A Mass General specialist in the treatment of hair loss answers some common questions about the disorder.

For most people, it is normal to shed 100 to 150 hairs a day. But bald spots and excessive hair loss may be a sign of a condition called alopecia. Here are answers to some of the common questions I hear about hair loss and alopecia in my dermatology practice at Mass General.

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What is alopecia?

Alopecia is a partial or complete absence of hair on areas of the body where it would typically grow. It affects both children and adults.

What causes alopecia?
There are many different causes of alopecia. Medical conditions like thyroid disease, short- or long-term illness, hereditary factors, poor diet, medications, hormonal imbalances and even certain hair styles have the potential to cause hair loss.

Some individuals can even be born with alopecia due to genetic problems that control hair development.

What does alopecia feel like?

Some people feel pain, itching, tingling or burning on their hair-bearing skin, while others have no symptoms at all.

How is alopecia diagnosed?

Some types of hair loss can be diagnosed when a dermatologist examines the patient’s scalp. Other times, a biopsy–a small sample of skin from the scalp–may be needed. This is done by numbing the area, removing a tissue sample less than the size of a dime, and closing it up with a single stitch. The whole procedure usually only takes about 15 minutes. The pathologist will look at the tissue under the microscope to aid in the diagnosis.

Some types of alopecia are temporary and the hair can grow back.

Will the hair grow back?

Some types of alopecia are temporary and the hair can grow back. Other types of hair loss are permanent and once gone, the hair cannot regrow.

How is it treated?

Treatment depends on the type of hair loss diagnosed.

In children, the most common cause is scalp ringworm (tinea capitis), an itchy fungal infection involving the scalp, eyebrows or eyelashes. It can be treated with oral medication and shampoo.

In adults, male or female pattern baldness (also called androgenetic alopecia) is most common. Certain hormones shrink the width of the scalp hair, making each hair’s diameter smaller over time. Treatment includes using topical solutions or creams, oral medications, injectable cortisone and even hair transplantation, when appropriate.

For more information about dermatology’s clinical care and research efforts, please contact us.

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Mariko R. Yasuda, MD, is a dermatologist who sees both children and adults at Mass General. Working in medical dermatology, Dr. Yasuda is particularly interested in the diagnosis and treatment of hair disorders. She is also board certified in dermatopathology, which focuses on diseases of the skin, nails and hair. Dr. Yasuda is interested in the interpretation of skin biopsies to provide meaningful clinical impact.