Studies show hair loss may signal more than a change in your looks, but treatments can help you keep baldness at bay

Don’t fret failing follicles: studies show hair loss may signal more than a change in your looks, but treatments can help you keep baldness at bay

If you’re watching the follicles fall, don’t just dismiss your hair loss as a fact of life or an inescapable part of aging. Truth is, although a majority of hair-loss cases can be attributed to genetics, sometimes another factor is involved–one that can be prevented or treated.

And, since excessive hair loss, or alopecia, may signify other medical problems, you may have more to worry about than just your image.

“Hair loss isn’t just a flimsy kind of complaint,” said Wilma Bergfeld, M.D., head of clinical research in Cleveland Clinic’s Department of Dermatology. “It can reflect acute problems or chronic problems and even genetic problems.”

For example, in a study published in the May issue of the Journal of the American Academy of Dermatology, Dr. Bergfeld and colleagues found that iron deficiencies may be related to many forms of hair loss, and that iron supplements may be effective in treating some hair-loss patients.

The good news is that, in many patients, medical treatments can slow or halt hair loss and its underlying conditions.


Your hair grows in a cycle, with 80 to 90 percent of your follicles in an active growing phase (anagen) and the remaining in a resting (telogen) state. You shed 50 to 100 telogen hair fibers a day. Several factors can cause alterations in your hair cycle, resulting in increased shedding.

Genetics are behind the most common form of hair loss, androgenetic alopecia (male pattern baldness), in which the hair cycle shortens, the hair follicles thin and more hairs remain in the telogen phase.

But, nutritional deficiencies are increasingly contributing to hair loss. Dr. Bergfeld said about 50 percent of her patients have deficiencies in available iron, more often in vegetarians and fast-food eaters. Red meat, whole-grain cereals, beans and dark leafy vegetables are good iron sources. Dr. Bergfeld recommends that vegetarians who are iron deficient ask their doctors about taking iron supplements, but not before undergoing blood tests to evaluate iron stores.

Also, a wide array of medications carry a slight risk of hair loss as a side effect. Talk to your physician about your medications and whether they might contribute to hair loss.


Hair loss can signal an endocrine abnormality such as diabetes or an imbalance involving the adrenal or thyroid glands or the sex hormones (testosterone and estrogen). In some cases, hair loss may be the product of a disorder such as lupus or rheumatoid arthritis, or an infection.

Also, a 2000 study, published in the Archives of Internal Medicine, found that male pattern baldness at the vertex, or crown of the head, appears to be a marker for increased risk of heart disease, particularly among men with high blood pressure or high cholesterol levels.

“Don’t write off all hair loss as genetic. There may be an element of genetics in it, but there’s usually something else,” Dr. Bergfeld said. “Hair loss opens up Pandora’s box.”


You may be able to close that box, however, by seeking an evaluation from a dermatologist or a doctor with an interest in hair loss. That evaluation should include not only scalp hair but also facial and other body hair, Dr. Bergfeld said. Your doctor should ask about your family medical history, your use of prescription, over-the-counter or recreational drugs, and your hair-styling and nutritional habits. You may have to provide a hair sample for analysis, and, depending on your medical history and symptoms, the doctor may order blood, hormone and liver tests.

The U.S. Food and Drug Administration has approved two drugs to treat hair loss: minoxidil (Rogaine) and finasteride (Propecia). Minoxidil is available as a topical cream and as a new foam product, while finasteride comes in pill form. Both drugs grow hair in more than 60 percent of patients, according to Dr. Bergfeld, and they reduce shedding, sustain hair growth and thicken hair fibers. You have to use minoxidil and finasteride permanently to regain and maintain hair growth.

If conservative treatments aren’t effective, hair transplant surgery may be in order. However, you have to be in good health for any surgery, and you may need multiple transplant sessions spanning as long as two years or more.


* Get at least 10 mg of iron a day. Whole-grain cereals, red meat, beans and dark leafy vegetables are good sources of iron.

* Don’t shampoo, comb and brush your hair excessively. Use a wide-toothed comb or a brush with smooth tips.

* Be gentle when towel-drying, brushing or combing your hair.

* Avoid nervous habits such as twisting your hair or rubbing your scalp.

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