Alopecia



Losing your hair (known as alopecia, in medical language) can be distressing. This article describes the different types of hair loss, explores treatment options and advises on where you can go to seek help.

What is alopecia and what causes it?

Alopecia is a condition that causes people to lose hair either from a single area or from multiple areas of their head, face or body.
The most common types are:
  • male pattern baldness
  • female pattern baldness
  • alopecia areata

Less commonly, hair loss can be caused by chemicals (such as cancer treatments), physical conditions, or by excessive pulling or tension caused by some hairstyles. This last reason is seen more often in women than in men.

Male pattern baldness

Male pattern baldness occurs when the hair follicles, which are the bottom of the stalks of hair, become too sensitive to hormones. The hair then stops growing.
Two things happen: the hair recedes back from the forehead; and the hair on top of the head thins. Some men end up with a 'horseshoe' shape of hair around the back of their head, while others lose all their hair.
Male pattern baldness tends to run in families.

Female pattern baldness

The cause of female pattern baldness (also called female pattern hair loss, or FPHL) is not as clear, but it’s also likely to be caused by a sensitivity to hormones. It can also run in families. In women, thinning is the bigger problem.

Alopecia areata

Alopecia areata is a treatable but not fully curable autoimmune disease that occurs when the immune system attacks hair follicles. It can affect children as well as adults.
No one knows for sure what causes alopecia areata, but it’s probably triggered by a combination of genetics and environmental factors. Some people believe that extreme stress and anxiety can trigger it, but there is little scientific evidence to support this.
Usually, alopecia areata leads to one or more small, circular patches of hair loss, usually on the head. Bald patches can grow quickly. The hair usually grows back, but it can take several months.
Apart from the head, alopecia areata can cause hair loss on the face, beard, eyebrows and eyelashes. Even nostril hairs can fall out. It’s less likely that your hair will grow back if you have this more extensive hair loss. But talk to your doctor about the options: your hair follicles aren’t dead, but they need a trigger to start working again.

How is alopecia diagnosed?

Talk to your doctor if you’re worried about hair loss. Your doctor will usually be able to find the cause, but might refer you to a dermatologist, who will inspect the area. If they are unsure about what’s causing the hair loss, they might take a sample of skin, hair or blood to examine more closely.

Living with alopecia

Alopecia can be temporary or permanent. You might find it easy to accept, and feel it doesn’t impact your life. However, you might find it confusing and embarrassing, affecting your self-image, self-esteem, confidence or mental health.
Accepting your hair loss is the most straightforward and cheapest way to cope, but this won't always be easy.
There are practical actions that a person living with alopecia can take, such as wearing a wig, getting a hair transplant or getting eyebrow tattoos.
If you have male or female pattern baldness, treatments such as minoxidil and finasteride can sometimes slow the hair loss – see your doctor for advice.
If you have alopecia areata, medications such as corticosteroids might help. Again, talk to your GP or your dermatologist.
Remember that you are not alone. If you are finding it difficult to accept your hair loss, there is still help and advice available to you.

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