Rebecca Campen, M.D., J.D. is an Assistant Professor of Dermatology at Harvard Medical School and former Deputy Director of the Harvard/Massachusetts General Hospital Cutaneous Biology Research Center (CBRC). She currently serves as Senior Advisor to the CBRC and divides her time between clinical practice of dermatology at the Massachusetts General Hospital and private practice in Savannah, Georgia. Dr. Campen is the author of two books for medical students and residents, Going Into Medical Practice and Blueprints in Dermatology.
Question:
I have a problem with hair loss. After I came back from Iraq I started losing hair in small patches, first on my beard and then on my scalp. Could my hair loss be caused by a fungus rather than stress?
Answer:
Hair loss can be caused by many factors, including stress, medications, hormonal abnormalities, infection, and scalp conditions such as psoriasis and seborrheic dermatitis. One of the most common causes of hair loss is androgenic alopecia, which is hair loss over time due to hereditary factors. In men, this often occurs as hair thinning around the temples and a bald spot on the back of the scalp that continues to grow with time.
Alopecia areata is hair loss in small patches. It can occur in the beard area, as well as on the scalp. The cause of alopecia areata is unknown, but the picture is one of well-demarcated patches of hair loss. Fungal infection can also cause hair loss. In contrast to alopecia areata, the patch of hair loss is usually scaly.
Because there are many possible causes of hair loss, it is important to see your doctor to determine the underlying cause. A scraping of the scalp can verify whether fungus is involved. A punch biopsy or other tests can be done if the cause is not evident. Because treatment can vary depending upon the underlying cause, it is important to have a correct diagnosis.
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