Introduction

In the realm of self-expression, our hair is more than just an accessory; it's a statement woven into our identity. Like the items we wear and love, it carries the weight of cultural and religious significance, a tradition of care echoing through the ages. But when hair loss enters the scene, it brings confusion and challenges to cope with. This guide aims to demystify the intricacies of hair loss, providing practical insights for those navigating the path toward regrowth.

5 types of hair loss

Androgenetic Alopecia — Male and Female Pattern Hair Loss

Cause: Primarily genetic, but hormonal factors also play a part.

Characteristics: Progressive thinning of hair, especially on the crown and temples.

About: This is the most common type of hair loss for both men and women. Female pattern hair loss usually appears around mid-age but can also start earlier in life, however, it is often developed post-menopause. FPHL doesn’t lead to loss of all hair but rather results in a progressive thinning of hair and widening of the part at the top of the head.

Male pattern hair loss may begin early with some men noticing as early as in their later teens or early twenties, however, this is not the most common case. According to the American Academy of Dermatology “By 50 years of age, more than half of white men have a visible sign of male pattern hair loss like noticeable thinning, a receding hairline, or balding.” MPHL often begins with a receding hairline or a bald spot at the crown of the head and extends across the head over time, and can after a longer period result in baldness.

For both men and women, it is always good to consult your dermatologist to ensure that this is the actual cause of your hair loss and not another underlying health condition.

Sources

American Academy of Dermatology (AAD): Hair Loss: Who Gets and Causes

American Academy of Dermatology (AAD): Thinning Hair and Hair Loss: Could It Be Female Pattern Hair Loss

American Academy of Dermatology (AAD): What Is Male Pattern Hair Loss, and Can It Be Treated?

Telogen Effluvium

Cause: Triggering factors like stress, illness, or medication disrupt the hair growth cycle.

Characteristics: Sudden shedding of hair, often three to six months after a triggering event.

About: A temporary form of hair loss that is not caused by genetics. This occurs as a reaction to mental, metabolic, or physical stress, pregnancy, medications, hormonal changes, and other illnesses.

A healthy scalp has a mix of telogen (resting) and anagen (growing) hair, with about 85% being anagen and actively growing. Usually, this growth phase lasts for about 4 years, before moving into a 4-month rest phase where the hair is not actively growing. While the hair is resting, a new growth begins beneath and thus pushes the hair out.

What happens when one experiences telogen effluvium is essentially that the stressor causes the body to prematurely enter its resting phase. This will not be noticed immediately, but once the hair gets back into the growth phase the hair that has been resting gets pushed out of the follicle and that is the hair loss we see.

Severe infections and trauma, major surgeries, not eating enough protein, intense dieting, and iron deficiency can all cause this type of hair loss as well. It can occur to anyone no matter their age, race, or gender, and it is common to experience this at some point in your life. However, women have a bigger chance of experiencing telogen effluvium because of pregnancy and the hormonal changes that it brings.

Källor

American Skin Association: Alopecia.

National Library of Medicine: Elizabeth C. Hughes and Dahlia Saleh: Telogen Effluvium.

Alopecia Areata

Cause: Autoimmune condition where the immune system attacks hair follicles.

Characteristics: Sudden loss of small, round patches of hair.

About: This condition can affect anyone of any age, race, and gender, and is thought to be caused by our body’s immune system attacking the hair follicles by mistake, thinking they are something harmful when that is not the case. It is not fully clear why this occurs, but we do know that both genetics and environment seem to influence alopecia areata and that those who have had a family member with the condition are more likely to experience it themselves.

The hair loss mostly occurs on the scalp and the face but could occur anywhere on the body, often in circular or oval shapes. In severe cases, hair loss can happen across the entire scalp or body. The more common case is that it happens in small sections.

Most of the people with the condition are otherwise healthy and do not experience other symptoms — yet, it should be noted that some also see changes to their nails, such as pits and ridges. The lost hair often grows back, but depending on the individual it can be a bit unpredictable.

Sources

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): Alopecia Areata

American Skin Association: Alopecia.

Traction Alopecia

Cause: Physical stress on hair due to tight hairstyles or hair treatments.

Characteristics: Hair loss from tension or pulling.

About: Traction alopecia is a preventable condition that happens as a result of repetitive and long-term pulling on the hair roots. Although this can happen to anyone, it is most commonly experienced by women with tightly curled hair, often of African descent, who wear their hair in tightly braided hairstyles such as corn rows. However, the likelihood of the condition is more common with age. It should be noted that it is not the shape or type of hair that is the cause of traction alopecia, but the hair care practices and styles that people wear that lead to hair loss.

People may also experience headaches that go away when the hair is no longer in the style causing the traction. More hairstyles that cause this include tight ponytails, braids, dreadlocks, as well as weaves and extensions. The hair loss is usually noticeable along the hairline and can be avoided by not putting excessive tension on the hair for long periods of time.

Sources

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS): National Library of Medicine: Joel K Pilickal and Feroze Kaliyadan: Traction alopecia.

Cicatricial (Scarring) Alopecia

Cause: Destruction of hair follicles leading to scarring.

Characteristics: Irreversible hair loss with visible scarring.

About: This type of alopecia differs from other hair loss conditions as the hair follicle in this case is destroyed, creating a scar instead. For primary cicatricial alopecia which we will be discussing in this article, it is generally a result of inflammation. For the other non-scarring types of alopecia, this is not the case but rather a change in the growth phase. The patches created from this hair loss are smooth, shiny, hairless, and lacking pores as there are no longer follicular openings. The scar itself is not visible as the fibrous tissue is located in the hair follicle. Secondary cicatricial alopecia has the same result, destroyed hair follicles and scarring, however, it is deemed as secondary when the original cause is from influences not related to the hair such as tumors and radiation treatments, burns, etc.

This type of scarring hair loss has several subcategories that are determined by the type of inflammation that causes the destruction of the hair follicles. Overall though, this is a condition that requires more research and the causes are not fully understood. What is known for certain is that all types involve an inflammation of the section of the hair follicle that hosts stem cells and the oil glands that make growth possible.

Sources

National Organization for Rare Disorders: Cicatricial Alopecia

Canadian Medical Association Journal: Rebecca Filbrandt, et al.: Primary cicatricial alopecia: diagnosis and treatment

American Skin Association: Alopecia.

Identifying the Causes

Now that we have a better understanding of what hair loss looks like for different people and circumstances, we can begin to evaluate what we know about our hair and bodies to get a fuller picture of how we can get towards hair regrowth.

1. Timeframe and Changes

Ask yourself when you first started noticing the hair loss. Was it just now or has this been going on for a few weeks? If you can gather an approximate timeframe it can be easier to begin understanding what could be the root issue. This way, you might be able to see if there’s any correlation with events in your life, illness, stressors, or hormonal and health changes that could have caused the hair loss.

2. Genetic Factors

Exploring family history — as mentioned, the most common type of hair loss is genetic. If possible, taking a look at your family history and speaking with relatives can help you understand if you are more prone to experiencing alopecia. If that is the case, knowing your genetic influence can be useful to get an overview of how the condition might play out. For example, if your parent began to experience hair loss in their late teens, there is a chance this may happen to you too.

3. Environmental and Lifestyle Factors

Hair loss can often be linked to lifestyle choices or stress levels in our lives. With your timeframe in mind, can you determine if you have noticed any other health symptoms? Have you had any major life changes, significant stress, or a shift in mental health during this time period? Self-care, diet, and medications can also play a part here — what products have you been using lately? Our environment has a significant impact on our health and stress levels for better and for worse. Living in a new place, eating different foods, being exposed to other people and potential contaminants could all be relevant.

Navigating Hair Loss

As stated earlier in the article, our hair usually carries a lot of feelings about ourselves and is a big part of our identity. For many, losing hair can be traumatic and result in a feeling of loss of control and helplessness. Even though hair loss is very common and generally a natural part of life, these changes can fill us with shame and disappointment; like many other things in life, something being common or natural doesn’t always make it easier to experience.

It is important to remember that it is completely okay to be upset about losing hair, no matter the cause. If you feel like your hair loss is impacting your well-being negatively, it is a good idea to reach out to someone you trust and can talk about your concerns, whether that is a friend, family member, or therapist. Hair loss potentially being related to other illnesses can be a difficult experience to deal with as it is easy for the mind to expect the worst, and unwanted changes in our looks can take a significant toll on our self-esteem and value of self. No matter what, it is always a good idea to confide in someone in your support system who can be there for you during this time.

Talking to your doctor or dermatologist is also important when it comes to hair loss and other health concerns, especially if a symptom could be related to underlying illnesses. Since you’ve already prepared by gathering information about your recent hair loss and lifestyle as of recent, it will be much easier for a professional to help you determine what the cause is, and thus treatment as well. Speaking with them also allows for further testing if other conditions are suspected, and they can help give you a proper diagnosis so you can fully understand why you are losing hair. A professional will also be able to help you find the best path of treatment and perhaps even ease some worries that may be lingering. Knowledge about your body is always key to living your best and healthiest life!

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