Understanding Hair Loss: Causes, Types & Why Early Dermatologist Care Matters

Over 80 million people in the United States are affected by hair loss, which is 25% of the population. There are several types of hair loss. We separate them into non-scarring or scarring hair loss. Scarring hair loss is based on inflammation around the hair follicle, leading to loss and scarring of the hair follicle over time, which causes the follicle to be destroyed. When this happens, the hair cannot grow back. This is why it is important to seek a diagnosis and treatment from a board-certified dermatologist (a medical doctor) when you notice signs of hair loss immediately.

Central centrifugal cicatricial alopecia (CCCA) is the most common type of scarring hair loss affecting Black women. It is prevalent in 2.5-5.6% of women with African ancestry and also occurs in Black men. It starts at the center or top of the scalp and spreads circularly. It often occurs with symptoms of itching, burning, and soreness. Diagnosis by a board-certified dermatologist and early treatment are vital to saving the hair follicles.

The most common form of hair loss overall is androgenetic alopecia. It is non-scarring. It is not due to inflammation affecting the hair follicles, but hormones binding to the hair follicle. When this happens, the hair follicle shrinks. Without treatment, the follicle will eventually become so small that the hair is no longer able to grow. This process cannot be reversed, but if diagnosed and treated early, the hair follicles that are still open can be saved.

Other types of hair loss are telogen effluvium, traction alopecia, alopecia areata, and lichen planopilaris. People often have more than one type of hair loss occurring at the same time. Treatments may include a combination of oral and topical medications. Vitamin supplementation is used if someone has a nutritional deficiency. One vitamin frequently discussed is biotin. Biotin is not an effective treatment for hair regrowth based on research studies. If you are taking a supplement with biotin, it is recommended to stop the supplement at least 48 hours before having thyroid labs checked. Biotin can affect the results of these labs and several others.  

Hair loss is a complex medical condition because it affects day-to-day life and how people view themselves. Developing a relationship with a board-certified dermatologist, seeking prompt diagnosis and treatment, and being consistent with treatment are the keys to tackling hair loss. If you are living with hair loss, you are not alone. There is help and support available to you.

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