Hair loss

Key messages

• Many conditions and diseases can result in hair loss, as can improper hair care.

• The most common cause of hair loss is hereditary thinning or baldness, also known as androgenetic alopecia. (1) This condition affects an estimated 80 million Americans — 50 million men and 30 million women. (2)

• While daily shedding is normal, people who notice their hair becoming noticeably thinner or falling out in large amounts should consult a board-certified dermatologist for proper diagnosis and treatment.

  • To find a board-certified dermatologist, visit aad.org/findaderm.

Supporting messages

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• Potential causes of hair loss, some of which are temporary, include:

  • Alopecia areata, a type of autoimmune hair loss that can affect all ages and causes hair to fall out in round patches. (3,4)

  • Genetic factors.

  • Tight hairstyles that pull on the hair. (5-7)

  • Shampooing, combing, or brushing hair too much or too hard. (5)

  • Hair plucking, which may be a sign of a disorder called trichotillomania. (5)

  • A variety of diseases, including thyroid disease and lupus. (5,8)

  • Childbirth, major surgery, high fever or severe infection, stress, or even the flu. (5)

• Hair loss can be dramatic and devastating for patients, negatively impacting their quality of life. (9,10)

Treatments

• If you need treatment for regrowth, the earlier you start, the more likely you are to see regrowth.

• Topical minoxidil (for men and women, available over the counter), oral minoxidil (prescription only), and oral finasteride (prescription only) have been shown to help the regrowth of hair and slow hair loss. (11,12) Hair loss caused by diseases, such as thyroid disease, may be reversed with treatment of the underlying disease.

• Topical or injectable cortisone medications have been shown to accelerate the regrowth of hair in some types of hair loss.

• Medications that affect testosterone in hair follicles, such as spironolactone, are sometimes prescribed for women experiencing hair thinning.

• Additional treatments may include hair transplantation.

Tips for healthy hair

1. Wash and condition your hair without traumatizing it. Hair that’s thinning or falling out is fragile and easily damaged. Dermatologists recommend that people who have hair loss:

   1. Use a gentle shampoo and apply to your scalp instead of the entire length of your hair. This helps to avoid drying your hair too much while still washing away built-up products, dead skin, and excess oil.

   2. Apply a moisturizing conditioner after every shampoo. If you have fine or straight hair, apply conditioner to the ends of your hair. However, if your hair is dry or curly, apply conditioner to the entire length of your hair.

2. Stop at-home coloring, perming, chemical straightening, and relaxing. If you want to use these, find a salon that has professionals who know how to examine your scalp and hair in order to find the product most suitable for you. Make sure the salon uses a moisturizing conditioner afterward.

3. Protect your hair from heat — no matter your hair type, excessive heat can cause breakage and damage. Limit blow drying and use of tools like flat or curling irons. Use low or medium heat settings and a product to protect your hair from the heat.

4. Make sure hairstyles that pull on your hair, such as a bun, ponytail, pigtails, cornrows, or braids are not too tight. This can cause a type of hair loss called traction alopecia. In time, anything that pulls on your hair can cause permanent hair loss.

5. Be gentle with your hair. Hair is delicate when it’s wet, so use a wide-tooth comb instead of a brush to detangle wet hair. Slowly comb the ends of your hair first then keep combing higher to detangle your hair with minimal damage.

   1. If you have thick, curly, or coily hair, the best time to comb is in the shower before rinsing out your conditioner.

   2. Wrap your hair with a towel or t-shirt to gently absorb the moisture, as roughly rubbing your hair dry can cause damage.

Related Academy resources for the public

References

1. Rossi A, Anzalone A, Fortuna MC, et al. Multi-therapies in androgenetic alopecia: review and clinical experiences. Dermatol Ther. Nov 2016;29(6):424-432. doi:10.1111/dth.12390

2. Androgenetic alopecia. National Library of Medicine. Updated 7/27/2023. Accessed 10/31/2024, https://medlineplus.gov/genetics/condition/androgenetic-alopecia/#statistics

3. Dainichi T, Kabashima K. Alopecia areata: What's new in epidemiology, pathogenesis, diagnosis, and therapeutic options? J Dermatol Sci. Apr 2017;86(1):3-12. doi:10.1016/j.jdermsci.2016.10.004

4. Rajabi F, Drake LA, Senna MM, Rezaei N. Alopecia areata: a review of disease pathogenesis. British Journal of Dermatology. 2018;179(5):1033-1048. doi:10.1111/bjd.16808

5. Fabbrocini G, Cantelli M, Masara A, Annunziata MC, Marasca C, Cacciapuoti S. Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review. Int J Womens Dermatol. Dec 2018;4(4):203-211. doi:10.1016/j.ijwd.2018.05.001

6. Phillips TG, Slomiany WP, Allison R. Hair loss: common causes and treatment. American family physician. 2017;96(6):371-378.

7. Geisler AN, Oyerinde O, Scott DA. Hairstyling practices to prevent hair damage and alopecia in women of African descent. Cutis. 2022;109(2):98-100.

8. Wolff H, Fischer TW, Blume-Peytavi U. The Diagnosis and Treatment of Hair and Scalp Diseases. Dtsch Arztebl Int. May 27 2016;113(21):377-86. doi:10.3238/arztebl.2016.0377

9. Davis DS, Callender VD. Review of quality of life studies in women with alopecia. Int J Womens Dermatol. Mar 2018;4(1):18-22. doi:10.1016/j.ijwd.2017.11.007

10. Davey L, Clarke V, Jenkinson E. Living with alopecia areata: an online qualitative survey study. Br J Dermatol. Jun 2019;180(6):1377-1389. doi:10.1111/bjd.17463

11. Ramos PM, Sinclair RD, Kasprzak M, Miot HA. Minoxidil 1 mg oral versus minoxidil 5% topical solution for the treatment of female-pattern hair loss: A randomized clinical trial. J Am Acad Dermatol. Jan 2020;82(1):252-253. doi:10.1016/j.jaad.2019.08.060

12. Gupta AK, Talukder M, Williams G. Comparison of oral minoxidil, finasteride, and dutasteride for treating androgenetic alopecia. J Dermatolog Treat. Nov 2022;33(7):2946-2962. doi:10.1080/09546634.2022.2109567

Last updated: 12/04/24