I am losing my hair; what can I do? When I run my hands through my hair, both hands are full of hair. It has been about two weeks since this started. I am really afraid. I know that something must be wrong. Please help!
When it comes to appearances, there is nothing more valued than hair. Powerful cultural values and associations are given to youthful-appearing hair; hair that is soft, full and shiny. One’s sexuality and physical appeal, for both men and women, are powerfully influenced by hair, although the associations vary from person to person, and culture to culture. Some people would prefer and are attracted to long hair or generous amounts of body hair. Others prefer short and well-cropped hair. And there are strong feelings about the removal — or not — of leg, underarm or facial hair. Even genital hair is the subject of fascination.
Hair loss, especially when it begins spontaneously and with no apparent trigger, causes worry and anxiety. For better or worse, we become attached to our hair, to our appearance. Becoming bald by shaving one’s head has a certain macho appeal. But becoming bald because all of one’s hair falls out, especially for women, causes grief, frustration and anger.
Losing Handfuls of HairLosing Handfuls of HairThere are a couple of notions that might help to understand hair loss. The first is that each individual hair has a growth cycle. The hair on the scalp tends to grow consistently over a period of two to five years. Then it falls out during a dormant phase lasting several months. After that it begins to grow once again. About 90 percent of the hair on the scalp is in an active growth phase at any one time. Therefore, if anything happens to disrupt hair growth, many more hairs may cycle into a dormant phase all at once, leading to a period of accelerated hair loss.
What kinds of things cause a disruption of hair growth? One of the most common is pregnancy. In the months after delivery, many women find that their hair falls out in large amounts. By and large, this is a temporary phenomenon related to the rise and fall of various hormones, and within 18 months everything is back to normal. (Some women feel that the amount of hair in their scalp is never the same after pregnancy. I am not sure if any studies have been done in this area.)
Other disruptions include significant or prolonged fevered illnesses, certain scalp infections, a variety of prescription medications including oral contraceptives, beta-blockers, some anti-depressants, and of course cancer chemotherapy. Other causes of gradual hair loss and thinning include an underactive thyroid, iron deficiency, and immunological diseases such as systemic lupus.
Some hair loss is genetic, most notably male-pattern hair loss. Here a family history of recession of the hair line around the temples and later the back and top of the scalp is characteristic. Female-pattern hair loss is usually more diffuse, not actually causing baldness or a receding hair line, but rather a generalized thinning of the hair, especially over the top of the scalp. This, too, sometimes runs in families. Then there are diseases such as “alopecia areata” that can cause sudden patches of complete hair loss on the scalp, or “alopecia totalis” (sudden total baldness) and, rarely, “alopecia universalis” (combined total facial and scalp hair loss). No one knows what causes these alopecia syndromes but they are easy to spot because of the completeness and suddenness of the changes. Remember that aggressive use of chemicals on the hair, be it for coloring, tinting, straightening or curling, can be toxic or mechanically damaging and result in hair loss.
Sometimes hair seems to fall out in larger amounts and it may be hard to tell what is happening when simply looking at your scalp. Time will tell. If you don’t have obvious progressive thinning or recession, don’t worry about what comes out in your hand or in the shower. On the other hand, be alert for scaling of the scalp and for hair shafts breaking (rather than falling off by the roots), and think back to whether you have been ill recently or whether you have been given a new medication. For women, if your periods have stopped, or facial hair is suddenly more pronounced, these are also clues that should prompt a visit to your doctor.
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