What are the types of Hair Loss in Men and Women? The human body is covered with hair with the aim to protect & preserve from external changes. For example, scalp hair preserves our brain tissues and nerves from sudden temperature changes in our surroundings. Keratin protein of hair is uniquely designed for this purpose and an adult human has normally 100,000 to 160,000 fibers in its scalp.
Dermatological studies have revealed that everyone among us, in a normal lifestyle without any health issues, shed roughly around 100 hairs every day and they are compensated by approximately the same number of new hairs every day. However, hair loss is a common problem among both the male & female population. Particularly males are most affected and reported in the literature. The biochemical reasons for this hair loss can be genetic or chronic as well as climate and lifestyle practices.
In medical & dermatological terms, hair loss or baldness is termed as “Alopecia”. Medics and dermatologists have characterized various types of hair loss involving different mechanisms and causes. Here today, we summarize a literature review about various types of hair loss among males and females. Below also is an outline of the Norwood-Hamilton scale for Hair loss that may be of interest to you
Types of Hair Loss
1, Androgenic Alopecia
Androgenic alopecia is more frequently reported topic in hair loss and it is common for both sexes, male and female. However, the male is more affected as 90% of male hair loss cases are androgenic. The process of hair loss is slow and involves complex biochemical changes over the time span of years. It starts with a decrease in hair diameter density (hair diameter in a unit area) which goes on slowly with fine hair eventually resulting in hair loss. That’s why hair loss intensity increases with increasing age in both sexes. Androgenic alopecia is believed to be a genetic issue and is carried on further by heredity. Mothers having hair loss problems enhances the probability of having hair loss among kids and the hormone derivative such as dihydrotestosterone also plays a role in accelerating hair loss.
These cases are easy to diagnose as it has a characteristic visual pattern for both male and female. For Male Hair Pattern Loss (MPHL), it starts at the front area moving inside in a typical pattern widening in the middle causing a big path in the middle of the scalp crown. In females (FPHL), it is mainly in the middle line at the apex crown of the scalp, widening and deepening over time.
2, Androgenic Areata
Areata cases account for almost 1% of the total reported cases of hair loss. It is predominant among male patients and can affect any part of the body, but scalp hair loss is a usual complaint. The severity of cases may vary from a small bald spot to a total scalp hair loss (Alopecia Totalis) and may even lead to total body hair loss (Alopecia Universalis). The skin at the hair loss spot might demonstrate slight erythema and a zone of discomfort. Androgenic areata can be treated with medication and treatment procedures.
3, Telogen Effluvium
This is another common category of hair loss and this occurs at almost all scalp areas when large numbers of hair move into a cyclic change together in one go (anagen entering telogen phase). It could be psychological as well as under the influence of long term medication. Almost all the medicine-related or drug-induced hair loss cases are grouped into telogen effluvium. The main reason is “stress at follicles" which might be due to metabolic changes, nutritional deficiencies or some serious health illness.
Trichotillomania hair loss is actually habitual or intentional pulling and plucking hair. There is no scalp inflammation or discomfort and the case is purely psychological. It is mainly due to mental health, stress, and turmoil in the workplace or private life. A common case observed among school-going young kids. Such cases require rehabilitation and help in settling psychological problems.
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5, Traction Alopecia
This type of hair loss is a form of mechanical & traumatic alopecia. It is caused mainly by vigorous scratching or excessive & aggressive combing. Thus, our hairstyle and day to day hair management might be accelerating or stimulating hair loss. A good example is reported among females using tight "ponytail". Traction alopecia follows a biphasic mechanism. Initially, hair loss is temporary, and hair regrows. However excessive & continuous traction may lead t permanent hair loss. A simple remedy to avoid and minimize such cases is to change our hairstyle approach.
6, Temporal Triangular Alopecia
It is a characteristic “well-marked bald spot” without any inflammation and discomfort at the skin dermis. This has been observed in newborn babies or developed in their first decade of life. The bald spot seems to be hairless, however, microscopic magnification shows tiny, thin light-colored hair (vellus hair). It is believed due to potential abnormal biochemical reactions inside follicles. Such hair loss problems can be resolved with time by having a balanced nutrition diet, a healthy scalp surface, and a healthy lifestyle.
7, Loose Anagen Syndrome
It’s a non-scary hair loss without any inflammation. This problem has commonly been observed among young kids with thin uneven hair with abnormal textures. It is mainly due to the degenerative mechanism underneath the hair root sheet.
8, Syphilitic Alopecia
Syphilitic alopecia can be characterized by a “patchy” well-marked area at scalp crown or more "light density area of hair spread over a larger area of scalp". In most of the cases, the pattern is an inflammatory and non-scarring process closely resembling alopecia areata. In remedy require medication and long-term dermatological treatments.
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9 Lupus Erythematosus
This kind of hair loss may have several forms and shapes at the scalp crown. Generally, patients with a history of prolonged illness may have this kind of diffused hair loss problem. It is mostly characterized by inflamed or damaged patchy areas with some scares and mild erythema. The problem deeply depends upon the health of the individual and hence requires a comprehensive plan to improve overall health issues.
10, Lichen Planopilaris
Lichen planopilaris has no distinct and definite pattern of hair loss. It generally has several scattered areas of partial hair loss with reduced hair density. Skin is inflamed and has scares almost all over the scalp crown. Clinical treatments are available to help in improving this problem.
11, Frontal Fibrosing Alopecia
A relatively new condition of hair loss reported in postmenopausal females. It is reported to have a progressive hair loss along the anterior hairline and the eyebrows.
Summary & Conclusion:
Hair loss is a problem that influences greatly the personality, outlook and overall way of our lives. It affects both genders and requires attention and proper clinical treatments to combat. In the literature, various forms and kinds of hair loss are reported and discussed. Here, we attempted to shape up a short summary of symptoms for most important classes of alopecia. Among all kinds, androgenic alopecia is the most reported and widely discussed.
Bibliography & Further reading:
- Zviak, C., The Science of Hair Care. Taylor & Francis: 2005.
- Sperling, L. C.; Cowper, S. E., An Atlas of Hair Pathology with Clinical Correlations. Taylor & Francis: 2003
- Camacho-Martinez, F. M. In Hair loss in women, Seminars in cutaneous medicine and surgery, No longer published by Elsevier: 2009; pp 19-32.
- Ghanaat, M., Types of hair loss and treatment options, including the novel low-level light therapy and its proposed mechanism. South Med J 2010, 103 (9), 917-921.
- Draelos, Z. D., Hair Care: An Illustrated Dermatologic Handbook. CRC Press: 2004.
- Marsh, J. M.; Gray, J.; Tosti, A., Healthy Hair. Springer International Publishing: 2015