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Making Sense of Hair Loss and Scalp Conditions

If you think you’re losing your hair, get the facts about three common scalp and hair loss conditions. Learn what you can and can’t do to save your hair.

“My hair was falling out in what seemed like handfuls,” says 31-year-old Samantha Ames*, who began losing her hair 10 years ago. “I even started showering in the dark to avoid seeing all the hair go down the drain.”

To women, hair is often a huge part of our self-image and what makes us feel attractive. Hair loss isn’t merely scary, it’s traumatic. Even the prospect of losing it can make you, well, lose it.

“There’s a stigma attached to women who lose their hair. When I began to lose my hair, I began to lose myself,” says Ames, who founded a Web site called the Women’s Hair Loss Project to unite and support women who find themselves with the same condition.

Yet even though she does a lot to help others with hair loss, she herself does not reveal her true identity publicly. No one who follows the blog or joins the support network knows her real name.

“I’m anonymous so I can be completely honest about my own hair loss situation,” says Ames. “That’s something I would never be able to do if I lived with the fear that a family member or co-worker could Google my name and find out my innermost thoughts.”

Understanding Hair Loss and Scalp Conditions
As with any issue we face, when it comes to hair loss, the more information you have, the better you can deal with the myriad feelings that arise if you start seeing more hair in your drain. Read on to learn about three common types of hair loss — and what you can do.

1. If you lose about 100 hairs a day …

Diagnosis: normal hair loss
Finding some hair in your shower drain or brush is nothing to worry about. It’s considered normal and a part of the regular growth cycle. “Hair grows for approximately three years, sits dormant for three months, then falls out,” says Dr. Jeffrey Epstein, a hair restoration surgeon in Miami and New York.

What to do: If you’re worried you’re losing too much, gently tug on about 50 strands of hair. If more than one or two come out, you may have abnormal shedding.

2. If your hair falls out after childbirth, an illness or stressful event …

Diagnosis: telogen effluvium
Hair can be affected by any significant shock to the system, including a high fever, starting or stopping use of birth control pills, having surgery or experiencing some other stressor, either psychological or physical.

What happens: The stress causes a significant portion of hair follicles on the scalp to transfer from the growing phase to the dormant phase, called telogen. Six weeks later, those hairs start shedding en masse and can continue falling out for several weeks or even months.

Although it’s alarming to wake up with lost hair on your pillow morning after morning, rest assured that new strands start growing immediately after hair falls out. Plus, since telogen effluvium causes shedding all over, it’s unlikely anyone else will even notice. In most cases, hair is back to normal within six months of when the hair loss started.

During this time of regrowth, it’s important to continue treatment of any scalp conditions. “Inflammatory scalp conditions such as psoriasis or dandruff can reduce the rate at which hair that has fallen out gets replaced,” says hair-and-scalp expert James Schwartz, who holds a doctorate in chemistry. “It’s similar to a plant that’s growing in soil: If the soil is unhealthy, plants tend not to look so good either.”

What to do: Watch for baby-fine strands around your hairline — the first sign hair is growing back. It’s a good idea to confirm the diagnosis with a dermatologist who specializes in hair loss.

3. If the part in your hair gradually grows wider …

Diagnosis: female pattern hair loss
“One of the earliest signs of female pattern hair loss is seeing more scalp when you part your hair,” says Epstein. “Or your ponytail feels lighter, or your hair is thinner on top and at your hairline.”

Hormonal changes cause most women a little thinning as they get older, which may make your scalp slightly more visible through your hair or at the part. But some women are more sensitive to the changes and are genetically predisposed to significant hair loss. You might experience more extreme, noticeable thinning, and hair loss could start as early as your teenage years.

Although the trait can be passed down from either side, the maternal side is the best predictor. That means if your mother suffers from hair loss, you probably will too.

What to do: The first step is to talk to a board-certified dermatologist. Certain topical products may slow thinning and regrow some hair. But with so many ineffective ones on the market, get advice before spending money. Your doctor may also suggest a hair transplant. Although it produces natural results, the outpatient procedure can cost thousands of dollars.

You can also take steps to minimize the appearance of hair loss. If your scalp is light, lighten your hair color to reduce the contrast. Getting highlights, and using volumizing shampoos and “thickening” powders and sprays help make fine hair look a little thicker. A short haircut will also help you achieve more volume. Or keep hair long so you can pin it back to cover thin areas on the scalp.

Wigs are another option. These days, you’ll find versions made of human hair that look natural and are comfortable to wear.

Regardless of the cause, if you are losing hair, remember that you’re not alone. “At first, I thought I was crazy,” says Ames, “but I had the same feelings as a lot of other women suffering from hair loss.”

* To protect her privacy, her real name is not used.

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