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Hair Loss

Hair loss, also known as alopecia, is a common condition that affects millions of men and women of all ages. While losing some hair daily is normal, excessive shedding or thinning can cause visible bald spots, receding hairlines, or overall loss of hair density. For many, this can impact confidence and emotional well-being.

There are several different types of hair loss. Many types of hair loss occur when the normal cycle of hair growth and shedding is disrupted. Each hair follicle goes through a life cycle that includes growth (anagen phase), transition (catagen phase), and rest (telogen phase). Normally, 85–90% of scalp hair is in the growth phase, but when more follicles prematurely enter the resting phase or stop producing hair entirely, noticeable thinning or baldness may occur. Other types of hair loss occur when the follicle or hair shaft is disrupted or damaged. Hair loss can be temporary or permanent depending on its cause. Temporary shedding may result from stress, illness, or medication, while permanent hair loss is usually related to genetic or autoimmune factors.

Hair loss has many potential causes, and understanding the underlying factor is essential for proper treatment.

Genetic factors (androgenetic alopecia):

The most common cause of hair loss is hereditary pattern baldness, which can affect both men and women. In men, it typically presents as a receding hairline and thinning at the crown. In women, it often appears as diffuse thinning across the scalp while maintaining the frontal hairline. Genetics influence how sensitive hair follicles are to dihydrotestosterone (DHT), a hormone that shortens the growth phase and shrinks follicles over time.

Hormonal changes:

Hormonal fluctuations due to pregnancy, childbirth, menopause, thyroid disorders, or discontinuing birth control pills can trigger temporary hair loss known as telogen effluvium. Conditions such as polycystic ovary syndrome (PCOS) can also contribute to thinning hair in women.

Stress and illness:

Physical or emotional stress, surgery, high fever, or severe infections can cause sudden shedding a few months after the triggering event. This type of hair loss is usually temporary, and hair often regrows once the underlying cause is resolved.

Nutritional deficiencies:

A lack of essential nutrients such as iron, zinc, vitamin D, or protein can weaken hair follicles and lead to shedding. Strict dieting or eating disorders can also contribute to hair loss due to insufficient nutrient intake.

Autoimmune conditions:

In autoimmune-related hair loss, such as alopecia areata, the immune system mistakenly attacks hair follicles, leading to round or patchy bald spots on the scalp or other parts of the body. In more severe forms, such as alopecia totalis or universalis, all scalp or body hair may be lost.

Certain medications, including those used for cancer, arthritis, depression, heart disease, and high blood pressure, can cause hair loss as a side effect. Chemotherapy is a well-known cause of temporary but complete hair loss across the body.

Excessive hairstyling or tight hairstyles that pull on the scalp (traction alopecia) can damage follicles and cause hair loss over time. Heat styling, bleaching, and harsh chemical treatments can also weaken hair structure, leading to breakage and thinning.

Fungal infections like ringworm (tinea capitis), psoriasis, and seborrheic dermatitis can interfere with normal hair growth. Treating these scalp conditions can help restore a healthy environment for regrowth.

Hair loss may develop gradually or suddenly, and symptoms can vary depending on the cause. Common signs include:

  • Gradual thinning on the top of the head (the most common pattern in both men and women)
  • Circular or patchy bald spots on the scalp, beard, or eyebrows
  • Sudden hair shedding during brushing or washing
  • Widening part lines or reduced ponytail volume in women
  • Redness, scaling, or inflammation on the scalp
  • Loss of body hair in autoimmune-related cases

Early recognition of these symptoms allows for prompt evaluation and better outcomes, especially in cases of inflammatory or scarring alopecia, where delayed treatment can lead to permanent follicle damage.

Dr. Joshua Freedman uses a comprehensive and personalized approach to identify the root cause before recommending treatment.

  1. Medical history and physical examination: A detailed review of your health, family history, medications, diet, and hair care practices helps identify potential contributing factors.
  2. Scalp examination: The dermatologist will closely inspect the scalp and hair follicles to assess the pattern and severity of loss. Dermoscopy (using a handheld surface microscope) may be used to detect miniaturized or inflamed follicles.
  3. Hair pull test: A gentle tug on a small section of hair determines how many strands come out easily, providing insight into the level of active shedding.
  4. Blood tests: Laboratory testing may check for thyroid dysfunction, iron deficiency, vitamin D deficiency, or hormonal imbalances that can contribute to hair loss.
  5. Scalp biopsy: In some cases, a small sample of scalp tissue may be taken to distinguish between scarring and non-scarring forms of alopecia or to identify inflammatory and autoimmune causes.
  6. Hair Shaft Examination: Microscopic examination of the hair shafts, called trichoscopy, is often performed in office. Some samples are sent out for pathological examination as well if preliminary exam indicates structural abnormalities that may be the cause of your hair loss.

Accurate diagnosis allows for an effective treatment plan tailored to your specific condition, whether that involves addressing nutritional or hormonal factors, modifying medications, or exploring advanced hair restoration therapies.

If you notice persistent shedding, visible thinning, bald patches, or scalp irritation, it’s important to schedule a consultation with a dermatologist. Early diagnosis offers the best chance of preventing further loss and stimulating new growth. Because hair loss can sometimes indicate underlying medical conditions such as thyroid disease or autoimmune disorders, timely evaluation is critical.

Dr. Joshua Freedman specializes in identifying the underlying causes of hair loss and creating individualized treatment plans to restore healthy hair growth. His approach combines advanced diagnostic tools, medical expertise, and aesthetic insight to achieve both natural and lasting results.

If you are experiencing thinning hair or noticeable hair loss, schedule a consultation with Dr. Joshua Freedman in Swedesboro, New Jersey. Early evaluation can make all the difference in restoring confidence and improving hair health. Contact the office today to begin your personalized treatment journey toward thicker, healthier hair.

At a Glance

Dr. Joshua Freedman

  • Double Board-Certified in Dermatology and Mohs Micrographic Surgery
  • Providing Comprehensive Medical Dermatology for All Ages
  • Expert in Mohs Micrographic Surgery and Reconstructive Techniques
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