Each year, millions of men and women suffer from unexplained hair loss.
Oftentimes, this visible problem may be a sign of an internal medical problem that is even more serious than the hair loss itself. Fortunately, a dermatologist can help many get to the root of the problem.
Speaking at the American Academy of Dermatology's 2003 Annual Meeting in San Francisco, dermatologist Amy J. McMichael, MD, associate professor, Department of Dermatology, Wake Forest University, Winston-Salem, NC, discussed some of the serious internal diseases as well as drug side effects that are linked to hair disorders.
While millions of Americans at any given time are on a quest to lose weight, some end up going to extremes to lose these extra pounds. Anorexia and bulimia are two common eating disorders that can have devastating effects on a person's overall health and self-esteem - and, as dermatologists point out, hair.
"People with serious eating disorders often try their best to hide their condition, but often it will affect aspects of their personal appearance that they can't hide, such as their hair," said McMichael.
People with eating disorders often develop calorie and/or protein malnutrition, which forces the body to save protein by shifting growing hairs into the resting phase. This shift causes shedding of the hair spread out over the entire scalp. This type of hair loss, known as telogen effluvium, is slow and not noticeable until close to half the hair is lost. There may also be increased loss when combing, brushing, and washing the hair. Oftentimes, patients may experience an increase in the baby fine hairs known as lanugo hairs that grow on the face over the cheeks and forehead.
Once the underlying eating disorder is diagnosed and treated, the hair loss can be reversed and prevented as long as the patient maintains a proper nutritionally-sound diet. Even individuals who are losing weight in a physician-monitored program may experience some hair loss 3 to 6 months after losing more than 15 pounds. This hair loss is common and will return to normal.
"This same pattern of hair loss experienced in individuals with an eating disorder is nearly identical to people who are anemic or have an iron deficiency," added McMichael. "Since there are at least 30 diseases that can cause permanent or long-term hair loss, such as thyroid disease or lupus erythematosus, it is crucial for anyone with unexplained hair loss to talk to their dermatologist for the correct diagnosis and treatment based on their condition. Your dermatologist can also determine whether or not the hair loss is a specific type of hair condition including, for example, androgenetic alopecia, characterized by thinning hair, or alopecia areata, marked by patches of hair loss or complete hair loss on the scalp."
Hair loss can also be a sign of both hyperthyroidism, an overactive thyroid, and hypothyroidism, an underactive thyroid. In hyperthyroidism, scalp hair may become fine and soft with scattered hair loss. In hypothyroidism, head and body hair can become dry and coarse with scattered partial hair loss, madarosis (or loss of the lateral one-third of the eyebrows), or an increased percentage of telogen hairs, or shedding hairs.
"Since laboratory tests are needed to diagnose a thyroid problem, it is important for patients who notice these types of changes in their hair to see a dermatologist," explained McMichael. "In most cases, hair loss caused by thyroid disease can be reversed with the proper treatment."
Oftentimes, a dramatic change in hormones can cause unexplained hair loss - especially in women. If, for example, the hormonal imbalance is associated with increased androgens (or male hormones), women will experience increased thinning over the crown of the scalp while still maintaining the frontal hair line. Since with this type of condition the hair is not as noticeable as it falls out because it becomes so thin, the scalp will become increasingly more noticeable as the condition worsens.
"Patients with this type of hair loss may require specific testing to measure abnormal hormones if we suspect that this is the culprit based on a patient's symptoms and hair loss pattern," said McMichael. "If a woman tests positive for ovarian overproduction of androgens, hormonal supplements may be required to regulate these hormones. However, this type of hair loss is harder to treat than the form of hair loss that occurs in patients with an eating disorder, iron deficiency, and thyroid disease. Once the underlying hormonal problem is treated, the hair loss may not improve or only improve minimally." This article was prepared by Health & Medicine Week editors from staff and other reports.
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