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Diffuse hair loss is the gradual thinning of hair from all parts of the scalp. The thinning is usually fairly even and without definite bald patches. In nearly every case it is shown to be a disturbance of the normal growth cycle of the hair with a large number of hairs entering the telogen phase (cessation of growth) at the same time. The replacement of old hairs by new ones (anagen) may be delayed so tha t the hair becomes sparse all over the scalp sometimes to the degree in which the scalp can be seen through the hair.

Unlike male balding the hair around the ears and at the nape of the neck are equally affected. The problem is more common among women than men and usually follows the event which caused the disturbance in the growth cycle often occurring about three months after the causative event.

In most cases the hair may be expected to re-grow unless the hair fall is being affected by a continuing cause.

Whilst there are many causes, and these must be carefully examined and eliminated, the most common factors are:-
Following pregnancy
Hormone imbalance
Drugs and radiation
Nutritional disorders
Physical stresses
A number of other factors may be held responsible…

Emotional stress
Accident or surgery
Fevers
Sepsis and septic foci
Iron deficiency anaemia
Depression
Traumatic hair loss

Emotional Stress
Whether acute or chronic can cause diffuse hair fall. Treatment lies in treating or coming to terms with the causes of the stress whilst at the same time using local measures to stimulate the growth of new anagen hairs by massage and regular treatment.

Accident or Surgery
Any form of traumatic injury to the body will also cause a temporary interruption of the normal growth cycle, giving variable degrees of hair loss not necessarily related to the degree of injury. Surgery and the accompanying anaesthetics, possible loss of blood and the medications including antibiotics which may be needed to assist and promote healing may cause similar effects. Following complete healing of wounds, treatment is advised.

Fevers
Although far less common than they used to be any form of fever, and this may include the more severe forms of influenza or pneumonia which are capable of causing a degree of hair loss. A rise in body temperature above 39° C will cause telogen hair loss within two and a half months of the onset of fever. The hair loss is only partial and is related to the maximum temperature and the length of time the temperature stays above 39° C. Re-growth of hair follows recovery from the illness and can usually be seen within two months from the onset of hair fall. As all of the hair does not always recover by itself, Treatment needs to be given following the illness.

Sepsis and Septic Foci
Occasionally chronic localised inflammation or infection may also cause diffuse hair loss. Bladder or urinary infections, impacted or infected wisdom teeth, gum inflammation or tooth abscess may be to blame as can chronic eye disorders such as blepharitis or conjunctivitis. Abscess occurring in any other part of the body will have the same effect.

Treatment involves finding the cause and having the appropriate treatment required. Once the focus of inflammation or infection has been found and treated, the hair will gradually try to improve within a few months. Local treatment is recommended to help speed up the instigation of new growth.

Iron Deficiency Anaemia
Occurs mostly in women. If diagnosed by a Doctor after a simple serum or blood test, iron supplementation will normally improve the hair growth within a few months.

In anaemia the hair also becomes dry and brittle and breaks off more easily, the fingernails may flake off in layers and usually there is a general feeling of tiredness and weakness often accompanied by low blood pressure.

Treatment of the anaemia solves all of these problems especially from the point of view of the poor hair growth and weakness of the fingernails.

Depression and Depressive Illness
For those unfortunate individuals who suffer from chronic depression, hair fall is a common occurrence. Some Psychiatrists look for this as evidence of a depressive state. Whilst depression can to some degree be controlled but rarely cured.

Traumatic Hair Loss
Although not a true form of diffuse hair loss, this problem may be the result of over enthusiastic hairdressing particularly colouring, straightening or perming. This may easily be confused with diffuse hair loss and has been mentioned for this reason.

Another form of apparent diffuse hair loss is that which is self inflicted and this is covered under Hair Oulling or Trichotillomania.

Diffuse hair loss without obvious scalp disease requires painstaking examination and questioning. A general medical examination by a Doctor to eliminate many of the possible causes may be advisable. Trichological Treatment is normally essential.

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