Definition

Alopecia refers to hair [2] loss in areas of skin that normally have hair [2]. There are two forms of alopecia:

• Scarring—This is the loss of hair [2] follicles, causing permanent hair [2] loss. Cutaneous lupus [3] erythematous and fungal kerions are the most prevalent forms of scarring alopecia.
• Nonscarring—In this case, the hair [2] shaft is gone, but the follicles are still present. Because the hair [2] follicles still exist, it often is reversible. It can, however, develop into the scarring type. Alopecia areata is a type of non-scarring alopecia. It is an autoimmune process and the cause is not known. Hair loss lasts approximately six months.

Causes

Many things can cause alopecia, including:

• Stress that prompts growing hairs to rest and shed
  
  • Illness or surgery
  • Prolonged fever
  • Childbirth
  • Emotional/psychological stress [4]
  • Crash dieting
• Hormonal problems
  
  • Overactive or underactive thyroid gland
• Medications
  
  • Blood thinners
  • Drugs for gout [5]
  • Chemotherapy [6] for cancer [7] treatment
  • Vitamin A
  • Birth control pills
  • Antidepressants
  • Blood pressure and heart [8] medications
• Allergic reaction to medications
• Radiation therapy [9]
• Infections
  
  • Fungal infections [10]
  • Syphilis [11]
  • HIV [12]
  • Herpes simplex [13]
• Autoimmune disorders
• Systemic and discoid lupus erythematosus
• Anemia [14]
• Hair pulled too tightly by:
  
  • Hair rollers
  • Pigtails
  • Cornrows
• Hot oil treatments (can inflame the hair [2] follicle and cause scarring)
• Twisting and pulling hair [2] out due to psychiatric problems
• Genes
  
  • Male-pattern baldness is usually inherited.
  • Birth defects can include problems with the hair [2] shaft.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

• Family history of baldness or hair [2] loss
• Advancing age (for male-pattern baldness only)
• Pregnancy
• Stress
• Poor nutrition [15]

Symptoms

Alopecia symptoms depend on the type of hair [2] loss. Some of the more common symptoms include:

Male-pattern baldness:

• Hair recedes
• Hair falls out at the top of the head
• Affects men and women

Female-pattern baldness:

• Hair thins over the entire head
• Hair comes out when brushing

Alopecia areata:

• Rapid hair [2] loss
• Round or oval patches of hair [2] loss
• Sometimes tiny hairs are visible in the patches
• Brittle and discolored fingernails and toenails with ridges

Stress-related:

• Gradual shedding
• Hairs come out with gentle pulling

Fungal infections:

• Patches of hair [2] loss
• Black dots in the patches
• Itching
• Scaling
• Inflammation (such as redness)

Diagnosis

The doctor will ask about your symptoms and medical [16] history, and perform a physical exam. The doctor will examine the area(s) of hair [2] loss, noting the pattern of hair [2] loss and condition of the scalp.

This physical exam may include:

• Gentle pulling on the hair [2]
• Taking samples of scalp areas with inflammation and examining them under a microscope
• Analyzing samples of hair [2]
• Checking for hair [2] loss on other parts of the body

The doctor will ask questions about:

• Diet
• Hair care
• Medication use
• Your personal and family medical [16] history
• Pregnancies, menopause [17], and monthly menstrual cycles

Other tests may include:

• Blood tests to help identify underlying conditions that may be causing the hair [2] loss
• Biopsy of the scalp—removal of a small tissue sample to be analyzed under the microscope

Treatment

Alopecia treatment depends on the cause of the condition. Treatments include:

Prevention

There are no prevention guidelines for the most common type of hair [2] loss, male-pattern baldness. However, the following tips may help you avoid other types of hair [2] loss:

• Do not pull your hair [2] tightly into a ponytail, cornrows, or curlers.
• Learn and practice stress-management techniques.
• Obtain medical [16] care for acute illnesses and to manage chronic conditions.
• Eat healthy, well-balanced meals.