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Alopecia
Totalis
Alopecia totalis is the loss of all head hair. Its causes are unclear, but it is
an autoimmune disorder, and can be the result of stress.
Baldness or hair loss is typically 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's sick or
maybe just not eating right. Some medications or medical treatments, like
chemotherapy treatment for cancer, also cause people to lose their hair. And
people can even lose their hair if they wear a hairstyle that pulls on their
hair for a long time, such as braids.
Losing hair can be stressful during a time when appearance really matters, but
the good news is that hair loss that happens during the teen years is often
temporary. Once the problem that causes it is corrected, the hair usually grows
back.
Hair Basics
Our 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 may be wrong. The medical term for hair loss — losing enough hair that
a person has visibly thin or balding patches — is alopeciaalopecia.
If you have unusual hair loss and don't know what's causing it, it's a good idea
to see your doctor. A doctor can determine why the hair is falling out and
suggest a treatment that will correct the underlying problem, if necessary.
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 kidney and liver diseases and 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 can also cause hair loss. Chemotherapy drugs for cancer are
probably the most well-known medications that cause hair loss, but some cancers
including leukemia and lymphoma can cause hair loss even before treatment
begins.
• 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 4
million people in the United States. Alopecia areata 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 and can progress to
total hair loss, although total hair loss only happens in a small number of
cases. Both guys and girls can get it, and it often begins in childhood. The
hair usually grows back in 6 months to 2 years, but not always.
• Trichotillomania. 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 can stop pulling their hair out.
• Hair treatments and styling. Having your hair chemically treated, such as
getting your hair colored, bleached, straightened, or permed, can cause damage
that may make the hair break off or fall out temporarily. Another type of
baldness that results from hair styling can actually be permanent: If a person
wears his or her hair pulled so tightly that it places tension on the scalp, it
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, or
getting anesthesia can temporarily stop the hair growth cycle. (Because the hair
we see on our heads has actually taken months to grow, a person may not notice
any disruptions of the hair growth cycle until months after the event that
caused it.) This type of hair loss corrects itself.
• Male-pattern baldness. Among adults, particularly men, the most common cause
of hair loss is androgenetic alopecia, also called male-pattern baldness. This
condition is caused by a combination of factors, including hormones called
androgens and genetics. In some males, the hair loss can start as early as the
mid-teen years. It can also occur in guys who take steroids like testosterone to
build their bodies.
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If you see a doctor about hair loss, he or she will check your scalp and, in
some cases, may take hair samples. You may also be tested for certain medical
conditions that can cause hair loss.
If medication is causing hair loss, ask the doctor if a different drug can be
substituted. If your hair loss is due to an endocrine condition, like diabetes
or thyroid disease, proper treatment and control of the underlying disorder is
important to reduce or prevent hair loss. Using a product like minoxidil that
can discourage hair loss and speed up hair growth also may be helpful. Alopecia
areata can be helped by treatment with corticosteroids. And if a doctor finds
that nutritional deficiencies are causing your hair loss, he or she may 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 go through a difficult time, especially girls.
It can help to feel like you have some control over your appearance when you're
losing your hair. Try some of the many options for disguising 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. And hair loss
during chemotherapy is usually a sign that the treatment is working to destroy
the cancer cells because you can see how it's working on the good cells (your
hair!).
Taking Care of Your Hair
Eating a balanced, healthy diet is important for a lot of reasons, and it really
benefits your hair. And don't forget to treat your hair well. For example, 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 you consider 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
also cause damage. Finally, be careful when using chemicals — such as
straighteners or color — on your hair.
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