What is Alopecia?

Written by the Manual Team · Medically approved by Dr Earim Chaudry - MD

In 30 seconds…

What is alopecia? Alopecia is the medical term for hair loss of any kind, whether due to age, autoimmune conditions, or stress.

Whilst we all shed hair, alopecia happens when much more hair is lost than usual. In alopecia areata, hair loss happens in an unpredictable way, with hair often shedding in clumps.

Male pattern baldness, or androgenetic alopecia, however, is the most common cause of hair loss in men, responsible for 90% of cases. Unlike other types of alopecia, it can be treated effectively, by using drugs such as Minoxidil and Finasteride.

What is Alopecia?

What is alopecia? Alopecia is a common medical condition that affects men and women of all ages. The primary symptom is hair loss, which can be entirely unpredictable – making it a condition that can be quite difficult to manage psychologically.

There are a number of different types of alopecia, each caused by different factors. Whilst alopecia areata, the autoimmune disease, is perhaps the most famous, androgenetic alopecia – or male pattern baldness (MPB) – is by far the most common. 90% of hair loss cases in men are due to MPB.

The causes of MPB are genetic and the symptoms, these days, are reversible. The patterns of hair loss are different in MPB compared to other types of alopecia, however – so it’s important to know what you are dealing with. In this article, we’re going to take a look at the different types of alopecia.

 

What Are the Different Types of Alopecia?

Alopecia is the medical term for the loss of hair in places where it should normally grow. Due to this, the term is used to describe conditions that have little in common besides hair loss. Different types of alopecia are the result of different causes, including aging, autoimmune diseases, and stress. However, the patterns of hair loss themselves differ between each cause.

 

What is Alopecia Areata?

Alopecia areata is a medical condition that causes hair to fall from the scalp primarily in small patches. These patches are often unnoticeable, depending on the location, until the condition develops so that the areas of hair loss connect. Alopecia areata is usually totally unpredictable, which adds an unpleasant dimension to the experience of hair loss.

The hair loss associated with alopecia areata is related to inflammation that results from an autoimmune response. This is when your immune system, usually primed to defend you against foreign bodies, starts to attack healthy cells. In this case, these are the cells in your hair follicles.

Alopecia areata is non-scarring, and people with the condition usually see hair regrowth within a year. However, it can lead to conditions known as alopecia areata totalis, in which all hair is lost on the scalp, or alopecia areata universalis, where all hair follicles on your body is affected. 

 

Androgenetic Alopecia, or Male Pattern Baldness (MPB)

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MPB is known as a type of alopecia – androgenetic alopecia, to give it its full name.

MPB refers to a specific pattern of balding related to hormonal changes in men. It is genetic, thought to be largely hereditary, and it is hugely common at any age. 30% of men aged 30 are affected by it, and 70% at the age of 70. Where alopecia areata is unpredictable, MPB is usually seen in specific patterns: a receding hairline will develop above the temples, or else hair will be lost at the crown.

These are the areas most sensitive to a hormone that your body produces as you age. That’s DHT, the chemical cause of MPB, which is produced from testosterone by an enzyme known as 5α-Reductase. The more DHT is produced, the weaker your hair follicles at your hairline and crown become. As a result of this follicular damage, your hair begins to fall out.

 

Are There Other Types of Alopecia?

These are the two most well-known types of alopecia. However, there are others – most commonly resulting from stress or injury.

 

Traction Alopecia

Traction alopecia is a type of hair loss that results from strain or pulling applied to the hair. People who wear dreadlocks or tight ponytails, or who regularly use tight-fitting safety helmets, are those to most commonly experience traction alopecia.

Where MPB and alopecia areata are non-scarring, traction alopecia can leave scars due to the damage to your follicles. Hair loss in this case can also be accompanied by irritation and pain. 

 

Telogen Effluvium

Although it doesn’t have the term in its name, telogen effluvium is a type of alopecia – and it results from periods of intense stress. For a reason that is not well understood, during stress your hair follicles can enter into a state of rest. This means that they no longer produce hair and that the hair that is already there can fall out. Whilst non-scarring, telogen effluvium can be sudden and unpredictable.

 

Trichotillomania

Another type of alopecia associated with stress is trichotillomania. This results from compulsive pulling of your own hair, either on your scalp, face, or eyebrows. The result is localised areas of hair loss, which, depending on the severity of the compulsion, can grow back. This is typically treated by CBT-like therapy, involving habit reversal training. You can find more information on the NHS website.

Is There a Treatment for Alopecia?

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Not all types of alopecia have a cure. Those resulting from stress usually stop when the stress has passed, whilst alopecia areata may stop of its own accord. Depending on its severity, however, traction alopecia can affect your follicles permanently.

Two drugs have been proven to be effective in combating MPB, or androgenetic alopecia, however. These are called Finasteride and Minoxidil, and they work in quite different ways.

Finasteride targets the 5α-Reductase enzyme that we mentioned above, meaning that your body no longer produces as much of the DHT to which your follicles are sensitive. Effective in stopping hair loss in over 80% of men, Finasteride should not be taken by women, however – as it is a hormonal medication to which women can react adversely. 

Alternatively, topical Minoxidil works as a vasodilator to increase the flow of blood to the scalp. By bringing oxygen and nutrients with it, improved blood flow can improve the health of your hair follicles. Known to be effective in combating MPB, Minoxidil has been shown to work for alopecia areata in men and women too. It can be used in combination with Finasteride for optimal effects.

 

Key Takeaways...

There are many different types of alopecia, resulting from stress, hormonal changes, or autoimmune diseases. None are particularly pleasant, but it is important that you know the causes if you are suffering from hair loss yourself. The majority of types of alopecia are reversible. That includes MPB, the most common, which is easily and effectively treated with medications that can even promote hair regrowth.