Hair disorders is a broad category that includes the following types.

• Alopecia: the loss or thinning of hair (two types of alopecia are scarring, in which hair follicles are destroyed, and nonscarring, which can be reversible)
• Male-pattern baldness (androgenic alopecia): the most prominent type of hair disorder affecting, to varying degrees, half of all men over 50 years of age
• Hirsutism: male-pattern hair growth affecting eight percent of adult women
• Hair shaft disorders: usually hereditary abnormalities

Hair disorders are accompanied by the following signs and symptoms, depending on the type.

• Alopecia (nonscarring) involves hair loss all over or in circular areas, receding hair line, broken hairs, smooth scalp, inflammation, and possibly loss of lashes, eyebrows, or pubic hair.
• Alopecia (scarring) is limited to particular areas and involves inflammation at the edge and follicle loss toward the center of lesions, violet-colored skin abnormalities, and scaling.
• Hirsutism involves male-pattern hair growth in women, irregular menstruation, lack of ovulation, acne, deepening of voice, balding, and genital abnormalities.
• Hair shaft disorders involve split ends, and hair that is dry, brittle, and coarse, as well as skin and other abnormalities.

Hair disorders can be caused by any of the following.

• Alopecia (nonscarring)—skin disorders, certain drugs, certain diseases, autoimmunity, iron deficiency, severe stress, scalp radiation, pregnancy, or pulling at your own hair
• Alopecia (scarring) —skin disorders, diseases, or bacterial infections
• Hirsutism— excess of androgen (steroid hormone that stimulates development of male sex organs and secondary sexual characteristics). This overproduction of androgen could result from certain drugs or conditions.
• Hair shaft disorders—overprocessed hair (coloring, permanent waves, excessive heating) or certain diseases.

People with the following conditions or characteristics are at risk for developing hair disorders.

• Alopecia—male gender, genetic predisposition, pregnancy, physical or emotional stress, poor diet
• Hirsutism—genetic predisposition, lack of ovulation
• Hair shaft disorders—genetic predisposition, damaging grooming practices

If you are experiencing symptoms associated with a hair disorder, you should see your health care provider. A physical exam can help identify the type of hair disorder, and laboratory tests can reveal any underlying diseases. In the case of hirsutism, imaging may help diagnose the cause.

Having a well-balanced diet and avoiding potentially damaging hair treatments can help prevent some types of hair loss.

The primary goals of treatment are to treat the underlying cause, re-grow the hair when possible, and correct damaging grooming practices.

Your provider may prescribe the following medications.

Alopecia:

• Minoxidil (Rogaine), for hair regrowth and possibly to prevent further loss
• Tretinion (Retin-A), to decrease thick scalp layer and increase minoxidil penetration
• Topical or injectable steroids

Hirsutism:

• Steroids
• Oral contraceptives

Hair shaft disorders:

• Minoxidil
• Drugs for underlying diseases

• Cosmetic therapies, such as surgical placement of follicle-supporting plugs or folds
• For hirsutism, possibly removal of ovarian tumor

A comprehensive treatment plan for hair disorders may include a range of complementary and alternative therapies.

• Eat foods high in B vitamins and minerals, such as whole grains, dark leafy greens, and sea vegetables; eat adequate protein.
• Avoid sugar, caffeine, and refined foods.

Potentially beneficial nutrient supplements include the following.

• B-complex vitamins, especially B₅ (100 mg four times per day), biotin (300 mcg per day), PABA (30 to 100 mg three times per day), and inositol (250 to 1,000 mg per day)
• Minerals, especially calcium (1,000 mg per day), magnesium (400 mg per day), selenium (100 to 200 mcg per day), manganese (10 mg per day), and zinc (20 to 30 mg per day)
• Vitamin C (500 to 1,000 mg three times per day), vitamin E (400 IU per day), and vitamin A (10,000 IU per day) or beta carotene (25,000 IU per day)
• Omega-3 fatty acids (EPA, DHA, flaxseed oil, fish oil) or omega-6 fatty acids (borage or evening primrose oil), 1 tbs. or equivalent two to three times per day

Herbal remedies may offer relief from symptoms. Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp per cup of water steeped for 10 minutes (roots need 20 minutes).

For alopecia and hair shaft disorders:

• Ginkgo leaf (Ginkgo biloba), rosemary (Rosemarinus officinalis), prickly ash bark (Xanthoxylum clava-herculis), horsetail (Equisetum arvense), yarrow (Achillea millefolium), and elderberry (Sambucus nigra)
• For bacterial infections, add coneflower (Echinacea purpurea) with goldenseal (Hydrastis canadensis); for fungal infections, add oregano (Origanum vulgare)
• For stress, substitute oatstraw (Avena sativa) for elderberry

For hirsutism:

• Saw palmetto (Serenoa repens) 200 mg two to three times per day

Topical applications of essential oils may be beneficial in skin infections and for stimulating new hair growth. Use three to four drops each of chamomile (Matricaria recutita), rosemary, and sage (Salvia officinalis) in 1 tbs. vegetable oil (for example, flax, borage, or olive). Massage gently into affected area one to two times daily.

Some of the most common remedies include Ignatia, Pulsatilla, and Sepia. Acute dose is three to five pellets of 12X to 30 C every one to four hours until symptoms are relieved.

These approaches may help address the underlying cause of a hair disorder.

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