Encyclopedia of Alopecia: Signs, Symptoms, and Treatment of Hair Loss

If you’ve been losing large amounts of hair and suspect it may be due to alopecia, you’re not alone. The term “alopecia” gets nearly 246,000 searches on Google each month. Alopecia is a broad term that encompasses 6 types of hair loss. The types are alopecia areata, traction alopecia, retrograde alopecia, androgenic alopecia, alopecia totalis, and alopecia barbae. Read on to learn more about the causes, symptoms, and types of alopecia, as well as treatment options. 

What is Alopecia? 

According to WebMD, Alopecia is a disorder that causes your hair to come out. Alopecia occurs to both men and women. The severity, area, and pattern of hair loss differs person to person, and provides insight into the reasons or causes for your hair loss.

In some cases, without treatment, hair loss may reverse itself and grow back.  Your doctor can help diagnosis your hair loss cause and if appropriate recommend a treatment option. It could be as simple as changing your diet or finding a way to eliminate certain stresses from your life, but it may also be hereditary or even an autoimmune disease.   

Signs and Symptoms of Alopecia 

Signs of alopecia include: 

• Small bald patches on your scalp or other parts of your body 
• Patches may get larger and grow together into a bald spot 
• Hair grows back in one spot and falls out in another 
• You lose a lot of hair over a short time 
• More hair loss in cold weather 
• Fingernails and toenails become red, brittle, and pitted 
• Hair falls out little by little  
• Receding hairline 

What Causes Alopecia? 

Causes of alopecia vary from person to person. Some reasons why you may be experiencing alopecia include: 

• Family history/genetics 
• Hormones 
• Medication and supplements 
• Radiation therapy to the head 
• A very stressful event 
• Hair styles and treatments 

Scarring vs. Non-Scarring Alopecia 

Scarring alopecia occurs when the hair follicle is damaged – usually by inflammation – to the point of no return. It forms a scar and follicle can no longer grow new hair. Non-scarring alopecia is more reversible, as the hair falls out but doesn’t form a scar.  

6 Types of Alopecia       

• • Alopecia areata – This type of non-scarring alopecia is an autoimmune disorder. In this case, the immune system attacks its own hair follicles, causing the follicles to shrink and slow down hair production. Types of alopecia areata include alopecia areata patchy, in which hair falls out in patches from the scalp or the body, diffuse alopecia areata, in which sudden hair thinning occurs without patches of hair loss, ohpiasis alopecia areata, which is hair loss around the sides and back of your head, alopecia areata totalis, which is complete loss of hair on the scalp, and alopecia areata universalis, in which there is complete hair loss all over the body. 

• Androgenic alopecia – This form of non-scarring alopecia is a genetic condition that affects both men and women. In men, it is called male pattern baldness, and hair loss can begin as early as their teens or early 20s. In women, it is called female pattern baldness, and hair loss isn’t usually noticeable until their 40s or later. 
• Alopecia barbae – Also referred to as beard alopecia. It is an autoimmune disorder in which your body’s inflammation attacks hair follicles. Symptoms of it include hypotrichia, which means “a decrease in the number of hairs.” 
• Alopecia totalis – This form of alopecia makes you lose all your hair on your scalp, usually within two years. 
• Retrograde alopecia – This is a condition that causes hair loss around the hairline at the nape of the neck. Symptoms of retrograde alopecia are gradual thinning over a period of months or years and noticing the hair has stopped growing and no new hair is being produced.  
• Traction alopecia – Formed by tight ponytails, braids, hair extensions, and chemical relaxers that leads to cause tension on the scalp, resulting in hair loss. Common symptoms include itching, redness, folliculitis or pustules, multiple short broken hairs, and thinning hair or hair loss. 

Is Alopecia Genetic? 

The inheritance pattern of alopecia areata is unclear because multiple genetic and environmental factors appear to be involved. Although it is unclear with many cases as to what triggers hair loss in people with alopecia areata, some genetic variations of it have been identified in people with other autoimmune disorders including vitiligo, system lupus erythematosus, atopic dermatitis, allergic asthma, and autoimmune thyroid diseases such as Hashimoto thyroiditis and Graves disease. People who share these disorders also have a higher increase in contracting alopecia. Women also tend to share stronger genes related to alopecia.  

Alopecia in Women  

About one-third of women experience hair loss at some time in their lives. Almost two-thirds of post-menopausal women experience hair thinning or bald spots. This can severely affect a women’s confidence, emotional well-being, and quality of life, according to Harvard. Within the U.S., approximately 30 million women experience female pattern baldness. This can be due to several reasons ranging from hormonal changes to menopause, to stress, to birth control, and other types of medications for ailments. Lifestyle choices also play a part as to why women may be experiencing hair loss or baldness.

There are generally three stages with female pattern baldness which includes thinning at the top of the head, the scalp being visible through thinning hair areas, and loss at the crown of the head. Consulting with an expert to get to the root of the problem is your next step in determining the type of alopecia you may have, and the best treatment for you.   

Treatment for Alopecia  

Although there is no cure for alopecia, there are many treatments you can take to help with your hair loss.  

• Alopecia areata: Treatments for alopecia areata include topical medication, steroid shots given by your dermatologist, and chemicals your dermatologist applies to your scalp for extensive hair loss.  
• Alopecia barbae: Treatments for alopecia barbae include corticosteroids: lab-made chemicals that fight inflammation in your body; minoxidil: topical or oral medication for male pattern hair loss; shaving lightly or cosmetic tattooing, and hair transplant. 
• Androgenic alopecia: Proven treatments for androgenic alopecia include minoxidil (Rogaine) and finasteride (Propecia). Supplements like saw palmetto and biotin have also shown promise. Those with androgenic alopecia are typically good candidates for hair transplant, so long as they still have some hair left in the donor area. 
• Traction alopecia: With traction alopecia, hair can regrow if treated early. Avoid tight hairstyles like ponytails, braids, cornrows, or hair extensions. Permanent hair loss can occur, so a hair transplant is a possible medical treatment.  
• Retrograde alopecia: Changing your diet can help with treating retrograde alopecia by eating plenty of Vitamin A-rich foods. You can also take use minixodil or low-level laser therapy (LLLT). Unfortunately, since retrograde alopecia affects the donor area at the base of the neck, the hairs can’t be used for hair transplant surgery.   
• Alopecia totalis: Systemic immunosuppressive therapy such as methotrexate or prednisone can be used as treatment.  

Medications like minoxidil and finasteride are best used to slow down balding, thinning, or shedding and help retain, grow and revive your hair follicles. The result is thicker, fuller, healthier growing hair. For those with hair loss who are looking to not only retain but restore their existing hair, hair transplantation is the best treatment.  

If you would like to learn more about the causes of hair loss and available treatment options, you can schedule a free consultation with a Bosley counselor. A Bosley physician can further help you develop a treatment plan that is right for you.