What is baldness?

Baldness is loss or lack of hair, usually from the top of the head. It may also occur on other parts of the body where hair grows. Baldness is usually part of the aging process. Some diseases and drugs may also cause baldness.

Hair loss may be either temporary or permanent, depending on the cause.

There are several types of baldness:

• hereditary
• general
• local.

How does it occur?

Hereditary baldness is passed through the family. It is most common in men, but sometimes occurs in women.

Local hair loss is usually patchy and confined to certain areas. It may result from:

• alopecia areata, a disease characterized by well-defined bald patches, whose cause is unknown
• ringworm, a fungus infection
• radiation therapy for cancer
• a hot comb or hair dryer
• repeated use of a hairstyle such as tight pigtails or cornrows
• nervous, repeated hair pulling
• permanent skin damage from burns or serious skin diseases.

General hair loss occurs when all of the scalp hair enters a resting phase at the same time and then falls out. This may be caused by:

• stressful conditions such as an acute illness or disease
• prolonged fever
• drug treatment for cancer
• surgery
• certain prescription drugs
• drug allergy.

Alopecia universalis is a rare and severe form of baldness that results in permanent loss of all body hair, including eyebrows, eyelashes, and hair in the pubic area and armpits. The cause is unknown.

What are the symptoms?

Symptoms may include:

• hair loss
• lack of hair regrowth after loss
• abnormal hair breaking and brittleness
• fine, dull hair lacking normal shine.

How is it diagnosed?

Your health care provider may examine you for symptoms of skin disease and lack of vitamins or hormones. Your provider will ask about any patterns of hair loss in your family.

How is it treated?

Baldness can be treated with medication or surgery.

Your health care provider may recommend medication to stimulate hair growth. Minoxidil (Rogaine) is a medication you can put on bald spots daily. Finasteride (Propecia) is a tablet men can take daily. Although other medicines are being studied, these two medicines are the only FDA-approved medications for treating hereditary baldness. They can improve hair growth or preserve hair in most people.

If you use minoxidil daily, some hair should grow back after 4 months. The hair will remain only if you continue to use the medication every day.

Only men should take finasteride. Pregnant women should not even touch the tablets because the medicine can be absorbed through the skin. The medicine can cause abnormal growth of the genitals in baby boys before they are born.

If an illness is causing you to lose hair, your health care provider may prescribe medication to treat the illness. For example, your provider may prescribe an antifungal medication if a fungus, such as ringworm, is the cause of your hair loss. Hair generally grows back in the affected areas.

If you have a case of alopecia areata, your hair will grow back naturally in 6 to 12 months. Your health care provider may try to speed up regrowth by injecting your scalp with steroids or by having you put minoxidil solution directly on the bald area. This problem can recur.

Hair transplant surgery involves moving sections of skin with hair from one part of the scalp to another. The results may last a few years or remain permanent.

How long will the effects last?

Baldness may be temporary and last only a few weeks or months. It can be permanent, however, especially if it is hereditary or the result of skin damage from a disease or burn.

How can I take care of myself?

If you have noticeable hair loss or a change in skin condition, consult your health care provider. In the meantime, eat balanced meals, get plenty of rest, and try to reduce stress. This can help you recover faster if an underlying illness is the cause of baldness.

Avoid irritating the area affected by baldness to help the healing process.

Avoid using nonprescription hair-growth products other than minoxidil. These products are generally not effective and may in fact harm the skin and hair.

What can be done to help prevent baldness?

There is nothing you can do to prevent most types of baldness. However, you can help delay normal balding by maintaining general good health.