Severe Hair Loss: Causes, Treatments, and Solutions

Severe hair loss

Hello, Doctor.
I noticed abnormal hair loss starting around November last year, with a small bald patch in my bangs.
I later visited a dermatologist who diagnosed me with alopecia areata.
I've been receiving scalp injections every two weeks, taking corticosteroids, and applying minoxidil to manage the condition.
However, after three months, the hair loss issue has not improved and has even worsened.
I now have large bald areas from the crown to the front bangs, where previously small patches have merged into one large bald spot, and hair loss continues.
I lose at least 300 hairs daily when I shower and blow-dry my hair, leaving a significant amount of hair on the bathroom floor.
My hair volume has decreased by at least one-third, and my scalp is visible from the front and top, which is very distressing.
I would like to ask you, Doctor:
1.
Besides maintaining a regular lifestyle, exercising, and managing stress, what other methods can help slow down my worsening hair loss? (It has only been three months since I noticed the issue and started treatment, yet I have experienced significant hair loss.)

2.
Are there any other oral medications or treatment options available besides the injections and minoxidil?
3.
I have been wearing a hat to cover the bald spots, but sometimes it causes scalp itching and dandruff due to the heat.
Could wearing a hat potentially worsen my hair loss? (I feel that my bangs have been falling out more since I started wearing a hat.)

Xiao Wang, 20~29 year old female. Ask Date: 2022/01/11

Dr. Wu Yuxin reply Dermatology

If the scalp injection treatment is not effective, you can discuss the feasibility of oral immunosuppressants with your physician.

Reply Date: 2022/01/11

More Info

Severe hair loss can be a distressing experience, and it is essential to understand the underlying causes, potential treatments, and lifestyle adjustments that can help manage this condition. Based on your description, it seems you are dealing with a significant hair loss issue, possibly exacerbated by stress, hormonal changes, or other factors. Here’s a comprehensive overview of the situation.

Understanding the Causes of Hair Loss
1. Genetic Factors: Androgenetic alopecia, commonly known as male or female pattern baldness, is a hereditary condition that can lead to progressive hair thinning. If there is a family history of hair loss, this could be a contributing factor.

2. Alopecia Areata: This autoimmune condition can cause sudden hair loss in patches. It appears you have been diagnosed with this condition, and it can sometimes lead to more extensive hair loss if not adequately managed.

3. Stress and Lifestyle: High levels of stress can trigger hair loss, particularly in conditions like telogen effluvium, where hair follicles prematurely enter the shedding phase. Your mention of lifestyle changes, such as weight loss and stress, could be significant contributors.

4. Nutritional Deficiencies: A lack of essential nutrients, such as iron, zinc, and vitamins (especially B vitamins), can lead to hair thinning. A balanced diet is crucial for maintaining healthy hair.

5. Scalp Conditions: Conditions like seborrheic dermatitis (dandruff) or fungal infections can also lead to hair loss. If you are experiencing scalp itchiness and flakes, it may be worth addressing these issues.

Treatment Options
1. Medical Treatments: Since you are already receiving corticosteroid injections and topical treatments, it is essential to follow your dermatologist's advice. These treatments can help reduce inflammation and promote hair regrowth. However, results can take time, and it may take several months to see improvement.

2. Oral Medications: Depending on your specific diagnosis, your doctor may consider prescribing oral medications such as corticosteroids or immunotherapy agents. These can help manage autoimmune responses in conditions like alopecia areata.

3. Minoxidil: This topical solution is often recommended for various types of hair loss. It can stimulate hair growth and is available over-the-counter. However, it is essential to consult your doctor before starting any new treatment.

4. Lifestyle Changes: Incorporating a balanced diet rich in vitamins and minerals can support hair health. Regular exercise and stress management techniques, such as yoga or meditation, can also be beneficial.

5. Avoiding Irritants: If wearing hats is causing scalp irritation, consider reducing the time spent wearing them or choosing breathable materials. Tight hats can lead to traction alopecia, which exacerbates hair loss.

Addressing Your Concerns
1. Managing Hair Loss: In addition to medical treatments, consider gentle hair care practices. Avoid harsh shampoos and minimize heat styling. Regular scalp massages can improve blood circulation and promote hair health.

2. Consulting Specialists: If your condition does not improve, consider seeking a second opinion from a dermatologist or a trichologist (a specialist in hair and scalp disorders). They can provide tailored advice and explore advanced treatment options.

3. Psychological Support: Dealing with hair loss can be emotionally challenging. Support groups or counseling can provide a space to share experiences and coping strategies.

In conclusion, while severe hair loss can be distressing, understanding the causes and exploring various treatment options can help you manage the condition effectively. It is crucial to maintain open communication with your healthcare provider and to be patient, as hair regrowth can take time. Remember, you are not alone in this journey, and there are resources available to support you.

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