Types of Hair Loss (Alopecia)

Alopecia

Alopecia is the medical term for hair loss. Hair loss may occur naturally, or it may be related to a disease or the use of certain medications. Symptoms of alopecia vary depending on the cause of the condition and range from a small bald patch to a complete loss of all body hair.

Norwood Scale

The Norwood scale (or Hamilton-Norwood scale) is a commonly used classification system used to measure the extent of male pattern baldness and ranges from stages 1 to 7. It provides easy-to-reference images that indicate different stages of balding.


Norwood-Hamilton Scale of Male Pattern Baldness

Ludwig Scale

The Ludwig scale is a method of classifying female pattern baldness (Androgenic Alopecia) and ranges from stages 1 to 3.

Ludwig Scale

Types of Alopecia

1. Androgenetic Alopecia:

This is a prevalent disorder that affects approximately 50% of men and many women (mostly older than 40 years). As many as 13% of premenopausal women reportedly have some evidence of Androgenetic Alopecia. This type of alopecia is commonly known as male pattern baldness or female pattern baldness. Thinning of hair occurs on the crown area, or the hairline starts receding from the temples. In most cases, hair continues to fall, leading to complete baldness with time. This progressive hair loss is believed to be due to genetic and hereditary factors.

Male Pattern Baldness
  • The most common form of alopecia affecting around 50% of men by the time they reach the age of 50
  • It is hereditary and thought to be associated with having an excess of a particular hormone, which affects hair follicles
  • Hairline typically recedes, and the hair becomes thin
  • Hair loss usually begins in the late 20’s or early 30’s.
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Male Pattern Baldness

      Possible Treatments: 

  • Minoxidil (Rogaine) 
  • Finasteride
  • Platelet-Rich Plasma Treatment
  • Hair Transplant
Female Pattern Baldness
  • This Androgenetic Alopecia affects women. 
  • It is similar to male pattern baldness, except that women can lose their hair in a different pattern than men. 
  • Hair loss in women is common, especially with age. 
  • Up to two-thirds of women experience hair loss after menopause.
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Female Pattern Baldness

Possible Treatments: 

  • Minoxidil (Rogaine) 
  • Spironolactone (Aldactone), a diuretic that blocks androgen production
  • Platelet-Rich Plasma Treatment
  • Hair Transplant

2. Scarring Alopecia

Hair loss due to scarring of the scalp is called scarring alopecia. Scarring can be due to a variety of causes. Traction alopecia over a period of time may lead to scarring and permanent hair loss. Similarly, trichotillomania (compulsive hair-plucking) can cause permanent scalp scarring over time. Injury to the scalp caused by physical trauma or burns may leave permanent scars and permanent hair loss. Diseases that may cause permanent hair loss due to scalp scarring include:

  • Auto-immune conditions- lupus erythematosus and scleroderma.
  • Bacterial infections such as folliculitis, fungal infections, and viral infections such as shingles (Herpes Zoster).
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Scarring Alopecia

A form of scarring alopecia may also occur in post-menopausal women, associated with hair follicles’ inflammation and subsequent scarring.

  • Hair follicles are replaced with scar tissue (hence the name)
  • In some cases, hair loss is without symptoms and can go unnoticed for long periods
  • In other cases, hair loss is accompanied by burning, itching, and pain and is more progressive
  • It can occur in men and women of all ages
  • Lichen Planopilaris (one of the more well-known Scarring Alopecia) results in inflammation around affected hair follicles. It mostly affects middle-aged adults as distinct patches of hair loss.
Possible Treatments: 

        Medical treatments (such as corticosteroids, topical creams, and injections) are available to limit      

        the progression of Scarring Alopecia. Results are case-specific and are not guaranteed. 

3. Alopecia Areata

This type of alopecia occurs as round or oval hair loss patches, most obvious on the scalp or in the eyebrows. Those who develop these round or oval hair loss areas can progress to total scalp hair loss (Alopecia Totalis).

The cause of Alopecia Areata is unknown but commonly believed to be an auto-immune disorder. The most common treatment is steroids (cortisone is one form), either topically or by injection.

  • People with this type of alopecia experience sudden or sometimes unrecognized falling out of hair in patches or spots
  • Patches can vary in size from 1/8 inch to 4 inches in diameter; the affected areas are usually lighter in color due to inadequate blood supply to the area
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Alopecia Areata

Possible Treatments: 

  • Steroids
  • Immunotherapy, which entails deliberately inducing an allergic response that triggers the growth of hair in bald areas. 

4. Alopecia Totalis

This refers to cases in which the scalp incurs complete hair loss. In an estimated 30% of patients, total hair loss occurs within six months after the disease’s onset.

It is an auto-immune disorder resulting in total hair loss, but on the scalp only. It is a condition intermediary between Alopecia Areata and Alopecia Universalis. Alopecia Totalis generally shows up in two types, the first being a relatively quick and complete hair loss in the head and the second being a slower type, which starts as a patchy loss (Alopecia Areata) and progresses to total hair loss in the scalp.

  • Starts with small, round patches of hair loss and progresses until there is total scalp hair loss
  • The disease may at times lead to complete baldness of the scalp 
  • Alopecia Totalis is usually resistant to therapy.
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Alopecia Totalis

Possible Treatments: 

  • No reliable medical treatment, some medications that may work include Diphenylcyclopropenone, which is a topical drug that has been successful in treating Areata
  • Hair Replacement Systems

5. Alopecia Universalis

This is the most advanced and rare type of alopecia in which there is a complete loss of hair all over the body. 

  • All body hair is lost
  • Areas like the nasal cavity, eyes, and scalp become very exposed to germs and microorganisms
  • People suffering from this condition need to guard themselves against sun exposure, bacteria, dust, etc.
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Alopecia Universalis

Possible Treatments: 

  • There is no known cure for Alopecia Universalis. Intralesional Corticosteroid injections may help.
  • Hair Replacement System is the only option.

6. Diffused Alopecia

Diffused alopecia – also known as Alopecia Areata Incognita, is a rare form of alopecia and affects primarily young males, and the hair loss on the head is radical and sudden.

Possible Treatments: 

  • Finasteride
  • Platelet-Rich Plasma Treatment
  • Low-Level Laser Treatment

7. Telogen Effluvium

When hair follicles are pushed prematurely in the hair growth cycle’s resting stage, the resulting hair loss is categorized as Telogen Effluvium.

  • Form of hair loss where more hair than usual falls out, causing the hair to thin in general rather than in patches
  • Head hair does feel thinner, but complete hair loss is unlikely. Other parts of the body are generally not affected. 
  • Condition is temporary, and the hair does start growing back after around six months in most cases
  • Telogen effluvium can be caused by the following:
    • Extreme emotional or physical stress
    • Intense physical stress
    • Hormonal changes
    • Chronic diseases such as cancer
    • Dietary changes or crash dieting
    • Severe infection
    • Certain medications
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Telogen Effluvium


Possible Treatments: 

  • Minoxidil
  • Platelet-Rich Plasma Treatment
  • High Protein Diet
  • Complete Hair Growth Supplements with a blend of biotin, vitamin C, zinc, iron, marine extracts

8. Triangular Alopecia

Loss of hair occurs in the temporal areas that sometimes begins in childhood. Hair loss may be complete, or a few fine, thin diameter hairs may remain. The cause of Triangular Alopecia is not known, but the condition can be treated medically or surgically.

9. Traction Alopecia

This alopecia is usually caused due to excessive pulling or tension on hair shafts as a result of certain hairstyles

  • The most common balding disorder among young women and girls with highly textured hair
  • Baldness occurs when the hair is pulled too tight and is pulled out of the follicle, taking out the hair root and the bulb
  • Destroying the hair shaft may cause white bumps and pus, or scaling may occur around the affected area
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Traction Alopecia
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Possible Treatments: Hair transplant is the only permanent solution.

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