My hair is thinning. What can I do?

Noticing more hair in your comb or shower drain lately? Maybe your part seems a bit wider than it used to be. Thinning hair or hair loss, also called alopecia, can occur anywhere on your body, is common among men and women, and is estimated to affect as many as 95% of adult men and more than 50% of adult women each year. 

Hair loss occurs for many reasons, in women and men of all ages, but is most common among middle aged and older people. You can lose the hair on your scalp or your entire body. Hair loss can be permanent or temporary. It can also be traumatic. Our hair is often a big part of our identity. Losing our hair is not physically harmful in most cases but the psychological damage can include anxiety, depression and social apprehension. People who have experienced hair loss have reported lower self-esteem, poorer quality of life and body image. 

A certain amount of hair loss is normal. Most of us lose 50 to 100 hairs each day, with new hairs taking their place quickly enough that we overlook the ones we've shed. The problems start when new hair doesn't replace the hair that has fallen out.

If your hair is visibly thinning, either in patches or all over, or if you notice unusual hair loss of any kind, it's essential to see your primary care provider or a dermatologist, to determine the cause and appropriate treatment. 

Possible causes of hair loss

Heredity. Your family history is the most likely determinant of how much hair you will or will not lose over the course of your life. Male-pattern and female-pattern baldness is hereditary and happens as we age. This condition is called androgenic alopecia. It usually occurs gradually and in predictable patterns — a receding hairline and bald spots in men and thinning hair along the crown of the scalp in women. These hereditary causes of hair loss are not preventable.

Trichotillomania. Commonly referred to as 'hair pulling disorder,' trichotillomania is the irresistible desire to pull out your body's hairs from your scalp, eyebrows, eyelids and other areas. Trichotillomania is a long-term (chronic) disorder, which can be mild and manageable or impossible to resist despite your best effort. Symptoms can vary in severity over time and depending on circumstance. If you can't stop pulling out your hair or feel embarrassed or ashamed by your appearance due to your hair pulling, the INTEGRIS Mental Health Clinic can help.

Medication. Some medicines can cause hair loss by disrupting the scalp's hair-growth cycle. Hair growth occurs in a three-phase cycle. The anagen phase is the growth phase, lasting 2 – 7 years. The next three months are the rest phase, or the telogen phase. After the telogen phase, the hair falls out and is replaced by new hair, which happens during the catagen phase. After that, the cycle repeats. The most common type of medicine-related hair loss is telogen effluvium, which causes your follicles to begin their resting phase and release the hair too early, at a rate 30 to 70 percent greater than the standard 100 or so hairs a day.

Common culprits to hair loss include acne medications that contain vitamin A, antibiotics, antidepressants, birth control medication, anticlotting drugs, cholesterol moderating drugs, cancer medications, high blood pressure drugs, mood stabilizers, steroids, weight loss medicines, thyroid drugs, nonsteroidal anti-inflammatory drugs (NSAIDs), medications for Parkinson's disease and hormone replacement therapies.

Hormones. Hormones drive both male and female pattern baldness. Women experience the onset of hair loss most commonly at menopause. Progesterone and estrogen levels diminish during menopause, which allows the body's male hormones (androgens) to increase. Androgens also drive hair loss in men. Women may also notice increased hair loss after giving birth. This phenomenon, often referred to as excessive shedding, is not considered true hair loss and results from decreased estrogen levels. 

Age. In men, this often starts with gradual thinning on top of the head or the hairline may begin to recede. Women may notice the part in their hair becoming broader, although receding hairlines are also becoming more common in women. This is the most common type of hair loss.

Stress or shock. A sudden physical or emotional shock can cause equally sudden hair loss and loosening. It's not usually immediate. For most people the stress/shock-related hair thinning or loss comes a few months after the stressful event occurs. Hair loss of this type is usually temporary.

Tips to hold onto as many of your strands as possible

• Be kind to your hair. No tugging when brushing or combing! Use a conditioning detangler and use a wide-toothed comb on wet hair to help prevent breakage or pulling. 
• Wear a hat or cap in the sun to minimize damage from ultraviolet light.
• Heat and tight ponytails/hairstyles can hurt hair. Avoid heat styling with hot rollers, curling irons or permanents. Tight rubber bands, ponytails, headbands or braids can also break or weaken hair. 
• Check with your doctor that your medications aren't known to cause hair loss as a side effect.
• Don't smoke. Studies have shown a correlation between smoking and baldness in men. (Don't smoke if you're a woman, either!)
• Cool it. If you're undergoing treatment with chemotherapy, check with your doctor about using a cooling cap. Scalp cooling, a technique used for decades in Europe, slows blood flow to your hair follicles by constricting blood vessels. This constriction may also limit the amount of chemotherapy drug that is able to reach your follicles.