What causes hair loss?

Hair loss usually occurs in one of several specific patterns and hence it has been called male or female pattern hair loss or androgenetic alopecia. Only about one percent of hair loss is caused by other conditions. These include various nutritional, metababolic and hormone disorders.

Male & female pattern  hair loss involves a genetic susceptibility of some of the hair follicles to the hormone dihydrotestosterone, (DHT). This hormone acting over time on these susceptible follicles causes a gradual shrinking, (miniaturization), and finally death of these follicles.

There is much debate on this topic. While the link between certain forms of hair loss and the immune system is well-accepted, there is also evidence for a connection between the immune system and pattern loss (androgenetic alopecia). In line with this, it appears that male hormones, especially DHT, trigger an autoimmune response in pattern loss, initiating an attack on the hair follicle that can be observed microscopically. This results in destructive inflammation that gradually destroys the follicle’s ability to produce terminal hair. The reason for this could be that androgens somehow alter the follicle, causing it to be labeled as a foreign body.

A possibly related factor is that elevated androgens also trigger increased sebum (oil) production, which can favor an excessive microbial and parasitic population, also leading to inflammation. In any case, hair progressively miniaturizes under the withering autoimmune attack, so that with each successive growth cycle it gets shorter and thinner until it finally turns into tiny unpigmented vellus hair (peach fuzz).

In men, balding typically follows the classic horseshoe pattern known as male pattern baldness or MPB, though diffuse thinning can also occur. It has been noted that both the number of androgen receptors and the level of 5-alpha reductase, which converts testosterone to DHT, are higher in susceptible areas than in the rest of the scalp. Women’s hair loss tends to be diffuse but is also primarily hormonally driven.

The story of balding is, however, not the story of androgens alone. Rather pattern loss appears to have multiple contributing factors once the process is underway. For instance, damage to blood vessel linings can inhibit a growth factor they ordinarily produce: endothelium-derived relaxing factor (EDRF) or nitric oxide (NO). Minoxidil probably works in part by mimicking this growth factor. Similarly it has been noted that severe baldness is strongly correlated with heart disease and even diabetes, so there appears to be some common etiology outside of the strictly androgen paradigm for pattern loss. There are likely other factors as well.

Is stress a factor in hair loss?

Sometimes stress can play a role in diffuse loss. Stress-induced loss ordinarily regrows within a year of eliminating the cause. In the absence of any prolonged emotional or physical trauma that has noticeably affected your overall health, stress is not likely the cause. Crash dieting, medical conditions, certain medications, pregnancy, and other major life changes can initiate stress-shedding however. In some cases extreme emotional tension for prolonged periods of time can have an effect as well.

Please view Women’s Guide to Hair Loss Treatment or Men’s Guide to Hair Loss Treatment for specifics.

Individuals with Alopecia Areata (patchy hair loss), Alopecia Universalis or Alopecia Totalis, can typically be struggling with an autoimmune condition. These could be considered stress triggers, as an overactive immune system is akin to a stress response, but the true condition is autoimmune, versus “stress”. You may wish to read more about these conditions in Alopecia Guide, or talk with others also experiencing these more extreme forms of Alopecia in Alopecia Community.

Synthetic vs. human hair wig?

When coming in for a 1-hour complimentary consultation, William Collier Design will discuss all of the replacement hair options that are available and help in choosing the style, color, and fit with their many years of hair replacement expertise. We are here to help our clients make the most informed decisions possible. Contact us today!

Here is a brief overview of the Pro’s and Con’s of both types of hair: 

Human Hair


  • More natural and realistic looking.
  • More ability to create a custom look to meet client’s needs.
  • Wide range of options available in the human hair “family” that can fit any budget, from the least expensive to the highest quality, most luxurious hair on the market.


  • More expensive than synthetic.
  • Requires regular styling (like your own human hair).


Synthetic Hair


  • Less expensive than human hair wigs.
  • Less styling necessary because they are created in a specific style and will stay that way with minimal care.


  • Does not look as realistic or natural.
  • Can “mat” up fairly quickly.
  • Color choices are limited to those available on manufacturers color ring, we have no ability to add color to a synthetic wig.
How do I care for my wig?

Human Hair and Synthetic Hair have very different care requirements. Please read our Human Hair Wig Care page or Synthetic Hair Wig Care page for the appropriate care for your piece.

How can William Collier Design help?

William Collier Design has been providing professional hair design, replacement and consultative services for people with all types of hair loss for over 35 years. We are happy to provide a 1-hour complimentary consultation to discuss a client’s particular hair loss situation and evaluate the best course of action for them.

We have a full range of human hair and synthetic hair options available and skilled, professional stylists to provide guidance for the most appropriate choice.

Most important to us is that our clients are educated in the options that are available to them and that whatever result they are hoping to achieve, that we help and support them to that end.

I have thinning hair.  Can you help me?

Yes, this is a big part of what we do! In addition to helping people select replacement hair pieces, we also specialize in specialty cutting for thinning hair. Our stylists are trained to provide optimal care, attention and skill while working with this condition. William Collier Design offers thinning hair clients the opportunity to engage in a positive dialogue in a private and caring environment. Contact us in Seattle, WA today for help!

Does insurance cover wigs?

Some insurance companies offer coverage for hair replacement prostheses (wigs), while others do not. However, it’s worth making a call to find out. Please read the information we’ve compiled that may be of help to you when contacting your insurance provider.

FOLLEA Hair Treatments