Hair loss

Baldness or hair loss is usually something only adults need to worry about. But in a few cases, teens lose their hair, too — and it may be a sign that something’s going on.

Hair loss during adolescence can mean a person may be sick or just not eating right. Some medications or medical treatments, like chemotherapy treatment for cancer, also cause hair loss. People can even lose their hair if they wear a hairstyle that pulls on the hair for a long time, such as braids.

Losing hair can be stressful during a time when you’re already concerned about appearance. Most of the time, hair loss during the teen years is temporary. With temporary hair loss, the hair usually grows back after the problem that causes it is corrected.

Hair Basics

Hair is made of a type of protein called keratin. A single hair consists of a hair shaft (the part that shows), a root below the skin, and a follicle, from which the hair root grows. At the lower end of the follicle is the hair bulb, where the hair’s color pigment, or melanin, is produced.

Most people lose about 50 to 100 head hairs a day. These hairs are replaced — they grow back in the same follicle on your head. This amount of hair loss is totally normal and no cause for worry. If you’re losing more than that, though, something might be wrong.

If you have hair loss and don’t know what’s causing it, talk to your doctor. A doctor can determine why the hair is falling out and suggest a treatment that will correct the underlying problem, if necessary.

What Causes Hair Loss?

Here are some of the things that can cause hair loss in teens:

• Illnesses or medical conditions. Endocrine (hormonal) conditions, such as uncontrolled diabetes or thyroid disease, can interfere with hair production and cause hair loss. People with lupus can also lose hair. The hormone imbalance that occurs in polycystic ovary syndrome can cause hair loss in teen girls as well as adult women.
• Medications. Some medications that have hair loss as a side effect may be prescribed for teens. These include acne medicines like isotretinoin, and lithium, which is used to treat bipolar disorder. Diet pills that contain amphetamines also can cause hair loss. Chemotherapy drugs for cancer are probably the most well-known medications that cause hair loss
• Alopecia areata. This skin disease causes hair loss on the scalp and sometimes elsewhere on the body. It affects 1.7% of the population, including more than 5 million people in the United States. Alopecia areata (pronounced: al-uh-pee-shuh air-ee-ah-tuh) is thought to be an autoimmune disease, in which the hair follicles are damaged by a person’s own immune system. (In autoimmune diseases, the immune system mistakenly attacks healthy cells, tissues, and organs in a person’s body.)

  Alopecia areata usually starts as one or more small, round bald patches on the scalp. These can get bigger, and in a small number of cases, can progress to total hair loss. Both guys and girls can get it, and it often begins in childhood. The hair usually grows back within a year, but not always. Sometimes people with alopecia areata lose their hair again.

• Trichotillomania (pronounced: trik-o-til-uh-may-nee-uh). Trichotillomania is a psychological disorder in which people repeatedly pull their hair out, often leaving bald patches. It results in areas of baldness and damaged hairs of different lengths. People with trichotillomania usually need professional help from a therapist or other mental health professional before they are able to stop pulling their hair out.
• Hair treatments and styling. Having your hair chemically treated, such as getting your hair colored, bleached, straightened, or permed, and applying heat to hair (like using a hot iron or hot blow drying) can cause damage that may make the hair break off or fall out temporarily.

  Another type of baldness that results from hair styling actually can be permanent: Wearing hair pulled so tightly that it places tension on the scalp can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the hair follicles.

• Poor nutrition. Poor eating can contribute to hair loss. This is why some people with eating disorders like anorexia and bulimia lose their hair: The body isn’t getting enough protein, vitamins, and minerals to sustain hair growth. Some teens who are vegetarians also lose their hair if they don’t get enough protein from non-meat sources. And some athletes are at higher risk for hair loss because they may be more likely to develop iron-deficiency anemia.
• Disruption of the hair growth cycle. Some major events can alter the hair’s growth cycle temporarily. For example, delivering a baby, having surgery, going through a traumatic event, or having a serious illness or high fever can temporarily cause shedding of large amounts of hair. Because the hair we see on our heads has actually taken months to grow, a person might not notice any disruption of the hair growth cycle until months after the event that caused it. This type of hair loss corrects itself.
• Androgenetic alopecia. Among adults, the most common cause of hair loss is androgenetic (pronounced: an-druh-juh-neh-tik) alopecia, sometimes called male- or female-pattern baldness. This condition is caused by a combination of factors, including hormones called androgens and genetics. Sometimes, the hair loss can start as early as the mid-teen years. It also can occur in people who take steroids like testosterone to build their bodies.
  

  What Can Doctors Do?

  If you see a doctor about hair loss, he or she will ask questions about your health and family health (called a medical history) and check your scalp. In some cases, the doctor might take hair samples and test for certain medical conditions that can cause hair loss.

  If medication is causing hair loss, ask the doctor if you can take a different drug. If your hair loss is due to an endocrine condition, like diabetes or thyroid disease or female-pattern baldness, proper treatment and control of the underlying disorder is important to reduce or prevent hair loss.

  If your doctor recommends it, a product like minoxidil that can increase hair growth in male-pattern baldness also might be helpful. Alopecia areata can be helped by treatment with corticosteroids. If nutritional deficiencies are found to be causing your hair loss, the doctor might refer you to a dietitian or other nutrition expert.

  Catastrophic Hair Loss

  Hair loss can be the first outward sign that a person is sick, so it may feel scary. Teens who have cancer and lose their hair because of chemotherapy treatments (especially girls) might go through a difficult time.

  It can help to feel like you have some control over your appearance when you’re losing your hair. When getting chemotherapy, some people like to cut their hair or shave their heads before the hair falls out. Some even take the hair they cut off and have it made into a wig.

  Many options can help disguise hair loss — such as wearing wigs, hair wraps, hats, and baseball caps. For most teens who lose their hair, the hair does return — including after chemotherapy.

  Taking Care of Your Hair

  Eating a balanced, healthy diet is important for a lot of reasons, and it really benefits your hair.

  If you’re losing hair, some doctors recommend using baby shampoo, shampooing no more than once a day, and lathering gently. Don’t rub your hair too vigorously with a towel, either. Many hair experts suggest putting away the blow dryer and air drying your hair instead. If you can’t live without your blow dryer, try using it on a low-heat setting.

  Style your hair when it’s dry or damp. Styling your hair while it’s wet can cause it to stretch and break. And try to avoid teasing your hair, which can cause damage. Finally, be careful when using chemicals — such as straighteners or color — on your hair, and avoid frequent use of chemical treatments.

  Reviewed by: Patrice Hyde, MD
  Date reviewed: October 2011

Hair loss