Alopecia can be a very misleading word. It simply means hair loss and there are several variations of it. Having ‘alopecia’ does not necessarily mean that you are going to completely lose all your hair.

There are many hair loss and scalp conditions. Below is a description of some of the more common ones:

 

Alopecia Areata

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This type of hair loss usually causes the hair to fall out in patches. This can vary in each person with some patches being small and not very noticeable to larger more visible patches forming.

This is caused by the immune system attacking the hair follicles but the underlying cause of this is not completely understood.

Alopecia areata can be unpredictable with patches appearing in different areas of the scalp and they are known to regrow spontaneously too. The eyelashes, facial hair and eyelashes can also be affected.

While patchy hair loss represents the typical pattern of alopecia areata, alopecia totalis (complete loss of scalp hair) or alopecia universalis (complete loss of scalp and body hair) can occur in around 5% of cases.

 

Androgenetic Alopecia in men

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This can also be known as Male Pattern Hair Loss (MPHL) and about 50% of men by the age of 50 will have suffered some form of androgenetic alopecia.

This is usually inherited and is caused by an individual being sensitive to a hormone called testosterone. This hormone can be converted to Dihydrotestosterone (DHT) which is a more reactive form. It is the DHT that causes the hair follicles to miniaturise and this results in the follicle producing finer hair.

In men this usually presents as thinning of the crown area or temples first or it can even be a combination of both.

How fast the hair loss progresses and at what stage it stops will depend entirely on the individual.

 

Androgenetic Alopecia in women

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This can also be known as Female Pattern Hair Loss (FPHL).

Similar to men, this can also be inherited and the effect of the male hormone testosterone that will cause the hair to miniaturise. However, this does usually present differently in women. Women will tend to notice their hair thinning on the top of their head and their parting progressively becoming wider although they do tend to retain the front hair line.

The progression of this type of hair loss and its severity will depend entirely on the individual.

 

Scarring Alopecia

 

This can also be known as cicatricial alopecia. This type of hair loss ultimately results in the hair follicle scarring over and causes permanent hair loss.

 

This can be either by a disease that affects the follicle (primary cicatricial alopecia) or by an external process, a burn for example (secondary cicatricial alopecia).

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This scarring happens because there is damaged caused to the follicular stem cells. Sometimes there can be with very little symptoms while others display symptoms such as burning, itching and inflammation.

It is important for this type of hair loss to be diagnosed quickly so the appropriate treatment can be given to stop the hair loss developing any further.

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Examples of scarring alopecia are:

Frontal Fibrosing Alopecia

Lichen Planopilaris

Folliculitis Decalvans

Discoid Lupus Erythematosus

Central Centrifugal Cicatricial Alopecia

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Telogen Effluvium (Hair Shedding)

 

This type of hair loss is very common and is characterised by increased hair shedding.

The amount of hair shed per day can vary and individuals may notice excessive hair in their brush, when showering and on their clothes. Some people may even experience itching or tingling on the scalp.

There can be numerous causes for this type of hair loss so it is important to get a proper diagnosis.

The causes can include:

shock, stress, post-partum, medication, illness, nutrition, low iron and deficiencies.

This type of hair loss is generally temporary and if the cause is resolved it is highly likely that the hair will return to its normal growth cycle.

 

Trichotillomania

 

This is also known as Trichotillosis and this type of hair loss can occur because of the hair being pulled or rubbed away.

This can be intentional, a habit or some individuals don’t even realise that they do it. This hair loss can occur in children and adults and there are many reasons as to why this happens, and the cause will need to be established to receive the appropriate treatment.

In severe cases this can lead to scarring.

 

Psoriasis

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Psoriasis of the scalp is very common. It usually effects the lower hair line at the top of the neck and above the ears but can also occur all over the scalp. There is generally patchy scaling and slivery scales present.

This can be very uncomfortable at times, it can feel tight on the scalp and become sore and itchy and in severe cases lead to hair loss. This scalp condition can successfully be managed but flare ups are often caused by stress or anxiety.

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Seborrheic Dermatitis

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This scalp condition can often be itchy and can be characterised by a flaky scalp and greasy yellow scales. These are frequently seen around the hairline, but it can also affect the eyebrows and around the nostrils. The symptoms can often be similar to that of psoriasis.

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Dandruff

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Dandruff or scaling of the scalp is very common and there can be several factors that contribute towards it. It can be oil(sebum) secretion, a yeast that is called Malassezia, stress and even our immune system. This condition, given the correct treatment can be easily managed.