Symptoms and Signs of Hair Loss (Alopecia)

Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 9/24/2021

Doctor's Notes on Hair Loss (Alopecia)

Hair loss (alopecia) becomes a cosmetic problem when it occurs in the wrong place at the wrong time in the wrong individual. Cosmetically significant hair loss falls into two categories: Scarring alopecia, which is irreversible hair loss characterized by damage to the underlying skin which results in scarring that destroys the hair follicle and its potential for regeneration; and non-scarring alopecia, which is a common and potentially reversible type of hair loss. Common causes of hair loss include male pattern baldness, female-pattern baldness, telogen effluvium (occurs mostly in females, especially post pregnancy), alopecia areata, certain medications and chemotherapy drugs, poor nutrition and strict dieting, and certain types of weight loss (bariatric) surgery.

Hair loss is a symptom itself that is usually noticed by individuals when they look at themselves in a mirror or when others bring it to their attention.

  • Hairs on the pillow in the morning or more hairs in the hairbrush or comb can be signs of hair loss.
  • Women may notice less hair in their ponytails or widening parts. 

What Is the Treatment for Hair Loss?

The treatment for hair loss depends on the cause. Medications and surgical treatments for hair loss include:

  • Minoxidil (Rogaine)
    • Self-treatment with foam or liquid available over-the-counter (OTC)
    • For men and women
  • Finasteride (Propecia)
    • Prescription pill medication
  • Spironolactone (Aldactone)
    • Prescription pill medication
    • Not safe for pregnant women
  • Topical immunotherapy
    • Used for alopecia areata
  • Topical corticosteroids
    • Creams or gel applied to areas of low hair growth
    • Used for alopecia areata
  • Surgical hair implants
    • Plugs or micro implants
  • Hair replacement systems
    • Toupee, wig, and permanent synthetic hair attachments
  • Post-pregnancy hair loss often resolves on its own without treatment

REFERENCE:

Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.