Q. My brother recently turned 49. He has had male pattern baldness since his early 20's. In the last 2-3 months his hair has been falling out in patches and he went from having almost no gray hair to being completely gray in this same period of time. What could be causing this?

A. Alopecia (loss of hair from the scalp, ie. baldness) is very common in men. There are several causes. The most common is male pattern baldness which is thought to be hereditary, and is hormonally mediated via testosterone, and generally is more pronounced with aging. There are several other causes of Alopecia including various drugs, fungal infections, Lupus and AIDS, amongst others. Your brother's case is more unusual. Other diagnoses to consider include thyroid disease and various nutritional deficiencies; Protein, biotin, iron and zinc deficiency could cause such symptoms. Blood tests can be done to exclude these. This could result from an intestinal malabsoption syndrome such as celiac sprue.

I would advise he see an internist for more medical evaluation, and possibly a dermatologist pending medical evaluation. In the meantime, there are lots of hats available!

American Academy of Dermatology: http://www.aad.org

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