These are the most common causes of hair loss, except for male and female Androgenetic Alopecia:
Alopecia Areata
Alopecia Areata is a periodic condition it means that it can occur several times in one’s life and can cause hair loss in every hairy area of the human body.
Alopecia areata is an autoimmune disease that affects 1-2% of the population both men and women, with the same frequency. Also it is very common among children and adolescents. This type of Alopecia often coexists with other autoimmune diseases such as Vitiligo, Hashimoto’s thyroiditis, Addison’s disease and atopic dermatitis.
Usually Alopecia Areata appears as circumscribed, clear, round or oval surfaces with complete hair loss, more apparent in the scalp or eyebrows. In other cases it appears plaque-localized, with one or more plaques on the head or the body. Diffuse Alopecia Areata occurs most commonly in people who already have Androgenetic Alopecia and also there is Ophiasis type of alopecia areata. It occurs mostly in the temporal or the occipital regions of the scalp. Ophiasis type of alopecia is identified by a turban or snake like pattern on the periphery of the scalp.
Though, the cause of Alopecia Areata is unknown it is widely believed to be an autoimmune disorder, ie the body does not recognize the hair follicles and attacks them and destroys them. Stress and anxiety are often accused by patients as causes of Alopecia Areata, but there is no scientific evidence that stress causes or is strongly associated with Alopecia Areata. Also, the appearance of Alopecia Areata may be triggered by a simple injury, viral or bacterial infection, pregnancy, hormonal disorders, chemicals, allergic reactions and seasonal changes.
The most common treatment for this type of Alopecia includes steroids (like cortisone) for cutaneous use such as creams and lotions or local injections into the lesion. The result of the treatment is more likely to be positive when Alopecia Areata is treated shortly after its onset (less than a year). Otherwise if the disease lasts more than a year, in most cases this treatment is ineffective, especially in adults. Therefore the newer treatment involves personalized cellular management of causes and enhancement of the immune system.
Treating this disorder with Hair Transplantation is only suggested in a few cases and provided only that Alopecia Areata remains inactive for at least 3-5 years.
Even without treatment in Alopecia Areata, hair usually grow back again within 6-12 months. However, most patients experience episodes of hair loss at the same or near point in the future. In some patients (1-2%), round or oval areas of hair loss may develop into total hair loss, called Alopecia Totalis or in Alopecia Universalis, with extended hair loss to their whole the body.
If you have any questions about Alopecia Areata, consult your Dermatologist.
Traction Alopecia
Alopecia from traction is caused by a chronic pulling of the hair and is mainly observed in women who choose this kind of hairstyles. It appears mainly along the frontline, where the hair starts on the forehead. Men who use wigs that are stuck in areas with existing hair may experience this type of permanent hair loss if the wig remains attached to the same place for a long time.
Trichotillomania (read below) is a form of Traction Alopecia associated with an obsessive-compulsive disorder caused when some patients pull their hairs, creating peculiar hair loss patterns.
Chronic cases of Trichotillomania can cause Permanent Alopecia.
If you have any questions about Traction Alopecia, please consult a dermatologist.
Scarring Alopecia
Hair loss with simultaneous scarring on the scalp is called Scarring Alopecia which may occur due to a number of causes.
Traction Alopecia, after a period of time, may lead to scarring and permanent hair loss.
Trichotillomania can also cause permanent scarring in the areas of the scalp from where hair are pulled out for years.
Injury to the scalp caused by physical trauma or burn can cause permanent scarring and permanent hair loss.
Autoimmune diseases, such as lupus, erythematosus and scleroderma, bacterial infections such as folliculitis, fungal and viral infections such as herpes zoster can cause permanent hair loss due to scalp injury.
If you have any questions about Scarring Alopecia, please consult a Dermatologist.
Trichotillomania
Trichotillomania is the pathological, compulsive pulling of hair from the scalp or from other hairy areas of the body.
Over time, continuous pulling of the hair from the scalp or other hairy parts of the body will result in a hairless area, that is, a permanently empty hair spot. Chronic Trichotillomania can cause permanent damage to the scalp and permanent Scarring Alopecia.
In its mildest form, Trichotillomania is the pathological pulling off of hair while a person reads or watches television. In the most serious condition, Trichotillomania acquires a ritual behavioural pattern and the hair pulling takes place in front of a mirror. A person suffering from Trichotillomania often has feelings of guilt about his “odd” behavior and will try to conceal it.
It is not yet clear whether Trichotillomania should be categorized as simply a “bad habit” or as an obsessive behavior. However, the specialization of Psychiatry deals with it, and in any case it needs assessment from a mental health specialist.
Triangular Alopecia
Triangular Alopecia sometimes starts during childhood as unexplained hair loss in the temples of the scalp. The causes of Triangular Alopecia are not yet known, but the condition can often be treated with medication or surgery. The characteristic pattern of hair loss in Triangular Alopecia is the thinning or the complete absence of hair in the area around the temples. If hair loss is not complete, the hair remaining in the area often shrinks and turns into a simple”fuzz”, ie thin, short and colorless hairs.
If you have any question about Triangular Alopecia, please consult a Dermatologist.
Telogen Effluvium
Telogen Effluvium (Telogenic Trichorrhoea) is when a large proportion of hair follicles passes abruptly and massively in the telogen stage, that is to the apoptosis phase of the hair follicle’s life cycle, where the hair stop growing and start falling.
The causes of this temporal abnormality of the telogen stage may be hormonal, nutritional, drug-related, anxiety or other causes. Most of the time, however, the hair that is lost grow back again.
If you have any questions about Telogen Effluvium, please consult a Dermatologist.
Loose-Anagen Syndrome
This Syndrome occurs more often to people with light colored hair. During the anagen phase of the hair follicle life cycle, the hair is so loosely attached to the hair follicles in which it grows that can easily be detached by combing or brushing. This condition is more common in childhood and gradually it is improved or even disappeared.
If you have any questions about Loose-Anagen Syndrome, please consult a Dermatologist.
Other causes of temporary hair loss
Temporary hair loss is often associated with hypothyroidism (lack of thyroid hormones). Treating this condition usually restores the normal cycle of hair follicles and the normal daily amount of hair loss. Other conditions include severe anemia in women with intense menstruation and inadequate levels of Iron, especially after pregnancy, which may lead to temporary hair loss, but usually this is manageable with the right medication and iron supplement.
Women may experience temporary hair loss during or after pregnancy. Hormonal changes after pregnancy can cause an abnormally large number of hair follicles to pass en masse into the telogen stage (the phase when the old hair fall of the hair follicle). This is because the telogen stage is suspended during pregnancy due to high estrogen levels. After pregnancy the estrogen return to normal levels, causing many hair follicles to pass at the same stage a few months after pregnancy. This change in the hair lifecycle associated with pregnancy is usually temporary.
However, the persistence of hair loss for months after pregnancy may indicate the existence of a hormonal imbalance that requires further investigation.
Strong physical stress, intense mental stress and high fever can occasionally cause temporary hair loss. The cause of this type of hair loss is not fully known. A variety of emotional and physical strains have been associated with the passage of an abnormally high number of hair follicles at the apoptosis stage. Abnormal hair apoptosis and its transformation into fuzz, a condition known as telogen effluvium, can be caused by high or prolonged fever and by extensive or severe physical trauma (eg, car accident or extensive burns). This condition usually appears several weeks after a traumatic event or a high fever illness. After chemotherapy or exposure to chemicals that act as hair follicle toxins we may notice an instant and massive hair loss which is known as anagen effluvium.
Changes in the life cycle of the hair follicle caused by stress and fever are almost always temporary. Even so, temporary hair loss can be aesthetically unacceptable to the person who is experiencing it. It is very interesting the fact that people who receive chemotherapy to treat cancer, consider their hair loss more disturbing than dizziness, vomiting, depression and all other side effects of chemotherapy.
A dermatologist or a surgeon specialized in hair transplantation can help you in many ways.
If temporary hair loss insists for weeks or months then we are talking about a chronic problem. A dermatologist or a surgeon specialized in hair transplantation are suitable to examine the causes and recommend the optimal solution to these problems.
