Different Types of Alopecia

A close-up view of a person's scalp with patchy hair loss.
Different Types of Alopecia

Alopecia serves as an encompassing term denoting conditions characterized by hair loss. It’s important to note that alopecia is not contagious, although it can occasionally signal other underlying health issues. Alopecia areata, an autoimmune ailment, ranks among the more prevalent variations of alopecia. However, not all instances of alopecia are linked to abnormal immune system responses.

Certain forms of alopecia are attributed to genetic, lifestyle, or environmental factors, as well as psychological conditions leading to hair pulling. Treatments for numerous types of alopecia are similar and may encompass oral medications and topical therapies. In some cases of alopecia, behavioral adjustments are necessary to reverse hair loss.

Various Forms of Alopecia Alopecia may arise from disruptions in the natural, healthy hair growth cycle. Some types of alopecia can be avoidable, while others can affect individuals of any age. Factors such as family history, age, gender, and ethnicity can all influence the likelihood of developing a particular form of alopecia.

For example, a 2020 study on alopecia prevalence by race suggested that African Americans have a higher risk of developing alopecia areata compared to Caucasians, whereas Asians have the lowest odds. Researchers postulated that a combination of health disparities and genetics underlies this variation.

The following section outlines the causes and symptoms of the most common forms of alopecia.

Alopecia Areata Alopecia areata is primarily characterized by hair loss in distinct patches, typically on the scalp. However, it can also affect areas such as eyebrows, eyelashes, and other parts of the body.

This autoimmune disorder occurs when the body’s immune system mistakenly attacks healthy hair follicles, which are small, pocket-like structures in the skin responsible for hair growth. The damage to these follicles results in hair loss. Alopecia areata often has a familial predisposition.

Persistent Patchy Alopecia Areata When patchy hair loss persists without improvement or worsening over time, it’s termed persistent patchy alopecia areata. This condition shares the same underlying factors as alopecia areata.

Alopecia Totalis Alopecia totalis refers to complete hair loss across the entire scalp. It appears to be linked, like some other alopecia forms, to an abnormal immune system response. However, the exact causes of alopecia totalis remain under investigation.

Alopecia Universalis As the name suggests, alopecia universalis involves the total loss of hair, encompassing both the scalp and the rest of the body. Similar to other autoimmune diseases, it remains unclear why some individuals develop this condition while others do not.

Diffuse Alopecia Areata Diffuse alopecia areata, also known as telogen effluvium, differs from alopecia areata in that it results in the thinning and scattered loss of hair across the scalp, as opposed to patchy hair loss. In rare instances, a similar pattern of hair loss may manifest in other parts of the body. Contributing factors include severe stress, sudden hormonal fluctuations, and side effects of medications.

Ophiasis Alopecia Ophiasis alopecia is a subtype of alopecia areata that predominantly affects the sides and back of the scalp. It is an autoimmune disorder that primarily impacts young individuals.

Androgenic Alopecia Androgenic alopecia is a common genetic condition that can affect people of all genders.

Male Pattern In male pattern baldness, hair loss typically commences with a receding hairline or hair loss at the crown, with the sides and lower back of the head being less susceptible to hair loss.

Female Pattern Female pattern baldness differs from the male pattern, typically beginning with thinning hair along the part line. The part line may eventually widen, but complete baldness is relatively rare.

Cicatricial Alopecia The precise causes of cicatricial alopecia are not fully understood, though this inflammatory condition sometimes develops after skin damage from burns or severe infections. Hair loss may occur slowly in patches or more rapidly in larger areas, with the affected skin often becoming itchy and inflamed.

Lichen Planopilaris Lichen planopilaris is another inflammatory condition that predominantly affects young women. It is a rare disorder with an unknown cause, leading to smooth patches of skin on the scalp.

Frontal Fibrosing Alopecia Frontal fibrosing alopecia, a variant of lichen planopilaris, usually leads to gradual but progressive hair loss, typically occurring just above the forehead. It may also affect the eyebrows and eyelashes.

Central Centrifugal Cicatricial Alopecia (CCCA) CCCA results in hair loss beginning at the crown and spreading across the top of the head. According to a 2020 report, this condition almost exclusively affects Black women over 30 years old. The exact reasons remain unclear, but CCCA likely has multiple contributing factors.

Traction Alopecia Traction alopecia arises from repeated pulling or tightening of hair in the same direction, leading to hair loss.

Alopecia Barbae Alopecia barbae, an autoimmune condition, causes circular patches of beard hair to fall out, sometimes with overlapping patches. However, the extent of hair loss is challenging to predict.

Postpartum Alopecia The sharp decline in estrogen levels following childbirth can lead to postpartum alopecia. It is essential to note that doctors do not consider this a typical hair loss, but rather the shedding of hair that had grown during pregnancy. Typically, regular hair growth resumes within a few months.

Alopecia types most common in men

Men experience noticeable hair loss more often than women. In addition to genetic and immune system triggers for hair loss, hormonal factors — particularly reduced levels of the male sex hormone dihydrotestosterone — can also contribute to male hair loss.

Among the most common types of alopecia affecting men are:

  • alopecia areata
  • androgenic alopecia
  • alopecia barbae
Alopecia types most common in women

Significant hair loss is less common in women than in men, but women do experience several types of alopecia. Among them are:

  • alopecia areata
  • androgenic alopecia
  • postpartum alopecia
  • traction alopecia
Alopecia types most common in children

Children experience hair loss much less frequently than adults, though certain types of alopecia can affect young people. Among them are:

  • alopecia areata, which often begins in adolescence
  • lichen planopilaris
  • ophiasis alopecia
What are the treatments for the different types of alopecia areata?

While there is no cure for alopecia, several treatment options may help regrow hair or at least slow or halt further hair loss. Among the more commonly used alopecia treatments are:

Corticosteroids

Prescription-strength corticosteroids can suppress the immune system and reduce damage to healthy hair follicles. These medications include oral, topical, and injectable treatments. The types of alopecia most effectively treated by corticosteroids include:

  • alopecia areata
  • alopecia totalis
  • alopecia universalis
  • CCCA
  • lichen planopilaris
  • ophiasis alopecia
  • persistent patchy alopecia areata

Microneedling

Microneedling is a relatively new treatment to trigger new hair growth. The treatment involves puncturing the scalp with tiny needles to promote collagen (a type of protein) production, which can restore hair growth. Types of alopecia helped by microneedling include:

  • alopecia areata
  • androgenic alopecia
  • ophiasis alopecia

Minoxidil

The commonly used medication, minoxidil (Rogaine), is an over-the-counter product. You can apply it topically to areas experiencing hair loss. Types of hair loss that tend to respond best to minoxidil include:

  • alopecia areata
  • CCCA
  • diffuse alopecia areata
  • ophiasis alopecia
  • persistent patchy alopecia areata

Stress reduction

Managing your stress and getting through especially stressful episodes in your life can sometimes halt hair loss triggered by severe stressors. One type of alopecia that may respond to effective stress management is diffuse alopecia areata.

Immunotherapy

In addition to corticosteroids, other types of medications can tamp down the body’s immune system response. These include oral medications, such as tofacitinib and cyclosporine. A 2018 study Trusted Source suggests that topical immunotherapy can be a safe and effective long-term treatment for alopecia areata. Doctors may also recommend immunotherapy for lichen planopilaris.

Platelet-rich plasma (PRP) injections

Plasma is a component of your blood containing special proteins that help your blood to clot. It also contains proteins that support cell growth.

PRP is made by isolating plasma from blood and concentrating it. Experts believe that injecting PRP into damaged tissues may stimulate your body to grow new, healthy cells and promote healing.

PRP scalp injections may make the scalp healthier and therefore a better environment for hair growth. In a 2014 study, hair loss decreased and hair growth increased after PRP injections.

 

Alopecia of various forms typically emerges suddenly and progresses at an unpredictable pace. While hair growth may spontaneously return in certain instances, seeking treatment is often necessary to facilitate the restoration of healthy hair growth. If you observe hair loss anywhere on your body, it is advisable to promptly consult a dermatologist to explore your available choices.

Effective treatment may entail a combination of medications and medical procedures. With perseverance, it is possible to potentially prevent further hair loss and recover some of the lost hair. In cases where natural regrowth proves challenging, a dermatologist can offer recommendations for hair restoration techniques, wigs, or alternative solutions.