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Commentary: What is Alopecia? 6 Things People Get Wrong About Hair Loss

02/06/22 Wendy S. Levinbook, MD, Hartford Dermatology Associates;

Few people expected hair loss to be a trending topic after this year’s Academy Awards. Yet searches around hair loss were up on and across the web following the annual awards ceremony. Much of the coverage around Jada Pinkett Smith’s alopecia highlighted some common misconceptions around hair loss.

We lose about 50 to 100 scalp hairs normally each day, according to the American Academy of Dermatology. But most people will experience more significant hair loss in their lives. We worry about how hair loss will impact our appearance, and in some cases it can be a sign of more serious medical issues. So even outside of celebrity news, many of us are curious about what causes hair loss, how hair loss is treated, and if hair loss can be prevented. Here are some common misconceptions around hair loss, along with the facts people should know.

Misconception #1 - Alopecia is a Specific Medical Condition

Alopecia is simply the medical term for any type of hair loss. It is not a specific medical condition. There are many specific types of alopecia. The most common is androgenetic alopecia, which is related to aging. By age 80, more than 70% of men and 50% of women will have this form of alopecia.

Misconception #2 - Hair Loss Only Affects Older Men

While androgenetic alopecia affects more people with age, it can begin at any time, including during adolescence and puberty. Hormones and heredity play a major role in when people begin to experience hair loss. What’s more, it’s not just men who experience hair loss. Women also experience hair loss, although the pattern of hair loss tends to be different in men and women. In women, hair is usually first lost on the top of the head. Typically, the hair thins rather than is completely lost, and the hairline stays intact.

Misconception #3 - Hair Loss is Passed Down from Just Your Mother or Father

There’s a persistent myth that hair loss in men is passed down from the mother’s side of the family while hair loss in women is passed down the father’s side. While genetics play a part in male- and female-pattered hair loss, these traits are passed down from both parents. Individuals can’t predict their hair loss odds by looking at specific aunts and uncles on either side of the family.

Misconception #4 - Nothing Can Prevent Hair Loss

There are a wide range of products, vitamins and therapies that claim to prevent or even undo hair loss – often with a hefty price tag attached. The reality is, it’s difficult to regain hair that’s already been lost in most cases. Slowing or stopping hair loss depends on the cause of the hair loss, but there are some products that can be effective if used consistently and effectively. Applying minoxidil to the scalp or taking finasteride may be helpful for some people, and in other cases hair transplants or wigs may be the best option.

Misconception #5 - Washing Your Hair Too Much Can Cause Hair Loss

Some people are concerned that washing their hair too often can cause hair loss. This is not true. A specific form of hair loss known as central centrifugal cicatricial alopecia, which is the most common cause of scarring alopecia in black women, was believed to be a result of hair care practices, but we now know there is a significant genetic component at play. Additionally, hats do not cause hair loss and in fact can be an effective way to protect the scalp from the sun.

Misconception #6 - Hair Loss is Only a Cosmetic Issue

The psychological impacts of hair loss should not be overlooked or minimized. Our society places a high value on appearance, and hair is closely tied to beauty standards across many cultures. Individuals struggling with hair loss should pay close attention to mental health issues that may come with it. Often, seeking support from loved ones or others going through similar challenges can help.

At the same time, hair loss is not always a purely cosmetic challenge. It can be indicative of more serious issues, including lupus, hormonal disorders, fungal infections, or nutritional deficiencies. It can also be caused by physical stresses, psychological stress, or an injury.

If the mental health challenges associated with hair loss become too great and symptoms of anxiety or depression develop, it’s worth talking to your doctor. What’s more, individuals should schedule a visit with their primary care physician or a dermatologist if their hair loss is accompanied by significant weight loss, fever, joint aches, or intolerance to heat or cold. Women should also be on the lookout for acne, changes in their voice, and irregular menses.

Despite the misconceptions, hair loss can be a significant challenge for men and women of any age. It’s important to take it seriously and look to reliable medical support instead of unproven and often expensive unproven treatments or products.

To learn more about alopecia and hair loss, visit the Manuals page on the topic.