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What is alopecia?

WHETHER due to illness or male pattern baldness, losing your hair can be a traumatic experience for many.

Alopecia is the medical term for baldness and covers all types of hair loss, from temporary to permanent.

 Alopecia can affect people at any age
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Alopecia can affect people at any age

What is alopecia areata?

Alopecia areata causes patches of baldness about the size of a large coin - both men and women are equally affected.

It can occur at any age but most cases first develop in teenagers and children.

At least half of the people with the condition develop their first patch of hair loss before they are 21 years old.

They usually appear on the scalp but can occur anywhere on the body.

In most cases of alopecia areata, hair will grow back in a few months to a year.

At first, hair may grow back fine and white, but over time it should thicken and regain its normal colour.

For women, sometimes birth can trigger postpartum alopecia too.

Some people go on to develop a more severe form of hair loss, where they lose all their hair.

This is called alopecia totalis (no scalp hair) and alopecia universalis (no hair on the scalp and body).

Alopecia areata is an autoimmune disease, where the immune system attacks part of your body by mistake.

In this condition the immune system surrounds and attacks hair follicles.

The cause is unknown but iron deficiency, and stress could trigger the condition.

People with a family history of alopecia areata also appear more susceptible and it is more common among those who have an overactive thyroid (hyperthyroidism), diabetes or Down's syndrome.

What types of alopecia are there?

As well as alopecia areata, there are many other types of alopecia that can affect people.

The most common type of alopecia is pattern hair loss, which can be found in both men and women.

Androgenetic alopecia

This is the medical name for pattern hair loss, but many people are unaware that this is a form of alopecia.

Male sufferers of this normally see their hairline recede as their hair thins and falls out, starting at the temples.

Women can see it as a thinning of hair all over the head.

This is a natural part of ageing so should not be a cause for concern.

Around 50% of men over the age of 50 have some form of hair loss, while 50% of women over 65 have androgenetic alopecia.

This is permanent damage so your hair will not grow back although you can slow the process.

Scarring alopecia

Alopecia can manifest in different ways, even when the reason is the same.

Scarring alopecia is a group of different types of alopecia which all appear in different ways on the head.

This type of hair loss can be caused by inflammation, infection, burns or auto immune diseases.

The hair follicle is destroyed and replaced with scar tissue, meaning the hair cannot regrow.

In some cases this is seen across the front of the scalp (known as frontal fibrosing alopecia) and others it can appear in patches around the front, back and sides (lichen planopilaris).

Other sufferers might see their hair begin to disappear at the crown of their head and spread out from there, this is called central centrifugal cicatricial alopecia.

Chemotherapy induced alopecia

Also called anagen effluvium, this type of alopecia is directly due to patients undergoing chemotherapy.

It is a side effect of chemotherapeutic drugs and is often one of the more visible side effects of the treatment.

This is mostly associated with cancer treatment but is not limited to cancer patients.

Some people lose eyebrow hair and eyelashes during this time, as alopecia can cause hair loss over your entire body.

Depending on your dosage, you can experience some thinning all the way to complete baldness.

Telogen effluvium

A less predictable type of hair loss, this is when your hairs move into a resting phase and shed.

It is a normal process but if more hair than usual moves into this phase, it can cause thinning and balding.

For many people this alopecia is triggered by a physical or psychological event and can spontaneously resolve itself.

Traction alopecia

One for ponytail fans, this alopecia is when hair has been pulled in a certain way for a long time.

Tight hairstyles such as ponytails or frequent use of extensions can result in traction alopecia.

It can be treated when hair loss is first spotted but repetitive pulling can cause permanent follicle damage.

Stop using tight hairstyles as soon the hair thins and it should grow back.

Trichotillomania

This is a psychological condition where alopecia is caused by an incontrollable need to pull out your own hair.

Commonly, the scalp, eyebrows and eyelashes are targeted.

Continued plucking of hair causes the follicle to be damaged and stop growing - which is why overplucking your eyebrows stops them from growing back.

Causes of hair loss

  • An illness
  • Stress
  • Cancer treatment
  • Weight loss
  • Iron deficiency

What treatments are there for alopecia?

For the more common types of hair loss, such as male and female pattern baldness, treatment is not necessarily needed because it is a natural part of ageing.

However, there are possible treatments which can be explored and anyone concerned should speak to their GP.

Hair transplants are common ways to treat baldness, although treatment can vary from £1,000 to £30,000 in the UK.

This is technically cosmetic surgery so is not covered by the NHS.

Alopecia areata is usually treated with steroid injections, although it's sometimes possible to use a steroid cream, gel or ointment.

You can inject or apply straight onto the bald patch to encourage growth.

There are two drugs currently available to treat pattern baldness, finasteride and minoxidil.

Neither are available on the NHS and women should only use minoxidil.

Many people are turning to tattooing for eyebrow hair loss, these tiny lines can make a hairline or brow look fuller immediately.

Light treatment and scalp reduction surgery are also options for treating alopecia.

It is often cheaper to turn to using wigs as these treatments can be expensive.

Which celebrities have suffered from alopecia?

Many celebrities over the years have announced they are suffering from alopecia, however it is normally most noticeable in women.

Because half of men will go bald at 50, this does not normally make news.

However, due to the emphasis on female hair, it is more likely to be commented on when women lose their hair.

Often when actors dye or bleach their hair for prolonged periods of time, due to roles, it can result in alopecia.

 

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