TYPES OF HAIR LOSS

If hairless spots are widening, you have bald spots, or you are shedding more hair than usual, you may be experiencing hair loss and should consult a dermatologist. There are several types of hair loss, each with its own causes. To help narrow down the causes, your dermatologist would most likely use a combination of your medical history and a physical exam. Also, in the case of malnutrition, your dermatologist might ask for a blood test to detect any nutrient/vitamin deficiency. Biopsies from the scalp might be performed, as well, to better diagnose the condition leading to hair loss. 

There are three different types of hair loss, which are anagen effluvium, telogen effluvium, and androgenetic alopecia.

Anagen effluvium 63

Anagen effluvium is caused by medications that poison the growing hair follicle. Anagen effluvium happens in the case of chemotherapy, for instance. These potent and quick-acting medications kill cancer cells, but they may also inhibit producing hair follicles. Hair usually grows back on its own after chemotherapy. Dermatologists can prescribe medications to help hair regrow.

Telogen effluvium 64

Telogen effluvium is a type of hair loss that occurs when a large number of follicles on the scalp enter the telogen phase of the hair growth cycle but do not enter the next growth phase. Hair falls out all over the scalp as a result, with no new hair growth. Telogen effluvium often occurs after medical events. 

Androgenetic alopecia 65

Androgenetic alopecia is the most common type of hair loss. It affects more than 50 million men and 30 million women in the United States. Androgenetic alopecia can be referred to as male or female pattern hair loss. It is hereditary but treatable with medication or surgery.

  • Hair loss in men can begin at any age after puberty. It starts over the temples and then around the head. It leaves a ring of hair around the scalp. Many men who suffer from male pattern baldness eventually go bald.
  • In women, hair gradually thins all over the scalp, but the hairline rarely recedes. Female pattern hair loss causes hair thinning, but it rarely leads to baldness.

Some other types of hair loss include:

Alopecia Areata66

In this type of hair loss, the immune system attacks healthy hair follicles, leading to hair loss. Hair falls out in little patches about the size of a quarter in the majority of cases. For the most part, hair loss is limited to a few spots, however it can be more severe in certain circumstances.

Tinea Capitis (also known as ringworms): 67

A fungal infection of the scalp is diagnosed as tinea capitis. It mostly affects children and frequently results in bald spots on the head that are itchy and scaly. The circular form of ringworm gives it its name. There is no worm involved, however.

Cicatricial alopecia: 68

This type of hair loss happens with an inflammation at the follicle. This inflammation causes a scar, where the hair does not regrow. It basically destroys hair follicles. The exact cause of the numerous cicatricial alopecia is unknown. Inflammation is directed at the top region of the hair follicle, where the stem cells and oil gland are located. There is no way to regenerate a hair follicle if these are damaged.

Hair shaft abnormalities: 69

This type of hair loss does not occur in the follicle but along the hair shaft, causing a breakage. Changes in color, density, length, and structure describe aberrant hair shafts. Hair shaft modifications are frequently caused by structural changes within the hair strands and cuticles, resulting in brittle and un-comb-able hair. Patients with hair shaft illnesses have dry, brittle hair that lacks luster.

Hypotrichosis: 70

In this type of hair loss, genetic factors come into play as little hair grows on the body and on the scalp. It is an uncommon condition in which hair does not develop on the head or body. The hair in the affected areas is usually short, dry, and scratchy.

Treatments based on types of hair loss: 71

With different types of hair loss, there are particular treatments. The key in treatment is to find the cause first—your dermatologist will help you do so. Some common treatments include the following: 

  • Finasteride works by inhibiting the more active male hormone in the skin, which is responsible for hair loss. Finasteride is a prescription-only medication that is taken once a day to three times per week in pill form.
  • Minoxidil is a type of disinfectant. Under certain conditions, this topical medication appears to provide modest regrowth of hair on bald areas of the scalp. It stimulates new hair growth by reversing the shrinking process of hair follicles. The effects are most promising in younger people who are just starting to show signs of baldness or have small bald patches. The medication is a solution or a foam, applied to balding spots twice a day. If Minoxidil is stopped, hair loss will resume. One effective product to use is Regaine®! Regaine® contains minoxidil and is formulated for men and women. 
  • Spironolactone is a pill that is taken once or twice a day to block male hormones in the skin that cause hair loss. This is occasionally used to treat female pattern hair loss, too.

Alternative hair loss treatments can include the following: 72

  • Steroid injections and creams 
  • Immunotherapy 
  • Ultraviolet light 
  • Tattooing 
  • Hair transplants and artificial hair transplant
  • Scalp reduction surgery

Don’t fall for the myths: 73

There are numerous myths about hair loss, which include the following: 

  • You are losing hair because you over-shampooed it, or because you've colored it or had it permed.
  • Dandruff causes permanent hair loss.
  • Stress causes permanent hair loss.
  • Shaving your head causes your hair to grow back twice as thick.
  • Standing on your head stimulates hair growth by increasing circulation.
  • Hats and wigs cause hair loss. 

On a final note, hair loss can be distressing. Many people consider their hair to be an important part of who they are. If your hair loss is causing you stress, know that you are not alone. Your doctor may be able to refer you to a counselor.

References: 

  1. 62https://nyulangone.org/conditions/hair-loss/types
  2. 63 Kanwar, A., & Narang, T. (2013). Anagen effluvium. Indian journal of dermatology, venereology and leprology, 79(5), 604.
  3. 64 Grover, C., & Khurana, A. (2013). Telogen effluvium. Indian journal of dermatology, venereology and leprology, 79(5), 591.
  4. 65 Lolli, F., Pallotti, F., Rossi, A., Fortuna, M. C., Caro, G., Lenzi, A., ... & Lombardo, F. (2017). Androgenetic alopecia: a review. Endocrine, 57(1), 9-17.
  5. 66 Wasserman, D., Guzman‐Sanchez, D. A., Scott, K., & McMichael, A. (2007). Alopecia areata. International journal of dermatology, 46(2), 121-131.
  6. 67 Gupta, A. K., & Summerbell, R. C. (2000). Tinea capitis. Medical Mycology, 38(4), 255-287.
  7. 68 Kanti, V., Röwert‐Huber, J., Vogt, A., & Blume‐Peytavi, U. (2018). Cicatricial alopecia. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 16(4), 435-461.
  8. 69 Itin, P. H., & Fistarol, S. K. (2005). Hair shaft abnormalities–clues to diagnosis and treatment. Dermatology, 211(1), 63-71.
  9. 70 Bennàssar, A., Ferrando, J., & Grimalt, R. (2011). Congenital atrichia and hypotrichosis. World Journal of Pediatrics, 7(2), 111-117.
  10. 71https://www.mayoclinic.org/diseases-conditions/hair-loss/diagnosis-treatment/drc-20372932
  11. 72https://www.nhs.uk/conditions/hair-loss/
  12. 73https://my.clevelandclinic.org/health/diseases/16921-hair-loss-in-women