Hair loss can range from mild thinning to total baldness. It may happen suddenly, or slowly, over time. It’s even possible to have more than one hair loss condition simultaneously.
Talk to your doctor if you’re shedding more than the average 50 to 100 hairs a day. It’s essential to find out if your hair loss can be attributed to one of the conditions listed below.
Androgenetic alopecia, or hereditary hair loss, is the most common type of hair loss and it’s progressive. Men and women with androgenetic alopecia are born with inherited hair follicles that are sensitive to a hormone called dihydrotestosterone (DHT). DHT causes hair follicles to miniaturize over time, producing thinner and finer hair. Eventually, the follicles stop producing normal hairs, leaving only “peach fuzz”. Men with this condition typically notice a hairline that recedes or thinning at the crown. Women with androgenetic alopecia don’t always follow a recognizable pattern, but may see a widening part, overall thinning or patchy hair loss.
Involutional alopecia is the gradual thinning and loss of hair that comes with age. Over time, a higher number of hair follicles move into the resting phase and remaining hairs become shorter, finer and fewer in number. Involutional alopecia is the second most common type of hair loss.
Alopecia areata is an autoimmune condition where the immune system mistakenly attacks the hair follicles, causing hair loss on the scalp, face and other areas of the body. Alopecia areata can occur in multiple family members, suggesting genetics play a part in this condition. It affects both men and women and often first appears in childhood.
There are several forms of alopecia areata, including:
- Alopecia areata (patchy hair loss): This is the most common form of alopecia areata, resulting in one or more round patches of hair loss.
- Alopecia totalis: This form of alopecia areata is characterized by the complete loss of scalp hair.
- Alopecia universalis: This condition is the most advanced form of alopecia areata. It results in the total loss of hair on the scalp and body.
- Ophiasis: This form of alopecia areata occurs in a wave pattern around the edge of the scalp, typically at the back of the head.
Traction alopecia results from damaged hair follicles due to constant tension or pulling over a long period of time. Repeatedly wearing tight hair styles, such as ponytails, buns or braids, can cause traction alopecia. This condition typically occurs near the temples or along the hairline. African-American women often experience this type of hair loss at their edges, which is the hairline area that goes from ear to ear and frames the face.
- Chignon alopecia: This is a form of localized traction alopecia that results in hair loss at the crown of the head. Wearing hair in a tight bun over an extended period of time can cause chignon alopecia because of the way the style constantly pulls on the hair.
Cicatricial alopecia, also called scarring alopecia, refers to a group of rare disorders that destroy hair follicles and replace them with scar tissue. Most forms of the condition first appear as small patches of hair loss that may expand over time. Many African-American women suffer from this condition. While these disorders affect a small number of the population, they can result in permanent hair loss.
- Central centrifugal cicatricial alopecia (CCCA) - CCCA primarily occurs at the crown. The hair loss is usually gradual and radiates outward in a circular pattern. It’s linked to harsh styling practices such as chemical relaxers and excessive pulling on the hair from tight braids and weaves. However, research now suggests that CCCA may also be due to a genetic predisposition. This form of scarring alopecia is most common in African-American women, though it can present in men and women of all ethnicities.
- Lichen planopilaris - Lichen planopilaris is a type of scarring hair loss that occurs when a skin infection called lichen planus affects the scalp. The condition typically causes intense itching and may be accompanied by burning and tenderness. The cause of lichen planopilaris is not known, but is thought to have a genetic link.
Anagen effluvium is the sudden loss of hairs in the growing (anagen) phase. This condition may be caused by exposure to chemicals or toxins such as those found in chemotherapy or radiation for cancer treatment. The condition is generally reversible and hair typically regrows within 1-3 months, but some hair loss can be permanent.
Telogen effluvium occurs when hair follicles are prematurely pushed into the resting (telogen) phase of hair growth. This condition is usually due to an acute external factor such as physical trauma, surgery, major illness or other intense stressors on the body. It typically appears as diffuse thinning across all areas of the scalp, and in many cases, is temporary and reversible.
Additional Types of Hair Loss
Hypotrichosis is a condition where there is no hair growth from the time of birth. Rather than having hair and losing it over time, people with hypotrichosis never grow any hair. This condition is thought to be caused by a genetic deviation during fetal development.
Trichotillomania is an impulse control disorder that drives individuals to pull out their own hair compulsively. Typically, trichotillomania results in patchy bald spots on the scalp, eyebrows and/or eyelashes.
Scalp folliculitis is usually due to a bacterial infection. It occurs when hair follicles become inflamed due to blockage or damage. Follicles may be surrounded by a ring of inflammation and look like acne. In the early stages, hair may still be present in the follicle, but as the condition progresses, it will fall out. In severe cases, the inflammation can permanently damage hair follicles and result in hair loss.
Trichorrhexis nodosa is characterized by weak points, or nodes, present along the hair shaft. The nodes cause hair to break easily, leading to the appearance of thinning hair or patchy hair loss. The condition can be triggered by harsh styling practices such as the overuse of chemicals and heat styling tools. In some cases, trichorrhexis nodosa may be caused by underlying medical disorders such as thyroid problems, an iron deficiency or a buildup of ammonia in the body.
*For informational purposes only. The information presented herein is general in nature and is not intended to substitute the advice of a physician or other health care professional.
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