Hair Loss & Thinning

Alopecia is a medical term that refers to hair loss and baldness. This condition has many causes and affects both men and women.

Hair loss is a personal issue. Depending on your goals, there are treatment options available at the Total Skin Center.

Normal Hair Growth

Hair growth is a cyclical event. Hair follicles actively grow hair at the rate of 1cm per month for about 3 years, then active hair growth stops since the hair follicle has a brief lifetime. This is followed by the telogen phase, where hair growth becomes dormant, causing shedding of the hair. After a brief resting time, hair growth resumes. This cycle continues during one’s lifetime.

Normal Hair Loss

Each hair follicle on the scalp is in a different growth phase, resulting in random hair loss. We only lose a small number of hairs each day because of this random pattern, rather than losing all our hairs at once. Normal hair loss is 50-100 hairs per day. Hair density is maintained by replacing lost hairs with hairs that are of similar size, shape and same characteristics.

The different types of hair loss and their cause

Hair loss can happen spontaneously on its own, or can be secondary to a variety of medical causes or due to medications.

Androgenetic Alopecia

Male pattern hair loss that occurs in a predictable fashion on the scalp (receding front hairline, then bald patch over crown or vertex of head). The term androgenetic refers to the cause of male sex hormones called androgens, and to a genetic predisposition (runs in families).

This is common in men, to a lesser extent in women. The percentage of hair loss increases with each decade in life. At age 50, 50% of men have significant hair loss. Women with this condition have slightly lower hair loss at each decade of life. Since the hair growth cycle is disrupted, new emerging hair is thinner and shorter than before, increasing the amount of hair loss each day.

In men, complete hair loss can occur on top of the head. In women, the hair loss or thinning of hair density stays confined to the crown of the scalp, extending to the frontal hair line. The frontal hair line usually remains.

Alopecia Areata

This condition results in sudden hair loss, typically in a round, random pattern, occurring on the scalp, but can also involve the eyebrows, eyelashes and even rarely involve all hair follicles on the body. The cause is autoimmune, where the patient’s own overactive immune system causes the hair follicles to go dormant. This can occur in men, women and children.

This condition can resolve spontaneously, or demand further effective medical treatment.

Tinea Capitis

Irregular areas of hair loss caused by fungal infection, resulting in fracture of hair shafts at the level of the scalp skin that appear as “black dots”, can be treated with antifungal medicines.

Scarring Alopecia

This is a rare condition of the scalp, that results in destruction of hair follicles. There is no chance of hair regrowth, like with alopecia areata, thus making early diagnosis very important.

Traction Alopecia

The hair becomes brittle after overuse of chemical treatments or mechanical devices, causing it to break.


Hair loss in this condition occurs because of twisting and plucking of hairs, causing breakage at irregular lengths. The hairs have the capability of growing back, if the pulling of hairs does not go on for long periods of time, since the underlying scalp is healthy.

Multitude of other causes of hair loss.
A wide range of medical conditions and medications can cause rapid hair loss. These can be reversed with medical treatment or cessation of the offending medication.

Women who discontinue their use of birth control pills may experience hair loss for 2-3 months, which may continue for as long as 6 months.

Chemotherapy can cause rapid hair loss of all scalp hair, which usually regrows after completion of cancer treatment.

Pregnancy and child birth can affect hair growth, leading to excessive hair loss in your hairbrush 2-3 months after delivery.

Longterm illness, major surgery, high fever, shock such as death in the family, can cause increased hair loss within 1-3 months of the event. Telogen effluvium, as this condition is called, is completely reversible within a few months of recovery.

Rapid weight loss due to crash diets, can cause hair loss like telogen effluvium.


You should discuss your hair loss concerns with our qualified staff at the Total Skin Center to tailor a treatment plan to your special situation.