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Hair loss (alopecia)

Information about hair loss (alopecia), as well as guidance about what support is available from Changing Faces and other organisations.

What is hair loss (alopecia)?

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.

Types of hair loss

There are many types of hair loss and we don’t cover them all on this page, only the most common.

Alopecia areata

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.

Causes

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.

Treatments

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

Causes

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

Treatments

Treatments include:

  • 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.

Causes

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.

Treatments

Treatments include:

  • Wigs, weaves and styling
  • Topical medication applied to the scalp which can stimulate hair growth
  • Transplants, which can be effective

Medication

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.

Real stories about hair loss

Menopause hair loss

The menopause is a natural process which happens to all women later in life. One of the changes is that periods stop permanently and you can no longer get pregnant. Although research is limited, many women report hair loss during the menopause.

Causes

Hair loss is likely to be caused by changing hormone levels, such as the body producing less oestrogen and progesterone. Hormone replacement therapy (HRT), which you may be receiving if you are going through the menopause, can also lead to hair loss.

Treatments

Drugs are available which can stimulate hair regrowth in women experiencing hair loss during the menopause.

Skin conditions

Certain skin conditions can cause hair loss:

  • Eczema – hair follicles may struggle to grow through the inflamed or damaged skin or may be damaged by scratching. Hair typically grows back following effective treatment of the eczema symptoms.
  • Psoriasis – scalp psoriasis can lead to hair loss if you scratch or pick at the affected area. As with eczema, it is temporary and effective treatment of the psoriasis leads to regrowth.

Stressors

Physical and psychological stress can lead to hair loss. Triggers include:

  • Stress – severe psychological stress can cause the hair to fall out.
  • Pregnancy – normal hair growth is usually regained by the child’s first birthday.
  • Illness – a high fever or severe infection can cause temporary hair loss, as can surgery.

Vitamin and nutrient deficiencies

Some vitamins and nutrients support hair growth. This means that deficiencies can cause hair loss. Common examples include:

  • Iron, which contributes to haemoglobin production. Haemoglobin transports nutrients and oxygen to hair follicles.
  • Selenium is needed for healthy thyroid functioning. Disruption to this can lead to hypothyroidism which is associated with hair loss. Deficiency is rare.
  • Vitamin D metabolises keratinocytes which are important for healthy hair growth.
  • Zinc also helps in the production of haemoglobin.

Is hair loss genetic?

Some forms of hair loss are genetic. In fact, hereditary hair loss with age is the most common form of hair loss. If your parents had hair loss with age, there is a chance you may experience it as well. However, hair loss does not have a single cause and there are many forms of hair loss which are not genetic.

Hair loss and my appearance

Hair loss can be distressing and it can affect how you feel about your identity and body image. If you are a woman with hair loss, you may be uncomfortable because you feel that others expect your hair to look a certain way. Other groups may attach cultural or social significance to hair or certain hairstyles, which can make hair loss particularly challenging.

Men can also experience distress as a result of hair loss. Younger men may feel self-conscious and even if hair loss occurs at a later age, you may still experience difficult feelings connected with your changing appearance.

You may also notice people staring at you, passing comments or asking questions about your hair loss.

What hair loss support can we offer?

There is plenty of support available if you are struggling with the impacts of hair loss.

At Changing Faces, self-help resources are available on our website for anyone experiencing hair loss and provide guidance with various aspects of living life with a visible difference. Topics include mental health, confidence, school and work life, relationships, social media and coping with others’ reactions.

Our Online Community is a chat forum for anyone struggling with the impact of hair loss. It is a place where you can talk to other people with visible differences, with moderation and support from Changing Faces staff. You can also read stories and accounts from people living with hair loss on the real stories section of our website.

In addition to the above, we have other wellbeing services available to people with many forms of hair loss, including alopecia areata, autoimmune conditions, early or unexpected hair loss and hair loss following chemotherapy.

Through our counselling and wellbeing support service, our trained practitioners work with you over a series of sessions to support your social, emotional and psychological wellbeing, providing the opportunity to talk through your thoughts, feelings and experiences.

Other ways we can support people with certain forms of hair loss are:

If you’d like to access our services, please contact our Support and Information Line. As well as connecting you with our services, our friendly team can also offer support calls for you to talk about the impacts of hair loss on your life.

Other organisations

Guidance, support and advice is also available from other organisations. Please follow the links to their websites to learn more.

Alopecia UK

Alopecia UK

Alopecia UK provides support to people with hair loss, raises awareness about alopecia and supports research into the causes and treatments of hair loss. They offer in-person and online peer support, provide self-help resources, organise regional and national events and provide individual support.

Outlook logo

Outlook

A national, highly specialist psychological service based at North Bristol NHS Trust, supporting adults (16+) with appearance-related distress. They can provide face-to-face and remote support via NHS Attend AnyWhere. Please speak to your GP or healthcare professional to discuss a referral.

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NHS

Please have a look at the NHS conditions page for official guidance on hair loss, information on when to see a GP, and advice about treatments available on the NHS. You will also find out what treatments are available on the NHS and how to seek help.