. This type of alopecia will improve when the medication is discontinued. If one suspects that a medication is the cause, they should discuss this with their doctor before stopping it.Hair loss can also be caused by metabolic diseases, such as hypothyroidism (an under active thyroid gland) or iron-deficiency anemia. In these conditions, the metabolism slows down and hair follicles enter the resting phase. Usually, other symptoms will also be present, such as weight gain or fatigue, but hair loss may be the only symptom. Hair loss will improve when the underlying condition is treated.Any discussion of hair loss would be incomplete without mentioning genetic hair loss. Also known as common baldness, it is more common in men but occurs in women as well. In females, the hair thins over the entire scalp. Hair loss can be mild or more complete, and approximately 25 percent of all women will experience some degree of genetic hair loss by age 50. While there is no cure, there are several medications that can promote hair growth. Because they alter male hormones, however, only one is approved for use by women.If you see your doctor for hair loss, they will do a complete physical examination of the scalp to identify any skin disorders and take a medical history to identify any medications or illnesses that may be to blame. They will likely also run blood tests to evaluate for metabolic disorders. While stress may be the cause, it is important to rule out other causes that may be treatable.Dr. Herbert is board-certified and owns Family Physician Falcon Family Medicine at 7641 McLaughlin Road in Falcon. For more information, call (719) 494-2006 or visit www.FalconFamilyMedicine.com
