Unwanted hair loss can shatter confidence and trigger mental and emotional distress. Real Health gets to the, er, root causes of this “silent epidemic”—and the reasons blacks are at higher risk.

Our hair is a large part of our self-image—it’s often called a “woman’s crowning glory.” That’s why alopecia, the technical term for hair loss, can be embarrassing and even traumatic for both women and men.

Our hair also reflects the physical and emotional health of our bodies. So if you’re dealing with hair loss, get a medical diagnosis right away. It may point to an underlying health issue. In addition, many treatments and solutions fight baldness—but the key is to start them early.

“Covering an area of hair loss can be [a quick fix] but may not be the best course of action in the long run,” says dermatologist and dermatologic surgeon Seymour Weaver III, MD, of the aesthetic treatment center Celestial Skin International in Katy, Texas. “I see so many ladies who come in with hair loss when they are beyond the benefit of medical treatment, so I want to help increase awareness of this silent epidemic taking place in our community.”

But what causes hair to thin, shed and create balding scalps in the first place? The answer is, a variety of factors, such as health, diet, lifestyle and genetics. Here is more about these common culprits.

Medical Disorders. Hair loss can result from a variety of diseases and illnesses, such as thyroid disease, discoid lupus, lichen planus and sarcoidosis, as well as bacterial or fungal infections. “While medical disorders of the scalp occur in all ethnic groups, a more severe type of hair loss called central centrifugal scarring alopecia (CCSA) occurs disproportionately more often in African Americans,” Weaver says. “The exact reason for this is not known, but there is reason to suspect that it might be related to grooming or styling practices.”

Stressful Events. Excessive shedding of hair can also take place two to four months after a major, stressful event. Weaver explains that this type of hair loss—called telogen effluvium—frequently occurs after childbirth, operations or illnesses with high fever.

Meds. The American Hair Loss Association (AHLA), a national nonprofit organization dedicated to educating the public and health professionals about the devastation of alopecia, indicates that many commonly prescribed drugs can cause temporary and permanent hair loss and trigger the onset of male and female pattern baldness. Many of these drugs are prescribed for illnesses that disproportionately affect African Americans, such as heart disease, HIV, hypertension and depression. A relatively large number of these drugs can cause telogen effluvium, according to the Bernstein Medical Center for Hair Restoration in New York City.

The center says that the hair shed during this kind of hair loss is reversible when individuals stop taking the meds. The AHLA urges people to research prescription meds to find out if alopecia is a possible side effect.

“Your pharmacist can give you this information before you fill a prescription,” says the AHLA. The organization also stresses that medication guides sold in bookstores or pharmacies and available online provide valuable information about any particular med’s side effects. If hair loss is indicated for a drug, ask your doctor to prescribe a different one.

As people are probably aware, cancer treatment drugs are most likely to cause hair loss.
Genetics. Hereditary hormonal balding, also called male or female pattern baldness or androgenetic alopecia, is the most common type of hair loss. “Although physicians know that it exists, we are still not certain what change or action occurs in genetically susceptible individuals that makes hair fall out,” writes award-winning hair transplant surgeon Matt Leavitt, DO, in his book Women and Hair Loss: A Physician’s Perspective.

Hair Styling Techniques. Traction alopecia is hair loss due to styling techniques. “Tight braids, rollers and hair extensions can contribute to this problem,” Weaver says. Another potential styling hazard? Using bonding glue to attach a hair piece to the scalp can injure hair follicles and lead to baldness with scarring (cicatricial alopecia), which can become permanent if not treated early.

Other Causes. Unbalanced diets, malnutrition, vitamin deficiency, birth control pills and other medications, hormonal changes, nervous habits and chemotherapy may also cause hair loss. 

Hair Loss Help Checklist

  • Seek medical attention at the first sign of excessive or unusual hair loss. A doctor can test for hormonal imbalances, illnesses and other health issues.
  • Eat a balanced, high-protein diet. Limit protein from red meat; instead, get it from sources such as beans, fish and chicken.
  • Take a nutritional supplement with vitamins and minerals.
  • Drink sufficient water to keep the body hydrated and to flush out toxins.
  • Maintain a healthy scalp. Work with your hair stylists to choose the right products for your hair and hair care regimen.
  • Stay away from chemical hair processes as much as possible.
  • Avoid tight braids and cornrows, extensions and hair weaves.
  • Choose styling products that don’t require excessive use of heat-styling tools.
  • Massage scalp for a few minutes each day to stimulate blood flow to hair follicles.
  • Try relaxation techniques for stress, such as meditation, yoga and deep breathing exercises.
  • Get sufficient sleep.

How I lost my hair…and got it back again

W. Renee Mothershed-Smith discovered a small patch of baldness. She was told it was hair fungus. But it was something else...

In 1987 I noticed a small spot of hair loss on my head. I was devastated. I consulted several different physicians for treatment. They indicated that I had developed hair fungus. They recommended various hair products to solve the problem, but none worked. I also experienced scalp inflammation and itchiness. It was some time before doctors discovered the real cause of the problem. Then I consulted with Dr. [Seymour] Weaver. He diagnosed me with discoid lupus. Discoid lupus is a chronic skin condition of sores with inflammation and scarring that can affect the face, ears, scalp and other areas of the body. To stimulate hair growth, Weaver prescribed a treatment of Kenalog injections [a steroid], which I am still receiving. He also prescribed steroid tablets. At present, the lupus is not active and I have had some hair regrowth. I also experienced relief of the itching, discomfort and irritation that troubled me in the past. Though my scalp has been injured by the disease, the treatment has given me enough hair growth to wear most of the hair styles that I like. Eventually, I hope to have complete hair regrowth in those damaged areas. Weaver and my hairdresser both recommended that I avoid perms. I have seen some progress, but it is still a struggle for me.  

These products are worth every cent.

  • Swastik Shikakai Shampoo Bar (3.5 oz., $3.95) Ayurvedic herbs in this long-lasting soap gently clean scalp and strengthen hair follicles. shivams.com
  • Avon Advance Techniques Intense Repair (Four 15 ml applications, $8.99) One weekly dose of this light-as-air creatine-infused formula can revive and remoisturize your tresses. avon.com
  • Nexxus Emergencée (3.3 fl. oz., $15) Got breakage? This serum transforms hair from wimpy to super strong. nexxus.com
  • Avon Advance Techniques Dry Ends Serum (1.7 fl. oz., $5) Smooth and moisturize dry, damaged ends. With UV filters. avon.com
  • Ojon Restorative Hair Treatment (5 oz., $55) Address almost any hair problem with this concentrated, luxurious cream, made with Ojon palm nut oil. ojon.com
  • Dr. Miracle’s Temple & Nape Gro Balm (4 oz., $8) Thinning hairline? Rub in this gel-like balm and stimulate growth. Available in three strengths. drmiracles.com
  • Nexxus Aloe Rid Gentle Clarifying Shampoo (13.5 fl. oz., $11) Product buildup can damage hair. Once a month, deep cleanse with this aloe vera shampoo for a fresh scalp, free of impurities. nexxus.com
  • Pantene Beautiful Lengths Conditioner (12.6 fl. oz., $5) Growing out your tresses? Moisturize hair from root to tip with this luscious conditioner. pantene.com