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Marri K. Brackman, DO

Hair loss--

So first of all, stop stressing about your hair loss—no seriously, there are numerous causes for hair loss, but stress can cause hair loss, too! Though before we can talk about abnormal hair loss, we need to talk about what is normal. It is normal to lose 50-100 hairs in a day (most people have 100,000+ hairs on their head). First step is the hair pull test. You gather a small clump of hair and gently tug. If less than 10% of the hairs fall out, you have what is considered normal hair loss. If there is more, there MAY be a problem.


So you pull out a lot of hair—now what? Well we have to figure out what is causing the hair loss. This is when you want to talk to your doctor.


First of all there is hereditary hair loss. . This the male and female-pattern baldness, which is the most common cause of hair loss. More common in men, though women can be affected too. This is IRREVERSIBLE hair loss.


Hormonal hair loss. This is what new mom’s see around 4 months post-partum, and then again when stopping breast feeding. While pregnant, the hairs stall in the last stage of cellular aging, which is why you have luscious, thick hair when pregnant. But eventually the cellular aging turns back on and wham—hair loss! This can also occur in menopause.


There are also certain medical conditions that cause hair loss—probably most commonly discussed is thyroid disease.


Certain medications will cause hair loss. Chemotherapy (though there are some studies that show some promise in helping this—cooling caps), certain medications for blood pressure, and some antidepressants as well.


Other causes of hair loss include:

Dietary deficiencies including calorie restriction, iron deficiency, biotin;

certain hairstyles that pull on the hair;

a medical condition in which people pull out their hair (trichotillomania )


Stress is also a very common cause of hair loss. A sudden physical or emotional stressor on the body can trigger hair loss.


So how do we diagnose the cause of the hair loss? Your history is really helpful, some lab work as well (especially for thyroid related hair loss). A biopsy of the scalp can also be done.


Treatment has a few layers. Obviously, start by treating the underlying cause—if one is found. Stop the offending agent that is causing the hair loss—good option for medication induced. Reassess your diet. There are some prescription medications that can help as well, some can be prescribed by your primary care physician, some will be treated by a dermatologist.


So if you notice increased hair in the drain, your hair dresser comments on thinning hair, or you notice increased hair on your brush, please talk to your doctor. Hair loss is something that can be reversible and treatable—just ask!


…until next time, IrishDoc07

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