Hair loss

The following can cause hair loss:

• Androgenetic alopecia is normally caused by a genetic disposition. It is the most frequent cause of hair loss in middle-aged men.
• Hormonal fluctuations can cause hair loss in women, e.g. when breastfeeding or in the menopause.
• A sudden circular hair loss - alopecia areata - is frequently the result of an auto-immune illness.
• Serious organic illnesses or infections
• Other skin diseases such as tinea capitis (fungal infection of the hair), burns or severe inflammations can result in scarring and thus also hair loss.
• Deficiency symptoms (vitamin, mineral or trace element deficiency), e.g. through dieting
• Metabolic disorders (glandular dysfunctions, diabetes)
• Intake of drugs e.g. cytostatics for the treatment of a tumour illness
• Harmful substances in the environment
• Stress, psychological burdens
• Mechanical burden caused by tightly bound hair styles, e.g. ponytails or frequently worn headpieces can cause hair loss or hair breakage.
• With children and young people, in particular among girls, there is sometimes a pathological need to pull out their hair (trichotillomania).

Damaging influences particularly affect hairs that are currently in their growth phase, so that these enter the telogen phase prematurely. With slight damage, the hair loss starts around 2 to 4 months later – after the telogen phase.

If the damage is greater, some of the anagen hair is transformed into telogen hair; sensitive anagen hair becomes dystrophic within a few days, i.e. they become more pointed and quickly break off at the narrowest point. Hair loss starts quickly.

Substantial damage results in hair loss starting within a few days. In extreme cases, the hair breaks in the follicle and falls out after a few hours.

Methods of examination

The following examinations are available to clarify the causes:

• Examination of the scalp for inflammations, scaly skin, scarred areas
• Examination of the hair distribution pattern
• Anamnesis: Asking about family and occupational pre-history, e.g. whether other family members suffer or have suffered from hair loss, what substances they work or worked with in their jobs, etc.
• Blood tests to determine the metabolic and hormonal values
• Carrying out of a trichogramme or trichoscan. With this method, it is possible to determine which phase of the cycle the hair is in. Indications of possible damage can be derived from the result. The trichoscan is a modern procedure with which enlarged photos of the scalp can be taken with the aid of a microscope and a camera and which can then be analysed using a computer. In addition to the life cycle phase, the hair thickness and speed of growth can also be determined.
• The doctor will normally ask the patient to collect and count all the hair that falls out over several days (between 80 and 100 hairs are normal).