Alopecia / hair fall refers to loss of hair. Hairfall may be in small patches or in severe cases larger patches may also be seen. Scalp is almost always involved but loss of hair may be seen from other body parts also.
Male-pattern baldness is the most common type of hair loss, affecting around half of all men by the age of 50.
It usually starts around the late 20s or early 30s, and most men have some degree of hair loss by their late 30s.
It generally follows a pattern of a receding hairline, followed by thinning of the hair on the crown and temples, leaving a horseshoe shape around the back and sides of the head.
Sometimes it can progress to complete baldness, although this is uncommon.
Male-pattern baldness is hereditary, which means it runs in families. It's thought to be caused by oversensitive hair follicles, linked to having too much of a certain male hormone.
As well as affecting men, it can sometimes affect women (female-pattern baldness). In female-pattern baldness, hair usually only thins on top of the head.
It's not clear if female-pattern baldness is hereditary, and the causes are less well understood.
But it tends to be more noticeable in women who have been through the menopause (when a woman's periods stop at around age 52), perhaps because they have fewer female hormones.
Alopecia Areata- It is an autoimmune condition in which the hair follicles are mistakenly attacked by the immune system causing patchy hairloss. The follicles become smaller and stop producing hair, leading to hair loss the patch may be single bald patch or there may be extensive patchy hair loss also.
Cause– exact cause of alopecia areata is not known but the condition is often associated with other autoimmune disorders like hypothyroidism, vitiligo etc or there may be family history of autoimmune disorders, such as type 1 diabetes, rheumatoid arthritis etc.
Alopecia Totalis- It is an advanced form of alopecia in which there is severe loss of hair or total loss of hair from the scalp and there may be complete baldness also.
Cause- Cause of alopecia totalis is also autoimmune in which the hair follicles are attacked by immunity cells but the condition is much more severe as compared to alopecia areata and the immune system attack of hair follicle is severe enough to cause complete baldness sometimes.
Alopecia Universalis- In this condition there is severe loss of hair from all body parts including eyelashes and eyebrows.
Cause- Cause is autoimmune in which hair follicles of whole of the body may be attacked including the eyelashes and eyebrows causing loss of hair from those areas also.
Alopecia Barbae- In this condition the loss of hair is localized to the beard area only and there can be a single bald patch or more extensive hair loss across whole of the beard area. Thus this condition is localized alopecia areata.
Cause- The main cause is autoimmune attack on the hair follicles of the beard. T lymphocytes are said to be the cause of this condition. The lymphocytes start entering the hair follicles in the beard area and start disturbing the normal hair growth rapidly and destroys the hair follicle which weakens the root and hair falls out sporadically.
Androgenetic Alopecia- it is the most common type of progressive hairloss and is hereditary in form. In this type of hairloss there is progressive thinning of hair and this type of hairloss is seen in both the sexes. This is also known as male pattern or female pattern hairloss.
Cause- In men below normal levels of hormones like sex hormone binding globulin, follicle stimulating hormone, testosterone, epitestosterone.
Androgens regulate sebaceous glands, apocrine hair growth, libido and with increasing age may stimulate facial hair growth and suppress scalp hair growth.
There may be genetic cause also.
Scarring/ Cicatricial Alopecia- In this type there is permanent hairloss.
Cause- There is inflammation of upper part of hair follicle where the stem cells and sebaceous glands are located and once these are destroyed; there is no possibility of regeneration of hair follicle which results in permanent hair loss.
Traction Alopecia- In this type of alopecia there is hair loss due to extensive pulling or tension on hair-shafts and if traction or pulling is prolonged, it can stop development of new hair follicle and lead to permanent hair loss.
Cause- Cause of traction alopecia is mechanical and hair are commonly pulled out from the follicles due to particular hairstyle which tenses the hair shaft.
Anagen Effluvium- in this type hair fall is due to chemicals and is usually a side-effect of some disease treatment e.g. cancer treatment in which there is loss of hair due to chemotherapy or radiation therapy but hair grow back normally once the treatment is stopped.
Cause- there is temporary loss of hair during medication, chemotherapy, radiation therapy which is soon recovered as the therapy is stopped.
Telogen Effluvium- It is a scalp disorder in which there is early entry of hair in telogen phase which is the resting phase of hair follicle. In this type there is loss of hair more than normal amounts along with general thinning of hair but the loss of hair is temporary and there is abrupt recovery in such loss of hair.
Cause- emotional or psychological stress, eating disorder, childbirth, crash diet, drugs, hypothyroidism, chronic illness, anaemia, major surgery are amongst the common cause of this type of hair loss.