There may be a serious underlying disease or disorder if you have one or more of the following symptoms:

• fever;
• moderate to severe pain;
• loss of concentration, confusion or other signs of mental disorder;
• difficulty in breathing;
• loss of appetite and weight loss;
• increase of appetite and weight loss (which may be more particularly associated with an overactive thyroid);
• either extreme of constipation or diarrhea;
• vomiting; or
• obvious blemishes, bruising or marks on the skin.

Depending on the extent of the fever and degree of pain, it may be appropriate to treat any combination of these symptoms as justifying emergency treatment.

This set of circumstances has moved you outside the conventional hair loss situation. The issue now is to diagnose the disease or disorder so you will be pitched into the usual round of lab work, x-rays, scans, etc. Once a diagnosis is confirmed, the doctors will be able to advise you on whether treatment of that disease or disorder will restore hair growth on its own. For example, if the diagnosis is thyroid disease, the standard drug therapies restore hair growth without the need for any additional specific treatment. But if the diagnosis is a cardiovascular problem, hair loss is a standard side-effect to the use of blood thinners. In other words, the problem is going to get worse before it gets better.

In many cases, the only remedy will be concealment. If you cannot face the world without hair, you will be looking at the use of a wig or hairpiece. If you make a good physical recovery from the disease or disorder, but hair is slow to begin growing again, you can ask your doctor about propecia which limits the production of hormones preventing hair growth. In some cases, propecia will be useful. However, you may have to consider surgery if drugs have proved ineffective. Transplanting plugs of hair or individual follicles from one part of your scalp to another can produce some evening of effect between areas of thick growth and bald areas. Slightly more extreme is scalp rotation which works well for younger but not older patients.

However, because all the required chemical reactions to stimulate growth are dependent on the free flow of blood to the capillaries supplying each follicle, anything that interferes with the flow or changes the composition of the blood can cause hair loss. Taking physical interference first, arteriosclerosis is the slow loss of volume through the blood vessels. One of the more common causes is high levels of cholesterol in a poor diet as excess platelets build up as deposits on vessel walls. Heavy smoking has the same effect. This will be accompanied by high blood pressure and possible symptoms suggesting heart problems such as angina. As to the chemical composition of the blood, many conditions can affect the hormone balance. An overactive or underactive thyroid gland may cause hair to fall out. The standard treatments for thyroid disease usually restore hair growth. In women, excess levels estrogens may need to be corrected to stop the hair loss. If oral contraceptives are being used, different dosages or a different method of birth control will often restore growth.

In more serious cases, people may be looking at hair loss as a first symptom of cancer. This may be a malignant tumour or cancer of the blood including lymphoma, leukemia and multiple myeloma. Ironically, the treatments using chemo- and radiotherapy remove the rest of the body hair. In slightly less serious cases, the problems may be liver or kidney disease, skin diseases such as lupus and major infections like syphilis. In all these cases, you must either bear with the hair loss or, in combination with any other medication prescribed by your doctor, take propecia. This will help to maintain the status quo except for the more radical treatments which cause stress and hair loss. Whether you do decide to take this drug depends on how important your physical appearance is while you are sick. In many cases, you may be too sick to care. However, there may be situations in which you feel the need to keep up appearances. In those cases, propecia is for you. It is quite slow acting but its effects are reasonably reliable.

What should everyone see when they look in the mirror – apart from someone “good looking”, of course? Whether consciously or not, people monitor their appearance. It results from the way parents bring up their children and how children relate to each other. Parents impose their choice of clothes on their children, directing the choice of hairstyle, dictating the “look”. The children compete with each other to break the parental mold, to impose their own choices and assert their individuality. The majority retain this interest in their appearance as they advance into adulthood. Those who are most into style and fashion are the most vulnerable to unexpected changes.

Most people will notice any change in their hair when they look in the mirror. They may also start finding more hairs caught up in a comb or brush. When hairs turn up on the pillow overnight or on the favorite chair, the list of symptoms is complete. There is a problem. For women, the first question is whether this is no more than damage caused by the excessive use of heat through curling tongs or the drier. Perhaps there have been too many applications of chemicals to dye or straighten hair. The style may also be slowly pulling the hair out by the roots so allowing the hair to be free rather than under traction may be the answer. For men who do nothing more than run a comb through their hair once every morning, the cause is most likely androgenic alopecia and the remedy is propecia. This applies regardless of race. The earlier men start taking this drug the better. It slowly restores the balance of hormones and prevents further loss. Over time, some hair will regrow. Propecia helps to maintain the same look over the years until age makes loss unavoidable.

For younger people, hair loss comes as a natural disaster like an earthquake, shaking their self-confidence and making them look different and, possibly, older. This hair loss would be easier to bear if it was the result of a disease. Everyone knows that cancer patients who go through chemo- or radiotherapy lose all their hair. But the usual explanation is genetic. Instead of a heroic struggle against a killer disease, people lose their hair because they inherited the trait. Cruel people, intent on causing pain, suggest that balding people have genetic defects affecting them in other ways and so morale is worn down.

So what can younger people do when they notice hair loss? Well, the first and most obvious question to ask, “Is this normal loss?” When you stand in the shower and see hair building up in the drain, this is not a cause for panic. People lose their hair naturally every day. Only when the volume of loss increases and a change in physical appearance begins to show itself is there a need for action. Try a simple test. Have someone take a photograph of your head every week from the same angle. This makes it easier to identify real problems. Once a definite trend is established, it is off to see the doctor. There may be a simple explanation and a quick and easy remedy.

For example, it may be the side-effect of a drug. Changing to a different drug may reverse the hair loss. In the cases where the reason is andogenic alopecia, the so-called male pattern baldness, the answer is propecia.

This is a drug designed to correct the hormonal imbalance that causes hair loss. Taken once-daily over significant periods of time, it can prevent further loss and, in some cases, promote regrowth. The earlier in the cycle men begin using propecia, the better the results.

Clinical tests show it is less effective when the hairline has significantly receded.