Hair loss (alopecia) can be a natural part of ageing or it can occur at an earlier age due to factors including medication, stressful emotional or physical events, vitamin and nutritional deficiencies, hormonal changes or a medical condition such as alopecia areata. It can affect your scalp, face or other parts of the body. Some forms of hair loss are temporary and some may respond to treatment.
The most common form of hair loss is hereditary hair loss with age. Male pattern baldness affects 85% of men and those assigned male at birth by the age of 50. In the UK, 8 million women and those assigned female at birth also experience some form of hair loss.
Whatever the cause, losing your hair can be a distressing experience. You may feel self-conscious about your appearance or that you are losing part of your identity. It’s important to know that there is lots of support available. Here, we look at the different types of hair loss, their causes and possible treatments.
Through our services here at Changing Faces, we can help you manage certain forms of hair loss, including alopecia areata, autoimmune conditions, early or unexpected hair loss and hair loss caused by chemotherapy. Our self-help resources are freely available to all. We introduce our support and services in detail further down the page.
There are many types of hair loss and we don’t cover them all on this page, only the most common.
Alopecia areata is an autoimmune disease which causes the hair to fall out in round or oval patches on the scalp and other places on the body where hair grows. There are different types of alopecia areata, including:
- Patchy alopecia areata – round or oval patches
- Alopecia totalis – total loss of all hair on the scalp
- Alopecia universalis – loss of all hair on the head and body
There are other types of alopecia areata which we haven’t listed here.
Alopecia areata is caused by the immune system attacking the body’s own cells. T cells from the immune system (specifically, NKG2D+ T cells) gather around the hair follicles, causing them to die.
About one in 1,000 people have this form of alopecia and 10-25% of these have a family history of alopecia areata or other autoimmune conditions.
Alopecia areata can be treated with corticosteroids and immunotherapy to suppress the immune response.
Other autoimmune conditions
Autoimmune conditions – like alopecia areata – are conditions where the immune system attacks cells in the body. Other autoimmune conditions which commonly cause hair loss include:
- Lupus – causes widespread inflammation, including of the skin on the scalp, which can cause the hair to thin out. Hair will often grow back.
- Type 1 diabetes – people with type 1 diabetes are more likely to have alopecia areata.
Chemotherapy and hair loss
Chemotherapy is used to treat some types of cancer. Some forms of chemotherapy can cause the hair to fall out. People sometimes assume that chemotherapy always leads to hair loss but this is not the case. Some drugs do not cause any hair loss, while others lead to slight thinning.
If you need to have chemotherapy, talk to your doctor about whether it is likely to lead to hair loss. Knowing in advance can allow you to prepare for this and decide what, if anything, you’d like to do about it. For example, some people choose to wear wigs or use cold caps during treatment to help lessen hair loss.
Female pattern hair loss
About one third of women and people who are assigned female at birth experience female pattern hair loss. It has a different pattern to male pattern hair loss, tending to occur:
- Around the parting
- As a widening of the parting
- Throughout the hair
It can be caused by genes or as a natural part of ageing but can also be triggered by:
- Stressors – for example, extreme weight loss, childbirth or stress
- Vitamin and nutrient deficiencies – including vitamin D and iron
- Tight hairstyles – such as having your hair in a ponytail
- Some drugs can be used to reduce or stop hair loss.
- Laser combs may be used to stimulate hair growth, although evidence on their effectiveness is mixed.
- Platelet-rich plasma therapy may stimulate hair growth.
- Transplants can be effective – transplanted hair will continue to grow.
Male pattern hair loss
Male pattern hair loss tends to occur in an M shape. Most men and those assigned male at birth (80%) have some hair loss by age 50. However, male pattern hair loss can begin in the late teens. For some, it can have a big psychological impact, affecting self-esteem and even leading to depression and anxiety.
Each hair has a growth cycle. In male pattern hair loss, the cycle weakens, causing hair follicles to produce shorter and finer hairs. Ultimately, the growth cycle stops altogether and new hairs do not grow at all.
Genetics are a major cause of male pattern hair loss, so a history of baldness in the family indicates that you may be susceptible to male pattern hair loss.
- Wigs, weaves and styling
- Topical medication applied to the scalp which can stimulate hair growth
- Transplants, which can be effective
A wide range of medications can lead to hair loss. Some of these are:
- Acne medication containing vitamin A. These contain retinoids, which can lead to hair loss.
- Antibiotics and antifungal drugs which can deplete vitamin B and haemoglobin, disrupting hair growth.
- Antidepressants which contain sertraline, which can cause hair loss.
- Contraceptives which contain progestin; this can lead to hair loss.
- Some immunosuppressants (although other immunosuppressants are used to treat it).
- Hormone replacement therapy (HRT), which contains testosterone.
- Drugs used to treat Parkinson’s disease, which replace or stimulate the chemical dopamine.
Have a look at the WebMD website which has a comprehensive list of medications which may lead to hair loss. Please do not stop taking your medication without speaking to a health professional first.