Hair loss is a common condition that affects both men and women and can develop gradually or suddenly depending on the cause. While losing some hair each day is normal, noticeable thinning, excessive shedding, or bald patches may signal an underlying issue affecting the scalp or hair follicles. Hair loss can impact appearance, confidence, and emotional well-being, especially when changes occur quickly or continue to worsen over time. At Beacon Dermatology, patients in Asheville, North Carolina receive comprehensive evaluations to identify the cause of hair loss and personalized treatment plans based on their specific condition and goals.

What is hair loss?

Alopecia is the medical term for all kinds of hair loss. Hair normally grows in cycles that include a growth phase, resting phase, and shedding phase. Disruptions in this cycle may lead to thinning hair, widening parts, receding hairlines, and areas of visible scalp. Alopecia occurs when hair sheds faster than it regrows or when the hair follicles stop producing healthy hair altogether.

Hair loss may affect only the scalp or involve other areas of the body, including the eyebrows, beard, or body hair. Some forms of hair loss are temporary and reversible, while others may become progressive without treatment.

The appearance of hair loss varies from person to person. Some individuals notice diffuse thinning throughout the scalp, while others develop circular bald patches or significant recession along the hairline. In many cases, early diagnosis and treatment may help slow progression and preserve existing hair.

What causes hair loss?

There are many possible causes of hair loss.  Identifying the underlying reason is one of the most important parts of treatment. Some causes are related to genetics, while others may result from medical conditions, stress, hormonal changes, medications, or scalp inflammation.

1. One of the most common causes is hereditary hair loss, also known as androgenetic alopecia. This condition affects both men and women and tends to develop gradually over time. Men often notice a receding hairline or thinning at the crown, while women commonly experience overall thinning along the top of the scalp or widening of the part.
2. Hormonal changes may also contribute to hair loss. Pregnancy, childbirth, menopause, thyroid disorders, and hormonal imbalances can disrupt the normal hair growth cycle and trigger excessive shedding. Some women notice increased hair loss after stopping birth control medications or during periods of significant hormonal fluctuation.
3. Stress is another major factor. Physical stress from illness, surgery, rapid weight loss, or high fever can cause temporary shedding known as telogen effluvium. Emotional stress may also affect hair growth and lead to increased shedding several months after the stressful event.
4. Autoimmune conditions can cause the immune system to attack healthy hair follicles. Alopecia areata is one example that may lead to smooth, circular bald patches on the scalp or beard area. In some individuals, more widespread hair loss can occur.
5. Nutritional deficiencies may also play a role. Low levels of iron, protein, vitamin D, zinc, or other nutrients can interfere with healthy hair production. Restrictive diets and poor nutrition may contribute to thinning hair or increased shedding.
6. Certain hairstyles and hair treatments can damage the hair and scalp over time. Tight braids, extensions, chemical treatments, excessive heat styling, and frequent tension on the hair may lead to traction alopecia, a form of hair loss caused by chronic pulling on the follicles.
7. Scalp conditions such as psoriasis, seborrheic dermatitis, fungal infections, or chronic inflammation may also interfere with healthy hair growth and contribute to thinning or patchy hair loss.

What are the symptoms of hair loss?

Hair loss symptoms can develop slowly or appear suddenly depending on the cause. Many patients first notice more hair than usual on pillows, in the shower, or while brushing their hair. Others notice visible thinning, changes in hair texture, or areas where the scalp becomes easier to see.

Common symptoms include:

• Gradual thinning on the top of the scalp
• Widening of the hair part
• Receding hairline
• Circular or patchy bald spots
• Excessive daily shedding
• Hair breakage or brittle hair
• Thinning eyebrows or eyelashes
• Scalp irritation, itching, or redness
• Areas of smooth or shiny scalp

Some types of hair loss occur without pain or irritation, while others may be associated with burning, tenderness, scaling, or inflammation of the scalp. Sudden or severe hair loss should always be evaluated by a dermatologist, especially when accompanied by other symptoms such as fatigue, weight changes, or skin rashes.

How is hair loss diagnosed?

Diagnosing hair loss begins with a detailed medical history and scalp examination. Dr. Michael Rains evaluates the pattern of hair loss, the condition of the scalp, and any signs of inflammation, scarring, or follicle damage. Understanding when the hair loss started, how quickly it progressed, and whether there is a family history of hair loss can provide important clues.

During the evaluation, he may examine the scalp using specialized magnification tools to assess hair density and follicle health. In some cases, a hair pull test may be performed to determine how much active shedding is occurring.

Blood testing may be recommended to identify underlying medical causes such as thyroid disease, iron deficiency, hormonal imbalances, autoimmune disorders, or nutritional deficiencies. These conditions can sometimes contribute to hair thinning or excessive shedding.

If the diagnosis remains unclear, a scalp biopsy may occasionally be performed. This involves removing a very small sample of scalp tissue for microscopic evaluation to better understand the type of hair loss present.

Because there are many different forms of hair loss, an accurate diagnosis is essential before determining the appropriate treatment. Early evaluation may improve the chances of preserving existing hair and slowing further progression.

At Beacon Dermatology, patients receive individualized care focused on identifying the cause of hair loss and helping restore healthier hair growth with evidence-based dermatologic treatment options tailored to their needs.

If you are suffering from hair loss, schedule a consultation with Michael Rains, MD, FAAD, Gabrielle Weaver, PA-C, or Margaret Frates, PA-C. Dr. Rains, Gabrielle Weaver, PA-C, and Margaret Frates, PA-C are widely regarded as some of the best dermatological providers in Asheville, North Carolina. He sees patients in Buncombe and Henderson counties.