Hi everyone, Dr. Paul from Hair Transplants Melbourne. One of the most common questions I get asked is, “What causes hair loss?” Broadly speaking, there are both pathological and non-pathological causes of hair loss.
The typical cause, particularly in men, is what we call male pattern or androgenic-related hair loss. It follows a typical pattern where men start receding at the hairline, developing peaked areas on either side of the forehead. They can also lose hair in the mid-scalp and the crown. This is typically related to the hair follicles on the top of the head being affected by a hormone called dihydrotestosterone (DHT). Some men are more genetically predisposed to have their hair follicles more sensitive to DHT, causing them to lose hair at a faster rate.
Women can also experience male-pattern hair loss, and sometimes androgen blockers are used to help treat this. In women, it is often found in those with polycystic ovarian syndrome and in those with a higher androgen state. To address this, we typically aim to reduce DHT levels in the scalp by blocking the conversion of testosterone to DHT, allowing the hair follicles a better chance to grow.
Metabolic disorders can also cause hair loss. For example, both an underactive and an overactive thyroid can lead to excessive hair loss or shedding. Additionally, deficiencies in vitamin D or iron, which are critical for metabolism, can contribute to hair loss. It’s important to check those levels.
Another common cause is traction alopecia, which often affects women who wear their hair tightly in ponytails. The constant pulling can damage the hair follicles, especially around the hairline, leading to hair loss. This type of hair loss is typically known as traction alopecia.
There are also behavioral causes of hair loss, such as trichotillomania. This is where individuals have a compulsion to pull their own hair out. This is difficult to treat because it is often linked to anxiety disorders.
On a more serious note, there are pathological causes of hair loss, including frontal fibrosing alopecia and lichen planopilaris. These are autoimmune conditions where the immune system attacks hair follicles, leading to hair loss. These conditions typically affect the hairline, extending backward, and may result in a waxy appearance of the scalp. They can be very difficult to treat.
There are other autoimmune disorders that can contribute to hair loss, including rheumatoid arthritis, lupus, and various connective tissue disorders. These can also cause hair loss as part of their broader effects.
