Hair loss, or alopecia, can result from various factors, including genetics, hormonal changes, medical conditions, diet, stressors, hair care practices, and lifestyle choices. A dermatologist for hair loss can help you get you to the correct diagnosis faster and offer the most appropriate treatments. A dermatologist is the most expert professional to diagnose and treat hair loss.
We may think of hair as an issue of vanity. Hair, however, is an important appendage of the skin that plays a role in our well being and provides signals about our health. Although hair itself is not a vital organ, its absence can have a tremendous psychological impact and cause suboptimal health function.
Our hair sends social signals about our age, fertility, and health status. Further, hair helps regulate our temperature, protects us from infection, and filters out external allergens, pollutants, and irritants.
About 50% of the population will experience hair loss at some time in life.
Understanding the Hair Growth Cycle
Hair growth is a complex biological process that follows a specific cycle. This cycle consists of three distinct phases: anagen, catagen, and telogen, each playing a crucial role in the development and renewal of hair and types of alopecia.
The anagen phase is the growth stage, where hair actively grows from the follicles. This phase can last anywhere from two to seven years, and the duration is largely determined by genetic factors. During the anagen phase, cells in the hair root divide rapidly, adding to the hair shaft and allowing it to grow longer. The length of time hair spends in this phase determines its maximum length, which is why some people can grow their hair very long while others cannot.
Following the anagen phase is the catagen phase, a brief transition period that lasts about two to three weeks. During this phase, hair growth stops, and the hair follicle shrinks. This stage marks the end of active growth and prepares the hair for the resting phase.
The final phase is the telogen phase, which lasts around three months. In this resting stage, the hair remains in the follicle but is not actively growing. Eventually, the old hair is shed, and a new hair begins to grow in its place, starting the cycle anew. On average, about 10-15% of the hairs on your scalp are in the telogen phase at any given time.
Understanding the hair growth cycle is crucial for identifying and managing hair loss conditions such as telogen effluvium and anagen effluvium. Telogen effluvium occurs when a significant number of hairs enter the telogen phase prematurely, often due to stress, illness, or hormonal changes, leading to noticeable shedding. In contrast, anagen effluvium involves the abrupt loss of hair during the anagen phase, typically caused by chemotherapy or other medical treatments that affect rapidly dividing cells.
Categories of Hair Loss
People often have a misconception that all hair loss is the same. The truth is that there are many types and causes of hair loss or alopecia. An important part of diagnosing hair loss is to determine if it falls into the categories of non-scarring vs scarring or cicatricial alopecia:
Understanding Primary vs. Secondary Hair Loss
Hair loss is generally categorized into two types: primary and secondary hair loss, each with distinct causes and implications:
Primary hair loss is directly related to conditions that specifically affect the hair follicles and scalp. Eamples of this would be androgenetic alopecia or alopecia areata.
In contrast, secondary hair loss is a result of external factors or underlying medical conditions that indirectly affect hair growth and health. Telogen effluvium is a type of secondary hair loss. It can occur due to a variety of reasons such as severe illness, nutritional deficiencies, medications, or psychological stress.
Distinguishing between primary and secondary hair loss is essential for determining the appropriate course of treatment. Primary hair loss often requires targeted therapies that address the specific condition affecting the hair follicles.
Hair loss diagnoses
Hair loss, or alopecia, is not itself a diagnosis. There are many different types of hair loss. We divide the diagnoses into the categories scarring and non-scarring:
Non-scarring hair loss (alopecia):
Non-scarring hair loss refers to types of alopecia in which there is the possibility that the hair can grow back. The hair follicles are still present and potentially functional. Non-scarring hair thinning can also happen with age. Here are some common types of non-scarring alopecia:
- androgenetic alopecia
- male pattern hair loss
- female pattern hair loss
- perimenopausal
- telogen effluvium
- post partum hair loss
- alopecia areata
- anagen effluvium from chemotherapy
- lupus
- syphilis
- traction alopecia (early)
- trichotillomania (early)
- tinea capitis or ring worm (early)
- age-related
Scarring (cicatricial) hair loss (alopecia):
In scarring, or cicatricial, alopecia some of the hair loss is permanent because of the absence of, or severe damage to, the hair follicle. Cicatricial alopecia can occur as a result of a primary hair disorder, or be secondary to a skin disorder or trauma. It is often worth it to treat scarring alopecia even when some of the loss is permanent in order to prevent further loss and attempt to restore function to injured hair follicles. Some common types of scarring hair loss include:
- central centrifugal cicatricial alopecia (CCCA)
- frontal fibrosing alopecia
- lichenplanopilaris (LLP)
- discoid lupus
- dissecting cellulitis
- traction alopecia (late)
- trichotillomania (late)
- tinea capitis or ring worm (severe)
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Diagnosis of hair loss
As there are many causes of hair loss, it is important to make a diagnosis before one starts treatment. The diagnosis of hair loss can be challenging even for doctors, and even some dermatologists without intense training and experience in this area. There is more involved in figuring out why someone’s hair falls out than exploring just their thyroid function or their diet.
At your initial consultation our hair loss dermatologist will go through a process to determine why your hair is falling out or thinning. The steps may include:
- health history
- family history
- physicial examination
- blood tests
- scalp biopsy
- fungal or bacterial cultures
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Treatment for Hair Loss
Once a diagnosis is established, our dermatologist will discuss treatments for hair loss. The treatment will depend on the cause. Treatments may be medical, surgical, over-the-counter, or prescription. Some hair loss treatments, such as minoxidil, can be used generally for many types of alopecia. Some types of hair loss require more specific interventions such as addressing a health problem, changing the diet, or procedures:
- medications
- supplements
- injections
- hair restoration (Alma TED, PRP, hair transplant)
- red light therapy
- laser therapy
- hair grooming practices
Hair Loss: Other Concerns
Normal amout of hair loss
Hair loss is an expected part of the hair growth cycle. There is nothing unusual about shedding between 50 and 100 hairs a day. However, shedding more than 125 hairs a day might indicate hair loss, and you should visit a dermatologist for an evaluation.
Similarly, you should visit a dermatologist of your overall hair is thinning, if you find new areas of baldness, your part is widening, or your hairline is receding. Remember, significant hair loss can be an indicator of more serious health concerns, and seeking an effective hair loss treatment plan is not purely cosmetic.
Hair loss and diet
Certain nutritional deficiencies are associated with hair loss. These include protein malnutrition, biotin, zinc, and iron deficiencies. Although it is more controversial, some believe that vitamin D deficiency contributes. Vegetarians and vegans, as well as people with bowel problems that affect their ability to absorb nutrients are also at an increased risk of hair loss. Rapid weight loss can also cause hair shedding.
Supplements and vitamins for hair loss
The value of taking vitamins or other supplements for hair loss depends on the specific product, the diagnosis and a person's underlying health. Taking excess amounts of biotin or zinc won't make hair grow longer or thicker if one is not deficient in these nutrients. At times, however, taking certain supplements for a few months when is recovering from hair loss can support this process. Discuss this with your doctor.
Hair loss on body?
Although we are more familiar with the idea of hair loss on the head, people can also develop alopecia on any part of the body that normally grows hair such as eyebrows, eyelashes, beard, legs and under the arms. Conditions that cause hair loss on areas other the scalp include alopecia areata, alopecia totalis, lupus, and lichen planopilaris.
Black Hair Loss
When it comes to hair loss, it's important that your hair loss specialist in familiar with the specific needs of your hair type. Black hair has a unique and delicate hair texture. Although hair loss affect people of all ethnic backgrounds, African Americans experience certain types of hair loss more commonly for the following reasons:
- Hair Texture: Curly and kinky hair is more fragile and prone to breakage with grooming. In addition, people with curly or kinky hair are more prone to developing ingrown hairs, which can cause inflammation, scarring, and hair loss.
- Grooming Practices: Market research indicates that style is very important to African American consumers. Some grooming practices required to achieve certain hair styles traumatize the hair and scalp resulting in damage and hair loss.
- Genetics: Some types of hair loss, such as central centrifugal cicatricial alopecia (CCCA), which predominantly affects African American women, is thought to be caused by a genetic predisposition to develop chronic inflammation in the scalp as a result of traumatic hair styling practices such as tight braids, tight weaves, or heavy dreadlocks.
Read: Skin of color
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Preparing for your Hair Loss Consultation
When you visit the dermatologist about hair loss it is helpful to be prepared for your visit. You hair and scalp needs to be available for examination. Ideally, your hair should be loose, not in braids or a weave. If you wear a wig, expected to remove it.
Conclusion | Dermatologist hair loss NYC
If you are experiencing hair loss contact us at Aglow Dermatology in New York City to schedule a consultation with our hair loss specialist. Call 212-627-1004 or fill out the consultation request form from our contact page. Dr. Dina Strachan and her professional staff serve patients in New York City and the surrounding areas. Virtual visits are available all over New York State and Connecticut.
YouTube Channel Hair Loss Contents
If you are not familiar with our YouTube Channel, please check it out. We have an entire section dedicated to Hair Care and Hair Loss. For those of you who may have a specific topic in mind, below is a list of our videos based on hair loss subject.
- Do You Comb Curly Hair?
- What is CCCA Alopecia?
- How Often Should I Grease My Scalp?
- Can Eczema Cause Hair Loss?
- How Often Should I Condition My Hair?
- How do I Treat Damaged and Dry Hair?
- Does My Hair Color Affect My Hair Loss?
- Do Pony Tails Cause Hair Loss?
- What are the Different Catagories of Hair Loss?
- Scalp Biopsy for Hair Loss, What is Involved?
- Punch Biopsy of Skin
- Does Zinc Affect My Hair Loss?
- Do Firbroids Cause Hair Loss?
- Why Do We Have Nose Hair?
- What Causes Eyebrow Thinning?
- Does Pregnancy Effect Hair Loss?
- Is My Hair Loss a SIgn of Something More Serious?
- What Causes Dry Scalp? Does It Cause Hair Loss?
- Does Wearing a Baseball Hat Cause Hair Loss?
- If I Stop Using Rogaine Will My Hair Fall Out?
- How Often Do I Have to Wash My Hair?
- Hair Loss is not a Joke
- Hair Discrimination and Hair Loss
- Dermatology Hair Loss Specialist Dr. Strachan on Hair Loss and Race
- What are the Causes of Hair Loss: Understanding Alopecia from A Board Certified Dermatologist