Alopecia Types, Causes, Symptoms, and Treatment

Alopecia is an umbrella term for conditions characterized by hair loss. It is not contagious, though sometimes it can be a sign of other health problems. Alopecia areata, an autoimmune disease, is one of the more common types of alopecia. Not all of them are related to an unusual immune system response, though.

Some types of alopecia are related to genetic, lifestyle, or environmental factors, as well as psychological conditions that lead to hair pulling. Treatments for many types of alopecia are the same and may involve oral medications and topical therapies. For some alopecia types, behavioral changes are needed to reverse hair loss.

Read on to learn about various types of alopecia.

Anything that disrupts the natural, healthy hair growth cycle can lead to alopecia. Some types of alopecia can be avoided, but others can affect anyone at any age. Your family history, age, gender, and race all can be factors in the likelihood that you’ll develop some form of alopecia.

A 2020 study of alopecia prevalence by race, for example, suggests that African American people are more likely than white people to develop alopecia areata, while Asian people have the lowest odds. The researchers thought a combination of health disparities and genetics were the root cause.

The following includes the causes and symptoms of the most common types of alopecia.

Alopecia areata

The main symptom of alopecia areata is hair that falls out in patches, usually on the scalp. But alopecia areata can affect the eyebrows, eyelashes, and elsewhere on the body.

Alopecia areata is an autoimmune disorder. With alopecia areata, the body’s immune system mistakenly attacks healthy hair follicles, small, pocket-like holes in our skin that grow hair, similar to the way the immune system might fight an infection. Injury to the follicles results in hair loss. This type of alopecia tends to run in families.

Persistent patchy alopecia areata

When patchy hair loss continues but does not improve or worsen over time, it’s characterized as persistent patchy alopecia areata. It’s caused by the same factors that lead to alopecia areata.

Alopecia totalis

When the entire scalp experiences hair loss, the condition is called alopecia totalis. Like some other forms of alopecia, it appears to be related to an unusual immune system response. However, researchers are still trying to discover the exact causes of alopecia totalis.

Alopecia universalis

As its name implies, alopecia universalis is a condition that involves complete hair loss. This includes the scalp and the rest of the body. Like other autoimmune diseases, it’s unclear why some people develop this condition and others don’t.

Diffuse alopecia areata

Diffuse alopecia areata is also known as telogen effluvium. It’s different from alopecia areata because your hair thins and then falls out in scattered areas across the scalp, instead of falling out in patches. In rare cases, similar hair loss patterns will occur in other areas of the body. Causes include severe stress, sudden hormonal changes, and medication side effects.

Ophiasis alopecia

Ophiasis alopecia is a form of alopecia areata that mostly affects the sides and back of the scalp. It’s an autoimmune disorder that mainly affects young people.

Androgenic alopecia

Androgenic alopecia is a common genetic condition that affects people of all genders.

Male pattern

Male pattern baldness usually starts with a receding hairline or hair loss on the crown. The sides and lower back of the head are usually the last areas to lose hair, if they lose any at all.

Female pattern

Female pattern baldness is different from male pattern baldness because it usually starts with thinning hair along the part line. The part line can eventually widen, but complete baldness is rare.

Cicatricial alopecia

Experts don’t entirely understand the causes of cicatricial alopecia, though this inflammatory condition sometimes develops after the skin is damaged by a burn or severe infection. Hair loss may occur slowly in patches or more rapidly in larger areas. The skin underneath may also become itchy and inflamed.

Lichen planopilaris

Lichen planopilaris is another inflammatory condition that tends to affect young women more often than men. It’s a rare disorder with an unknown cause that results in smooth patches of skin on the scalp.

Frontal fibrosing alopecia

Frontal fibrosing alopecia is a form of lichen planopilaris. It usually causes slow but progressive hair loss, usually just above the forehead. The eyebrows and eyelashes may also be affected.

Central centrifugal cicatricial alopecia (CCCA)

CCCA causes hair loss that starts on the crown and then spreads across the top of the head. According to a 2020 report, CCCA almost exclusively affects Black women over 30 years old. Experts aren’t sure why, but CCCA probably has multiple causes.

Traction alopecia

Traction alopecia is hair loss triggered by repeatedly pulling or tightening hair in the same direction.

Alopecia barbae

An autoimmune condition, alopecia barbae causes beard hair to fall out in small circular patches. Sometimes patches overlap as the condition progresses. However, it’s difficult to predict how much hair will be lost.

Postpartum alopecia

The rapid and significant drop in estrogen levels following childbirth can result in a condition known as postpartum alopecia. However, doctors don’t consider this to be typical hair loss. Instead, postpartum alopecia is actually the hair shedding following the enhanced hair growth that can occur during pregnancy. Within a few months, regular hair growth usually resumes.

Alopecia occurs when the usual cycle of hair growth is interrupted or halted. The pattern of hair loss varies depending on the type or cause of alopecia.

Male and female pattern hair loss tend to start on different parts of the scalp and progress in different ways, too.

Men experience noticeable hair loss more often than women. In addition to genetic and immune system triggers for hair loss, hormonal factors — particularly reduced levels of the male sex hormone dihydrotestosterone — can also contribute to male hair loss.

Among the most common types of alopecia affecting men are:

  • alopecia areata
  • androgenic alopecia
  • alopecia barbae

Significant hair loss is less common in women than in men, but women do experience several types of alopecia. Among them are:

  • alopecia areata
  • androgenic alopecia
  • postpartum alopecia
  • traction alopecia

Children experience hair loss much less frequently than adults, though certain types of alopecia can affect young people. Among them are:

  • alopecia areata, which often begins in adolescence
  • lichen planopilaris
  • ophiasis alopecia

While there is no cure for alopecia, several treatment options may help regrow hair or at least slow or halt further hair loss. Among the more commonly used alopecia treatments are:

Corticosteroids

Prescription-strength corticosteroids can suppress the immune system and reduce damage to healthy hair follicles. These medications include oral, topical, and injectable treatments. The types of alopecia most effectively treated by corticosteroids include:

  • alopecia areata
  • alopecia totalis
  • alopecia universalis
  • CCCA
  • lichen planopilaris
  • ophiasis alopecia
  • persistent patchy alopecia areata

Microneedling

Microneedling is a relatively new treatment to trigger new hair growth. The treatment involves puncturing the scalp with tiny needles to promote collagen (a type of protein) production, which can restore hair growth. Types of alopecia helped by microneedling include:

  • alopecia areata
  • androgenic alopecia
  • ophiasis alopecia

Minoxidil

The commonly used medication, minoxidil (Rogaine), is an over-the-counter product. You can apply it topically to areas experiencing hair loss. Types of hair loss that tend to respond best to minoxidil include:

  • alopecia areata
  • CCCA
  • diffuse alopecia areata
  • ophiasis alopecia
  • persistent patchy alopecia areata

Stress reduction

Managing your stress and getting through especially stressful episodes in your life can sometimes halt hair loss triggered by severe stressors. One type of alopecia that may respond to effective stress management is diffuse alopecia areata.

Immunotherapy

In addition to corticosteroids, other types of medications can tamp down the body’s immune system response. These include oral medications, such as tofacitinib and cyclosporine. A 2018 study suggests that topical immunotherapy can be a safe and effective long-term treatment for alopecia areata. Doctors may also recommend immunotherapy for lichen planopilaris.

Platelet-rich plasma (PRP) injections

Plasma is a component of your blood containing special proteins that help your blood to clot. It also contains proteins that support cell growth.

PRP is made by isolating plasma from blood and concentrating it. Experts believe that injecting PRP into damaged tissues may stimulate your body to grow new, healthy cells and promote healing.

PRP scalp injections may make the scalp healthier and therefore a better environment for hair growth. In a 2014 study, hair loss decreased and hair growth increased after PRP injections.

Alopecia is just one of several causes of hair loss. Some are unavoidable but treatable either with medications or hair restoration procedures. Other types of hair loss include:

  • Age-related. Many hair follicles simply stop growing hair as the years pass.
  • Cancer treatment. Both radiation and chemotherapy can cause hair loss, though it is often temporary.
  • Hair care products. Some products and hairstyles can damage hair follicles.
  • Hormonal imbalance. This is more common in women and especially people with polycystic ovary syndrome.
  • Scalp infection. Inflammation of the scalp can lead to temporary hair loss and patches of red, scaly skin.
  • Stress. Physical and emotional stressors can often cause hair to fall out. But when the stress eases, hair loss often stops.
  • Thyroid disease. Thinning hair and hair loss are common symptoms, but they can be reversed with effective thyroid treatment.

Most types of alopecia develop without warning and progress at an unpredictable rate. In some cases, hair growth returns on its own. But often treatment is necessary to try to restore healthy hair growth. If you notice hair loss anywhere on the body, visit a dermatologist soon to discuss your options.

Successful treatment may require a combination of medications and procedures. But with some patience, you may be able to prevent further hair loss and bring back some of those lost locks. And if that’s not possible, a dermatologist may be able to recommend hair restoration procedures, wigs, or other options.

https://www.healthline.com/health/alopecia-types