For a person who suffers from hair loss, determining the cause is the first step to creating a treatment plan. The most common cause of hair thinning is adrogenetic or androgenic alopecia. There is known to be a genetic component to this form of hair loss though the exact genetics have not been completely elucidated. There are many genes which contribute to androgenic alopecia. The condition can also affect both men and women, though it is often called male pattern baldness. Almost half of all men will develop androgenic alopecia at some point int heir life. The pattern of loss in men is well described and pathoneumonic. For women, the pattern of hair loss is much less well defined and female hair loss often requires additional testing to ensure that the hair loss is not due to another cause.

Alopecia areata is the next most common form of hair loss. This form of hair loss results in rapid loss of hair in circular or oval patches. It may be episodic or persistent. Alopecia areata will generally resolve within six months to a year. Should it persist for longer, the chance of recovery is minimal. The condition will recur in approximately one third of patients. The exact cause of alopecia areata is unknown. There are multiple theories and the current leading theory is hair loss due to an autoimmune condition, where the body attacks its own hair follicles.

A wide range of medications can cause hair loss. The most widely known are chemotherapy drugs but other more common drugs including blood thinners and Vitamin A can cause hair loss. After taking the medications, hair growth is abruptly interrupted and growing hairs are shed after 1-4 weeks. This form of hair loss rapidly affects 80-90% of the scalp but complete recovery can be expected once the medication is stopped.

Certain infections can cause hair loss. Children may have hair loss caused by a fungal infection of the scalp. The infection is easily treated with antifungal medicines. Hair loss may occur as part of an underlying disease, such as lupus or diabetes. Since hair loss may be an early sign of a disease, it is important to find the cause so that it can be treated.

The most common cause of childhood alopecia is trichotillomania. It is an impulsive disorder in which the patient must pull their hair. Onset is in the early teens. Treatment relies on counseling, behavior modification techniques, and hypnosis. Once the behavior is stopped, the hair will generally regrow as long as scarring has not occurred.

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