Alopecia

Alopecia is hair loss or balding. It may happen on any part of the body. There are many types of alopecia. Some types cause temporary hair loss and your hair will grow back. With other types, hair loss can get worse, and become permanent.

What are some types and causes of alopecia?

  • Alopecia areata affects any part of the body, including the scalp. It may be caused by your immune system attacking your hair follicles. It may start with patchy hair loss. Many people will recover from this condition within a year. Alopecia areata may come back or lead to more severe hair loss.
  • Androgenic alopecia is also known as male or female pattern baldness and affects the scalp. It is a genetic condition that causes the hair follicles to get smaller and produce less hair over time. It usually starts at 20 to 40 years of age and is more common in men.
  • Telogen effluvium happens when hair sheds more than usual and leads to hair thinning. It can be caused by many things including certain medicines, injury, and physical or mental stress. It can also be caused by a change in hormones and poor nutrition.
  • Anagen effluvium is caused by chemotherapy, radiation, and poisoning.
  • Traumatic alopecia happens when chemicals, scarring, or tension on your scalp or hair follicles cause hair loss. Braids, chemically treated hair and trichotillomania are some examples. Trichotillomania is a behavior disorder that causes a strong urge to pull out your hair.
  • Tinea capitis is an example of alopecia that is caused by infection. Alopecia can be caused by bacterial, viral, or fungal infections.
  • Alopecia mucinosa and alopecia neoplastica are examples of alopecia caused by cancer.

What other signs or symptoms may occur with alopecia?

  • Burning, tingling, or itchiness on your scalp
  • Hair that easily breaks
  • Problems with your fingernails or toenails, such as notching or pitting
  • Scales or flakes from the areas of hair loss
  • Swelling and redness on your scalp

How is alopecia diagnosed?

  • A pull test may be done. Your healthcare provider will tell you to not shower or wash your hair for 24 hours. He or she will gently tug on about 60 hairs. If more than 6 hairs come out, they may be sent for tests.
  • A punch biopsy is done to look at your scalp. Your healthcare provider will get 2 samples of scalp tissue and send for tests.
  • A trichogram measures hair loss. Your healthcare provider will look at hair under a microscope. He or she will measure the different stages of hair growth.
  • Blood tests may be done to find the cause of your alopecia.

How is alopecia be treated?

The treatment for hair loss depends on the cause of your condition. Sometimes your hair loss may get better on its own and no treatment is needed. If your hair loss is related to a medicine you are taking, talk to your healthcare providers. There may be other medicines you could take instead that will not cause hair loss. If your hair loss is severe, you may need one or more of the following treatments:

  • Medicines:
    • Hair growing agents help promote hair growth. The medicine must be used continuously until new hair grows on the affected area.
    • Steroids help decrease inflammation and damage to the hair follicle. Corticosteroids may be used to treat alopecia areata.
    • Estrogen is a female hormone that is used for women with hyperandrogenism (high levels of male hormones). Estrogen can reduce the effects of male hormones on hair growth. This treatment is used in women with female pattern baldness.
    • Immunologic agents affect the immune system cells that may be attacking hair follicles. This treatment is used to treat alopecia areata.
    • Antibiotics or antifungals may be needed if your alopecia is caused by an infection.
  • Hair transplant surgery removes hair follicles from one part of your head and puts them into the bald area. This is usually done only if your condition is severe and medicines fail to improve your hair loss. Ask your healthcare provider for more information about hair transplant surgery.

What can I do to manage my alopecia?

Relief from alopecia depends on the cause of your symptoms and your treatment. Alopecia may go away and then come back. It also may continue, even with treatment. The following may help you manage alopecia:

  • Avoid hair and scalp trauma. Use a soft-bristled hair brush and wide-toothed comb to protect your scalp from damage. Avoid the overuse of chemicals on your hair. Avoid hairstyles that pull your hair too much.
  • Eat healthy foods. Hair loss can be caused by poor nutrition. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Eat healthy snacks, such as low-fat yogurt, if you get hungry between meals.
  • Reduce stress. Try to get enough sleep and daily exercise. Learn new ways to relax, such as deep breathing, meditation, and listening to music. These may help you cope with stressful events.

When should I contact my healthcare provider?

  • Your symptoms get worse, even with treatment.
  • You have questions or concerns about your condition or care.