Many people believe that if you want to be able to predict whether you'll be bald, look at your maternal grandfather and uncles.
That's not exactly all there is to it, according to Dr. Nicholas Agnesi. "Genetics play a part in hair loss, and you might be genetically pre-disposed," said Agnesi. "But you can't really predict how your hairline will look, based on family history."
Agnesi is the medical director and founder of Advanced Hair Restoration in Canfield.
We all lose about 100 hairs from our head every day but since the average scalp contains more than 100,000 hairs, it's not really noticeable.
"A very large percentage of the male population is affected with hair loss," said Agnesi. "Anywhere from 50 to 70 percent of men will lose their hair. The numbers are smaller for women, but they experience hair loss as well."
The word "alopecia" means "hair loss" and doesn't refer to a specific reason or disease. According to the American Hair Loss Association, the most common cause of hair loss is androgenetic alopecia, a genetically determined condition.
Both men and women lose hair as they age, but their hair loss is different. Male pattern baldness involves a receding hairline and thinning at the crown until there's just a "horseshoe" ring of hair around the sides. Women experience an overall thinning of hair throughout their scalp, but their hairline generally remains the same.
Finasteride, a medication marketed under the brand name Propecia, can be used to treat male pattern baldness; it slows or stops hair loss by decreasing the hormone responsible for the hair loss, said Agnesi. It is not used for women due to the possibility of side effects and lack of effectiveness.
Other hair loss conditions go by the name "effluvium." The most common of these is telogen effluvium (TE) that happens when, for a variety of reasons, the number of hair follicles producing hair drops significantly; the result is shedding or TE hair loss.
TE can develop from a shock to the system, such as a crash diet, surgery or even a physical trauma such as being in a car accident. The hair loss many women experience after having a baby is a type of effluvium called postpartum alopecia. Whatever form TE takes, it is reversible, as there are just more hair follicles in a resting state than there should be.
"Sometimes when clients come in with complaints about their hair, I find out, during consultation, that they've been dieting or eating a very restricted number of foods," said Molly Risner, master stylist and salon educator at Casal's de Spa and Salon in Howland. "We can offer a treatment that puts protein back in the hair shaft, but it doesn't work overnight. Clients need to keep coming in and stick with it."
The third most common form of hair loss is alopecia areata (AA). Researchers believe AA is an autoimmune disease, such as rheumatoid arthritis, but in this case, the person's own immune system attacks their hair follicles rather than joints as in arthritis. AA can affect men, women and children; kids who develop AA before their teens are more likely to have extensive hair loss.
Treating AA involves steroids in either a cream, injection or by taking a pill. However, these treatments have significant side effects, and many people find they don't work that well.
Fungal infections such as ringworm, overprocessing with hair dyes and straighteners and even repeatedly pulling your hair back in a ponytail too tightly can damage the hair follicles or hair fibers so much that hair loss occurs.
"We can condition and offer treatment when hair has been over-processed," said Risner. "But listen to your stylist, and be generous with trims to get the dry, broken ends cleaned up."
De Lisio's Hair Replacement in Austintown offers different forms of non-surgical solutions to help clients cope with hair loss. "There are many different options in hair replacement today," said Jean De Lisio. "Some hair systems are attached by painting a liquid onto the scalp then attaching pieces of a skin-like material. Others are more of a mesh, called a Hollywood lace, that gives a super-soft, undetectable hairline."
Low-level laser therapy can help some people with hair loss, according to Agnesi. "I recommend it as an adjunct to other therapies," said Agnesi. "Some patients may have dramatic results from medication, others benefit from a combination of treatment."
Hair transplants are another option for those wishing to pursue that treatment option. According to Agnesi, strips of skin are removed from the back of the neck, a place of permanent hair growth, and brought up to the front of the head and transplanted. "The risks are very low," said Agnesi. "It's an autograft, the patient's own skin, so there's no risk of rejection and minimal tenderness at the incision."
Women can have hair transplants as well, although they are more difficult because of the way women lose hair. However, Agnesi said his patients often have significant improvement.
Both Agnesi and Risner say they recommend starting with your physician if you have concerns that you are losing an excessive amount of hair or are losing hair in patches. Thyroid conditions, hormonal problems or medication can cause hair loss and should be diagnosed by a physician.
"I suggest clients next get to a professional stylist and express their desires," said Risner. "Book a consultation, listen to their recommendations about color and style - men included - and exchange ideas. If you don't find the stylist a good fit, go to another one."
"Thinning hair doesn't make anyone feel good," said Agnesi. "It is psychologically significant. There are many options now, and I encourage people to investigate them."