Early treatment is incredibly important.

By Helen Sondag
March 11, 2020

Hair is deeply intertwined with identity, and so it can feel like a real blow to our egos when it is gone. This is something Dr. Shani Francis, MD, MBA, a board-certified dermatologist specializing in hair loss, knows very well. "I lost my hair when I was a little girl," Dr. Francis, who is now the executive vice president of research and development at Ashira Industries, tells us. "I have a personal connection to what hair loss sufferers go through. I understand how impactful this can be to someone's identity, their self esteem, the way they relate to people, the way they seek out opportunities, the way they feel about themselves."

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But when diagnosed and treated early, hair loss is usually reversible, and that's why scheduling a consultation with a board-certified dermatologist is imperative. Permanent hair loss, also known as scarring alopecia or cicatricial alopecia, is caused by inflammation that leads to just that: scarring. Essentially, this type of hair loss is permanent because the disorder has wiped out the hair follicles, leaving scar tissue in its wake. "Permanent hair loss can be seen in certain types of inflammatory conditions, such as lupus or a condition referred to as lichen planopilaris," explains Dr. Marc Glashofer, a board-certified dermatologist and hair loss specialist practicing in northern New Jersey. Lichen planopilaris refers to scarring hair loss caused by a skin disease called lichen planus.

Related: How to Take Care of Thinning Hair

A form of alopecia that can lead to permanent hair loss is traction alopecia, which can be a result of hairstyles that are too tight or cause tenderness to the scalp. "Traction alopecia is luckily reversible if the traumatic practice is stopped in time," Dr. Francis tells us. "This condition can affect anyone, young and old and all ethnicities. However, curls tend to be pulled more. Choosing hairstyles more consistent with the natural state of your hair tend to be less traumatic and overall healthier."

Meanwhile, there are disorders that typically cause only temporary hair loss. "These include hypothyroidism, polycystic ovarian syndrome (PCOS), and nutritional deficiencies such as low iron, folate, or B12," Dr. Glashofer says. Several other inflammatory conditions behind hair loss are reversible, Dr. Francis notes, including atopic dermatitis, also known as eczema, as well as seborrheic dermatitis, psoriasis, and contact dermatitis. The same goes for certain autoimmune diseases, including alopecia areata. With this condition, which presents as patchy bald spots (and is what most people think of when they hear the word "alopecia"), the hair follicles do not die and can grow back. Then there's trichotillomania, a reversible hair loss disorder caused by the conscious or subconscious pulling of one's own hair. "Controlling impulses and reducing stress will usually lead to complete regrowth," Dr. Glashofer explains.

Clearly, as Dr. Francis says, "hair loss is complex, complicated, and there's a lot of medical issues that could contribute to it." However, timely diagnosis through detailed history analysis, physical exams, and in some cases, scalp biopsies and blood work could be the difference between temporary and permanent hair loss. "Don't delay getting a diagnosis," Dr. Francis says. "Help could be just one click away."

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