Forms of Thinning Hair and Alopecia

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Androgenetic Alopecia

The most common form of hair loss in Men, but is also a surprisingly common cause of female hair loss. Often known as Male Pattern Baldness, it results when:

1. Hair loss occurs at an abnormally high rate;

2. Hair replacement occurs at an abnormally slow rate;

3. Normal hairs are replaced by smaller, thinner hairs, called "miniaturisation"

Androgenetic Alopecia affects nearly 30% of men before they reach the age of 30, and 50% of males over the age of 50. More surprisingly, it also affects 40% of women over the age of 50.

The causes of Androgenetic Alopecia are still not completely understood, although as its name suggests, it is widely thought to involve both hormonal (androgens are hormones) and genetic causes. Of the many hormones that regulate hair on the scalp, Androgens have the largest effect.

Many women find that the hair on their head is thinning during menopause or pregnancy- this is due to changes in the levels of the hormone Dihydrotestosterone (DHT) in the scalp. Hair loss in women is often referred to as hormonal hair loss rather than Androgenetic alopecia, but they are in fact the same condition.

In men, DHT is very important for reaching maturity; it is DHT that causes body and facial hair to begin growing. Later in life however, these same Androgens (primarily DHT) are responsible for the reduction in size of the follicles in the scalp.

The longer the hair follicle is kept in the presence of DHT, the more miniaturized the follicle becomes. Miniaturisation is caused by the shortening of the Anagen or growth phase, and is when the hair itself becomes shorter and thinner. DHT also increases the rate of hair loss by signalling to the hair to reach Telogen phase sooner, so more hair is lost is well; these factors combined give noticeable thinning hair.

If treatment is not administered, this process continues, the follicles progressively become shorter and less visible, and some will eventually close completely and stop growing.

DHT is integral to the majority of hair loss sufferer's problems. So it is clear that any hair loss treatment should begin by removing DHT or relieving the effects of DHT. There are many products available to inhibit DHT formation, the prescription option Finasteride is very effective, but unfortunately has a wide variety of severe side effects, and can't be used by women. There are a variety of alternatives to Finasteride available; some like saw palmetto also prevent DHT production, and some like Minoxidil or Superoxide Dismutases work in a different way to reverse the effects of DHT.

Alopecia Areata

The causes of Alopecia Areata are not completely understood, but it is thought to be the result of the body's immune system attacking the hair follicle. It is also thought in some cases to be caused by extreme stress. This form of alopecia appears as random patches of hair loss on the scalp and usually rectifies itself without treatment. Alopecia Areata can exhibit as hair loss in men or women, and at any age, unfortunately as the mechanism isn't yet understood, reliable treatment is not possible.

One hope for Alopecia Areata patients is Platelet Rich Plasma (PRP) Therapy. Whilst still extremely experimental, the one test patient that has been treated with PRP did respond well. It is hoped that in the future either PRP or a similar treatment may help Areata patients. More information on PRP is available on an earlier article PRP and hair loss.

Many Alopecia Areata sufferers find hair loss concealers useful, as their hair loss is often temporary, they provide a solution that is affordable, and relieves much of the stress of the condition, which can aid recovery.

Traction Alopecia

This condition results from long term pulling on the hair and is generally only seen in people with long hairstyles. Traction Alopecia can be caused from wearing the hair in certain hairstyles, such as tight braids, weaves, and ponytails. This form of thinning hair usually resolves itself once the cause of the pulling has been eliminated.

Alopecia Totalis or Universalis

These forms of hair loss are thought to be similar to Areata in cause, and are equally poorly understood.

Alopecia Totalis sufferers lose all the hair on their head, and Alopecia Universalis sufferers lose all of their hair, all over their body. The most noticeable forms of hair loss, these are also conditions with no reliable cure currently available. Many Universalis or Totalis patients invest in wigs or hairpieces. Like Areata though, both Totalis and Universalis can occasionally resolve themselves without treatment.

There are many other causes of hair loss or diffuse hair thinning. Certain illnesses and hormone imbalances, skin conditions, drug treatments, and some dietary deficiencies can all cause thinning hair.

If you are at all concerned about the cause of your hair loss, you should seek medical advice.