Hair Loss Types: Causes, Treatment Specialty Center at Chennai, Tamilnadu

Androgenic alopecia (male- and female-pattern baldness):

Ø  Most common cause of hair loss

Ø  Localized and systemic hair loss, which usually begins with the fronto parietal scalp and then the vertex

Ø  Male-pattern baldness in females is indicative of androgen excess and may be accompanied by hirsutism in mild cases and virilization in more serious ones

Ø  Female-pattern baldness is similar but more diffuse, usually without complete baldness and maintaining the frontal hairline

Alopecia areata:

¬  Second most common presentation of non scarring alopecia

¬  Hair is rapidly lost in circular or oval patches or, less commonly, may be diffuse involving the scalp

¬  May include facial or body hair

¬  May be episodic or persistent

Telogen effluvium:

v  Diffuse alopecia following a triggering event, such as surgery, childbirth, emotional stress, hormonal fluctuations, or medication use

v  Hair loss occurs approximately 3 months after the event

v  Usually affects less than 50% of the scalp

v  Recovery is often complete once triggering factor is resolved

Anagen effluvium:

Ø  Diffuse hair loss that occurs as a result of exposure to certain toxins

Ø  Following toxic exposure, hair growth is abruptly interrupted and anagen hair

Ø  Rapidly affects 80% to 90% of the scalp

Ø  Complete recovery can be expected once triggering factor is removed

Traction alopecia:

v  Hair loss that is caused by direct insult to hair

v  Associated with such styling techniques as using hot rollers or braiding

v  Pattern of hair loss may relate directly to technique used

v  More common in black patients

v  If continued, may progress to scarring alopecia

Trichotillomania (subtype of traction alopecia):

¬  Self-inflicted loss of hair, typically from frontoparietal region progressing backwards

¬  Regrowth of up to 1.5 cm may also be visible before hair is long enough to pull again

Cicatricial alopecia (or scarring alopecia):

Ø  Hair loss that occurs with permanent destruction of hair follicles

Ø  Often presents with inflammation arising from injury or disease

Ø  Scalp lesions may also be present

Ø  Initially localized, it may become diffuse in chronic presentations

Ø  Scalp will gradually scar, becoming smooth without any evidence of hair follicles

Ø  Once scarring is initiated, hair loss is permanent

Tinea capitis:

v  Fungal infection that causes hairs to break off close to the scalp leaving a 'black dot' effect

v  Often a result of a secondary bacterial infection

v  Scalp is intensely pruritic or painful

v  Predominantly affects children; more commonly, inner city black populations

Alopecia neoplastica:

Ø     Hard nodules/tumors or flat unchanged skin with loss of hair

Ø     Can be secondary to primary skin cancer of scalp or metastatic tumor

Alopecia mucinosa:

ü  A form of localized hair loss sometimes seen in patients with mycosis fungoides, but may occur alone

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