Hair loss (alopecia) may affect just the scalp, just the body, or both, depending on the underlying cause, and it may be temporary or permanent. Hair loss may be the result of genetics, a medical condition, hormonal changes, medications or a part of the normal ageing process. Baldness refers to excessive hair loss from the scalp, hereditary hair loss is the most common cause of baldness.
There are a number of different types of hair loss, some examples include:
Alopecia areata
An autoimmune condition which causes hair to fall out in patches that may be localised or diffuse. Alopecia areata most commonly affects the scalp, but may affect hair on any area of the body. Rarely alopecia areata may result in a complete loss of hair over the scalp (alopecia totalis) or the body (alopecia universalis).
Female pattern baldness
Hair loss is common as women age, up to two thirds of women will experience hair loss after menopause. In female pattern baldness hair follicles shrink and the hair growing phase slows down resulting in less hair and finer hair. This type of hair loss typically starts along the part, and may eventually result in thinning throughout the hair.
Frontal fibrosing alopecia (FFA)
FFA is a form of idiopathic, scarring alopecia that affects the frontal hair margin. Hair loss may also affect other areas of the face and body, but this is less common. FFA typically affects post-menopausal women. It is likely FFA is an autoimmune condition, and may be affected by a variety of genetic, environmental and hormonal factors.
Male pattern hair loss
Male pattern hair loss is very common, affecting half of all males by age 50. This type of hair loss is impacted by three main factors: genetics, hormones and age. In male pattern hair loss follicles on the scalp shrink, producing finer and shorter hairs. Eventually as the growth cycle for each hair ends, no new hair grows in its place. In men, hair loss typically presents as a receding hair line, loss of hair over the crown, or both.
Telogen effluvium
Telogen effluvium is a temporary form of hair loss in which more hairs shift to the shedding (telogen) phase of the hair cycle. Most often this is triggered by a stressor such as an illness, surgery, or psychological stress, by changes in hormones such as after pregnancy, by underlying conditions such as iron deficiency or thyroid imbalance, or by certain medications. Telogen effluvium rarely lasts longer than 6 months, but in some cases may become chronic.
Traction alopecia
Traction alopecia is a form of hair loss caused by constant pulling (traction) on the hair. Traction alopecia is typically associated with repetitive tight hairstyles such as tight ponytails, braids and buns, and weaves and hair extensions. Often hair loss is seen at the front, back or sides of the scalp. Traction alopecia can be reversed when identified early.
Trichotillomania
Trichotillomania, also known as hair-pulling disorder, is a psychological condition characterised by a recurrent, irresistible urge to pull out hair from your scalp, eyebrows or other body areas. Trichotillomania typically begins in adolescence and may continue into adulthood.
A workup to evaluate for any potential underlying cause of hair loss may include a scalp biopsy and/or blood testing.
Treatment for hair loss may include:
- Hair styling modifications
- Supplements
- Topical prescriptions
- Oral medication
- Platelet rich plasma (PRP)
