Female hair loss can have many causes and it can often take some time to identify which ones are really to blame. One common cause is medication, which can cause side-effects including loss or damage to hair.

The way in which medication damages hair is in interrupting the natural hair growth cycle. This cycle has two main phases – anagen and telogen. The anagen phase is when the hair follicles grow, and it can last for three to four years. The telogen phase is the resting stage, when the hair follicles recover for around three months before falling out.

Medication can interfere with this cycle, either stopping the anagen phase in some way or sending too many hairs into the telogen phase. This can cause mass shedding, where a lot of hair falls out at once.

Medications

There are many medications which could cause hair loss as a side-effect in some cases. Always check with your doctor if you have any concerns.

• Anticoagulants (blood thinners)
• Epilepsy medications
• Oral contraceptives
• Acne medication
• Antidepressants
• Antifungal medications
• Antibiotics
• Hormone replacement therapy (for women – progesterone or oestrogen)
• Steroids
• Mood stabilisers
• Chemotherapy medications
• Thyroid medications
• Immunosuppressant medications
• Cholesterol-lowering medication

Trichotillomania is a hair loss condition and compulsive disorder in which a person pulls out their own hair. This kind of hair pulling can occur to the point that hair loss is noticeable to other people.

Loss of hair is obviously the first and most evident sign of trichotillomania, but what are the other symptoms? Identifying the following symptoms in a suspected sufferer can help your GP or trichologist diagnose the condition properly and distinguish it from other hair loss conditions.

Trichotillomania symptoms

A person with trichotillomania may experience:

• The irresistible urge to pull hair
• A feeling of tension before pulling hair, or when resisting
• A sense of satisfaction, relief or pleasure after giving in to the hair pulling impulse
• Bare patches on the scalp or skin where hair has been pulled out
• Other compulsive body-focused behaviour such as chewing hair, eating hair (trichophagia) inspecting hair roots and excessive playing with hair

The condition is occasionally difficult to diagnose properly because sufferers feel ashamed of their urges and attempt to hide their symptoms and behaviour from others. These people often wear hats, wigs and scarves to try to hide their hair loss.

Trichotillomania, the compulsive hair-pulling disorder, is not a condition that is talked of much in the public sphere. This is mainly because sufferers are embarrassed to admit to pulling their own hair out, and so many conditions go undiagnosed.

Once this hair loss condition has been diagnosed, however, it’s time to think about treatment. Even though research into trichotillomania has advanced a great deal over the last few years, there is no one definitive treatment known to ‘cure’ all sufferers.

However, there are numerous treatment offers you can try, some of which have been successful at improving the condition. These include:

• Cognitive-Behavioural Therapy – This is a type of therapy that aims to change behaviour by pinpointing exactly what causes a person to pull their hair. The patient will learn new responses to identified triggers, helped by a psychologist.

• Medications – Drug therapy has not proved to be very successful for trichotillomania patients, although it does work for some. Seek advice from your doctor if you are considering medication.

• Alternative Therapies – Some people choose to try herbal remedies, yoga, dietary changes, hypnosis, meditation and prayer.

• Support Groups – As with any female hair loss condition, talking about how trichotillomania affects you with other sufferers can be really helpful.

Most people are aware that chemotherapy treatment for cancer causes hair loss, but the side effects of other cancer treatments such as radiotherapy are not well known or often discussed.

Although both treatments are used to eradicate cancer cells, radiotherapy differs from chemotherapy in that it is generally a more localised treatment. Whereas chemotherapy floods the body with cancer-killing chemicals, radiotherapy focuses solely on the cancerous area. However, chemotherapy and radiotherapy are often used together in conjunction with other treatments to give the patient the best chance of defeating their illness.

Similarly to chemotherapy, one of the most noticeable side effects of radiotherapy is hair loss. However, patients undergoing radiotherapy may experience hair loss (medically known as epilation) some months after their treatment has finished. This differs to chemotherapy, where hair loss is often evident after just two courses of treatment.

In line with the way in which the treatment works, hair loss after radiotherapy is generally localised, occurring in hair bearing skin within the radiation field. Hair loss after cancer treatment is not usually permanent, but it does occur in some cases where radiotherapy doses are very strong.

If you have decided to choose a wig as a way to manage your hair loss, you are likely to be faced with a lot of decisions before you find the right one for you. Wigs have moved on a great deal in the last few years, meaning that it is no longer a case of ‘one type suits all’.

You can now find wigs in a wide range of different styles, colours and materials, so there should be something available to suit you. Even better, you can get wigs that are personally tailored to you, so they look completely natural right from the start.

The first choice you will have to make when choosing a wig is between synthetic and human hair wigs. To help you choose, here are the pros and cons of each:

Human hair wigs

Pros: They look very natural, can be styled just as you like, and you can generally use them for up to a year.

Cons: Human hair wigs are more expensive than other varieties (due to how natural they look) and it can sometimes be tricky to get the hang of styling them yourself.

Synthetic wigs

Pros: They are less expensive than other varieties, are colour-fast, and come pre-styled. This means you don’t have to style them yourself, as they stay in shape even after washing.

Cons: You can’t change the colour or style of synthetic wigs, they sometimes look false or over-shiny, they can be damaged by heat and they don’t last very long.

Hair loss conditions can sometimes be difficult to diagnose, mainly because there are many different contributing factors and causes. The exact causes of hair loss vary from person to person, and in some people are never pinpointed.

Proper diagnosis of hair loss is made even more difficult when the condition is rare. One of these conditions is tufted folliculitis, an uncommon disorder which can cause hair loss and scarring of the scalp.

Symptoms

People with tufted folliculitis often have patches of scarring alopecia accompanied by something known as doll’s hair-like bundling of follicles. This means that multiple hairs emerge through expanded follicular orifices. This causes the ‘tufting’ effect, along with the retention of telogen hairs in the follicles and a fibrosing process.

Associated conditions

Tufted folliculitis is a symptom of a number of scarring diseases and conditions, including:

• Graham-Little syndrome
• Chronic lupus erythematosus
• Folliculitis decalvans
• Chronic staphylococcal infection
• Acne keloidalis nuchae
• Dissecting cellulitis
• Lichen planopilaris
• Immunobullous disorders

Treatment

At present, no definitive curing treatment for tufted folliculitis has been found, although there are measures sufferers can take to reduce discomfort and improve the appearance of the scalp.