Interview by Stephanie Bouchard
September 27, 2023

Ask the Doc

Am I Losing My Hair?

By Victoria Barbosa, MD

Q: I don’t want to seem vain, but I’m losing my hair, and I’m freaked out. Is there anything I can do about it?

A: Hair loss — also called alopecia — is intensely personal for people. It has a psychological impact on their self-confidence and overall well-being.

Many people are taught from a young age that your hair is your crown and glory. For some, their hair has been a source of compliments and a source of pride. When people start to lose hair, there’s psychological discomfort, and sometimes actual distress as the person in the mirror becomes less recognizable. There’s a real sense of personal loss that accompanies hair loss for many. It really impacts one’s identity.

While many people may talk to their hair stylist about their hair loss, they often don’t speak to their medical providers about it. Sometimes they’re embarrassed, but more often they don’t think of it as something that can be fixed, or they consider it not important enough to bring up. Hair loss is frequently seen as something that just happens, either because of age or genetics, and people think they just have to learn to live with it.

It’s true that many forms of hair loss don’t have a cure, but almost all of them have some treatment options. Before a treatment can be selected, you need to figure out what’s causing the hair loss. Shedding approximately 100 hairs a day is normal, but losing excessive amounts of hair is not.

Q: What causes hair loss?

A: Many factors cause hair loss, including age and genetics. Stress is a big one. It’s pretty frightening to see your hair suddenly come out in clumps due to stress, but this stress-induced hair loss is also one of the best forms of hair loss to have because sooner or later, it reverses itself.

Hair loss can also be related to medical conditions such as autoimmune disease or thyroid disease, medications, and hair styling practices. People of color are at greater risk of certain forms of hair loss that result in permanent, scarring damage to hair follicles, so it’s particularly important for them to seek treatment earlier rather than later. Once hair follicles are gone, they’re gone. It’s much easier to treat hair loss early and to prevent additional loss than it is to treat very advanced hair loss, but it’s never too late to get evaluated.

Q: How do you know when you should see a doctor about hair loss?

A: Some types of hair loss may be managed with home remedies or over-the-counter topical treatments. Often, though, home management just delays a diagnosis and more effective treatment. If you have hair loss that persists beyond six months; if you have unexplained completely bald patches; if you have tried over-the-counter treatments for six months and they didn’t help — see a dermatologist. There’s no specific percentage of hair loss that you should wait for to prompt you to contact a doctor. If, especially, your hair loss is causing you some level of distress, don’t hesitate to seek help.

Victoria Barbosa, MD, is an associate professor of dermatology and the director of the Hair Loss Program at the University of Chicago, dermatology section.