Causes of Excessive Hair Loss

Please discuss causes of excessive hair loss. I don't know if my hair loss is due to illness, diet, or medications.

Excessive hair loss can be due to a wide variety of causes. Individuals who notice that they are shedding hair after combing or brushing or that their hair is becoming thinner or falling out should consult a dermatologist, who can determine if a specific disease is present and whether the problem will respond to medical treatment. The dermatologist may evaluate a patient's hair problem by asking questions about diet, drugs taken within the last six months, family history of hair loss, any recent illness, and care of hair. The dermatologist may ask a female patient about her menstrual cycles, pregnancies, abortions, and menopause. After examining a patient's scalp and hair, the dermatologist may check a few hairs under a microscope. In a few cases, additional laboratory tests, including drawing some blood for analysis and performing a scalp biopsy, may be necessary.

Between six weeks and three months after a person has any illness accompanied by a high fever, he or she may be shocked to see a lot of hair falling out. This hair loss is usually temporary, with normal growth resuming within a few months.

Abnormal thyroid gland function—both hyperthyroidism (excess secretion by the thyroid gland) and hypothyroidism (a deficiency of thyroid hormone secretion)—can cause hair loss that is usually reversible with proper treatment.

Various drugs may also cause reversible hair shedding in a small percentage of people. Examples of such drugs are some anticoagulants, some anti-gout and anti-arthritis drugs, some antidepressants, some beta blockers (for controlling heart problems and high blood pressure), vitamin A in high doses, and birth control pills.

Hormonal abnormalities in females can result in alopecia, along with other problems such as acne, hirsutism, obesity, and infertility. (Only occasionally are hormonal abnormalities the cause of hair loss in males.) If the hormonal abnormality is corrected, normal hair growth usually resumes.

Other causes of abnormal hair loss, such as childbirth, are discussed elsewhere in this chapter. You can write to the American Academy of Dermatology, 1567 Maple Avenue, Evanston, Illinois 60201, for more information on hair loss.

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