Stop pulling out hair over hair loss!

Hair loss is a big deal. Hair plays a significant role in our sense of self. Your hair shapes who you are. It impacts your well-being. Most of the babies I had the privilege to deliver were born with hair. My children were born without hair. I loved seeing how my children’s hair changed from birth. As they grew up, their hair continued to change. My oldest now has straight hair, my second child has thick wavy hair, and my youngest have thin hair with beautiful curls. Every baby is born with different hair, according to their genes. Those genes will also determine whether they will keep their beautiful thick curls or lose them later in life. The good news is that our genetics are not the only cause of hair loss, and for many types of hair loss, there is something we can do about it.

In my Family Practice, I have learned over the years that hair doesn’t only affect my patients cosmetically but has a very high psychological impact. Once I noticed the effect on mental health, I made it my mission to find out everything I could about hair loss and how to treat and prevent it.

I will discuss the four most common conditions I see in my clinic.

1. Hair shedding

The medical term for hair shedding is Telogen Effluvium. It is very common to see postpartum moms suffer from hair loss. There are multiple reasons for this; for some it may be due to blood loss during delivery, for some due to a hormonal shifts and for others due to the physiological stress that their bodies have gone through.

I commonly see hair loss in patients after they had COVID. Other causes of hair loss could be iron deficiency, thyroid hormone deficiency, infection, medication, stress, chemotherapy, after admission to ICU or major surgery (again, stress on your body). I also see it very commonly after a patient lost a loved one or went through a stressful period (as seen in my refugee patients).

The way I would diagnose the root cause of hair loss is first to do a thorough assessment of my patient’s history where I don’t only ask about their medical and surgical history, medication and infections, but also about stressors in their life.

During my initial exam I always ask about the five s’s of hair loss:

1. Site of hair loss

2. Speed of hair loss

3. Symptoms

4. Supplements and medication

5. How much hair they are shedding

The next step is to do bloodwork. Your family physician will start by testing for iron deficiency and thyroid disorders. Further, they might request testing for nutritional deficiencies.

2. Androgenetic alopecia

Androgenetic alopecia happens to males and females. In males, we recognize a balding pattern easily, as we commonly see older men with this type of balding pattern. In females, it is also common, but typically my female patients go to great lengths to hide this, so we less commonly see women with balding hair, as they will more often wear wigs/hair coverings.

3. Tinea capitis

Tinea capitis is a fungal infection of the scalp, that is sometimes found in school-aged children. You will recognize this by a grey patch and dry scaling of the scalp. Your primary care provider can diagnose this by sending skin scrapings away, where the laboratory will do a fungal culture.

4. Alopecia areata

Alopecia areata is an autoimmune disorder that affects about 2% of patients. It looks like a coin-shaped bald patch on the scalp. The individual hairs are thick but then thin closer to the scalp, known as an exclamation mark morphology. We sometimes see this on other body parts such as eyelashes, eyebrows or beard hair.

5. Traction alopecia

Traction alopecia is when hairstyling pra