Hair Loss (Baldness)

What Is Hair Loss (Baldness)?

A normal scalp sheds about 25 to 100 hairs per day. An increased rate of hair shedding or development of bald areas on the scalp constitutes hair loss disorder, which is also known as alopecia.

What Causes Hair Loss?

The causes of hair loss include:

• Abnormal hair cycling
• Aging
• Burns
• Change in hormones
• Deficiency in iron or protein intake
• Excess vitamin A intake
• Family history of baldness
• Illness
• Infection or inflammation of the scalp
• Protein or iron deficiency
• Rapid weight loss
• Trauma
• Untreated ringworm of the scalp

However, hair loss is not caused by the following:

• Poor circulation to the scalp
• Dandruff
• Excessive hat-wearing

Generally, the earlier hair loss begins, the more severe the baldness will become.

Types of Baldness

Some common types of baldness include the following:

• Female-pattern baldness: Although less common, female-pattern baldness differs from that of male-pattern baldness in that the hair generally thins all over the head, but the frontal hairline is maintained. Female-pattern baldness rarely results in total hair loss.
• Male-pattern baldness: Male-pattern baldness usually is a hereditary condition. The condition may begin at any age. Hair loss often begins on the front, sides or crown of the head. Some men may develop a bald spot or just a receding hair line, while others may lose all their hair.
• Alopecia areata: This hair loss disorder is characterized by sudden loss of hair in one particular area, which grows back after several months. However, if all body hair is suddenly lost, regrowth may not occur. The exact cause of this type of hair loss is unknown. There is a genetic link as well as a link with autoimmune conditions and allergies.
• Toxic alopecia: Toxic alopecia, sometimes called telogen effluvium hair loss, may occur following a high fever or severe illness. Certain medications, especially thallium, high doses of vitamin A and retinoids, may cause toxic alopecia. Medical conditions, such as thyroid disease and childbirth may also trigger toxic alopecia. The condition is characterized by temporary hair loss. Also, some cancer medications can cause hair loss.
• Scarring or cicatricial alopecia: Scarred areas may prevent the hair from growing back. Scarring may occur from burns, injury or X-ray therapy. However, other types of scarring that may cause hair loss can be caused by diseases, such as lupus, bacterial or fungal skin infections, lichen planus, sarcoidosis, tuberculosis or skin cancer.
• Trichotillomania (hair pulling): Hair pulling, a habit most common among children, may cause hair loss.

Signs and Symptoms of Hair Loss

Signs and symptoms vary depending on the cause of hair loss. Among the common symptoms patients may notice are:

• Receding hairline due to hormonal pattern hair loss
• Increased hair shedding 3 to 4 months after physical or mental stress
• Red, inflamed scalp followed by hair loss and scarring

Treatment for Hair Loss

Most forms of baldness have no cure, especially if a person has total baldness. Some types of baldness will disappear on their own. Treatment may include:

• Certain medications to promote hair growth (such as minoxidil and finasteride)
• Corticosteroid injections (when treating alopecia areata)
• Treating any underlying condition or disease
• Hair transplants
• Scalp reduction
• Skin lifts and grafts

What Is Hair Replacement Surgery?

We offer several hair replacement techniques at UCLA Dermatology, although hair replacement surgery cannot help those who suffer from total baldness. Candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. This hair will serve as hair donor areas where grafts and flaps will be taken.

We offer four primary different types of hair replacement methods:

• Hair transplantation: During hair transplantation, the surgeon removes small pieces of hair-bearing scalp from the back or sides of the head to be used as grafts. These grafts are then relocated to a bald or thinning area.
• Scalp expansion: In this procedure, a device called a tissue expander is placed underneath a hair-bearing area that is located next to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Another operation is then required to place the newly expanded skin over the adjacent bald spot.
• Flap surgery: Flap surgery is ideal for covering large balding areas. During this procedure a portion of the bald area is removed and a flap of the hair-bearing skin is placed on to the bald area while still attached at one end to its original blood supply.
• Scalp reduction: Scalp reduction is done in order to cover the bald areas at the top and back of the head. This technique involves the removal of the bald scalp with sections of the hair-bearing scalp pulled together filling in the bald area. This can be performed alone or in combination with hair transplantation.

Possible complications associated with hair transplantation procedures may include the following:

• Patchy hair growth: Sometimes, the growth of newly placed hair has a patchy look, especially if it is placed next to a thinning area. This issue can often be corrected by additional surgery.
• Bleeding or wide scars: Tension on the scalp from some of the scalp reduction techniques can result in wide scars or bleeding.
• Unsuccessful grafts: Occasionally, there is a chance that the graft may not "take." If this is the case, surgery must be repeated.
• Infection: As with any surgical procedure, there is the risk of infection.

Contact Us

For more information or to schedule an appointment, call (310) 825-6911.