Alopecia (Hair loss)

Alopecia is the medical word for hair loss. Some types of alopecia can cause you to lose hair from a single area.

Other types of alopecia can cause hair loss from several areas of your:

• head
• face
• body

Alopecia can be divided into 2 groups — non-scarring alopecia and scarring alopecia.

Non-scarring alopecia is when your hair follicles are not permanently damaged, so your hair may grow back. Common types of non-scarring alopecia include:

• alopecia areata (hair loss due to an autoimmune disease)
• androgenetic alopecia (pattern hair loss)
• telogen effluvium (hair loss due to stress)
• traction alopecia (hair loss due to pulling)

Scarring alopecia is when your hair follicles are permanently damaged. This means the hair loss is usually permanent. Scarring alopecia is much less common and includes conditions such as fibrosing alopecia (hair loss caused by scalp scarring).

You can watch a video provided by the Australasian College of Dermatologists (Opens in new tab).

The symptoms of alopecia depend on what type of alopecia you have. Common symptoms of alopecia include:

• patches of thinning hair or hair loss, usually on your head
• more hair falling out than usual
• flaky skin on your scalp
• an itchy or burning feeling in the areas of hair loss
• hair loss in other areas of your body, such as your eyebrows, beard or chest

There are many possible causes of alopecia, including:

• genetic conditions
• medical conditions
• hormonal changes
• environmental triggers

Androgenetic alopecia

Androgenetic alopecia is the name for both male pattern hair loss and female pattern hair loss. It's usually genetic and you may inherit it from one or both of your parents. It's caused by the effects of androgens (male hormones) on your hair follicles.

Alopecia areata

Alopecia areata is an autoimmune disease where your immune system attacks the hair follicles on your head and body. It's not always clear what causes alopecia areata, but it can be due to genetics.

Telogen effluvium

Telogen effluvium is when a shock to your body temporarily stops your hair from growing. Your hair may stop growing for a few months — during this time more of your existing hairs fall out than usual. This causes temporary hair thinning or baldness. You may only notice the hair loss a few months after the trigger occurs.

Triggers that can cause telogen effluvium may be psychological or physical. Psychological triggers include:

• trauma
• grief
• major life changes
• stress

Physical triggers include:

• childbirth
• prolonged high fever (temperature of 38℃ or higher)
• sudden weight loss
• nutritional deficiencies, such as iron or zinc deficiency
• some health conditions, such as hypothyroidism (underactive thyroid) or kidney failure

Sometimes, there is no clear cause of telogen effluvium.

Traction alopecia

Traction alopecia is a type of hair loss caused by repeated pulling on your hair. This pulling can damage your hair follicles and lead to thinning hair or hair loss. Traction alopecia can be caused by some hairstyles such as tight ponytails or hair extensions.

Traction alopecia is different to trichotillomania — this is a condition where you have a strong urge to pull out your hair.

Other causes

Other possible causes of alopecia include:

• medicines, such as cancer treatments
• stressful life events, such as surgery or trauma
• infections, such as tinea

It’s normal to lose hair every day — you may see hairs in your hairbrush or when you wash your hair.

If you think you are losing more hair than usual, or if your hair is falling out in clumps, talk with your doctor.

Often your doctor can diagnose alopecia by asking about your symptoms and examining you.

Your doctor might also:

• take a biopsy (small sample) of your skin or hair to examine more closely
• refer you for blood tests to check for health conditions that may cause hair loss
• refer you to a dermatologist (a doctor who specialises in skin conditions) to help diagnose the cause of alopecia 

Treatment of alopecia depends on the cause. If you have an underlying infection or health condition, treating it may reduce hair loss.

If you are experiencing telogen effluvium, the hair loss will often stop after the underlying trigger goes away. Psychological support can help you identify and manage triggers of hair loss.

Medicines for treatment of alopecia in males

In some cases, medicines can help to slow your hair loss and encourage hair regrowth. Medicines used to treat alopecia in males include:

• minoxidil to encourage hair growth
• finasteride to manage hormones that can cause hair loss
• steroid creams and lotions
• steroid injections

Medicines for treatment of alopecia in females

Some medicines can help treat alopecia in females, including:

• minoxidil to increase hair growth
• anti-androgen tablets, such as spironolactone — these help to reduce the effects of hormones that can cause hair loss

Some medicines, such as minoxidil and spironolactone, are not suitable for use during pregnancy. If you are pregnant or planning to become pregnant, talk to your doctor before taking any medicines for hair loss.

Other treatments for alopecia

In some cases, you can have a hair transplant to help treat alopecia. A hair transplant is a surgery that takes hair follicles from part of your scalp with healthy hair growth and moves them to areas affected by alopecia. A hair transplant is not suitable for all types of alopecia — talk with your doctor or dermatologist about whether this option might suit you.

Many over-the-counter products and supplements are marketed for hair growth. However, there is limited evidence that these products can treat alopecia. Talk to your doctor or pharmacist before starting any supplements or treatments for hair loss.

Sometimes, treatment for hair loss doesn't work. For many people, hair loss can be distressing and affects their self-esteem or mental health. It may help to see a psychologist or to join a support group — they can provide strategies to manage the emotional impact of hair loss.

You might find it helpful to take steps to mask your hair loss, such as:

• wearing a scarf or hat to cover your scalp
• shaving the remaining hair on your head
• using hair products to add volume to your hair

You may choose to wear a wig to help you feel more comfortable with hair loss. There are many types of realistic wigs available. Some private health insurance policies help cover the cost of a wig or hairpiece if you have a referral from your doctor.

If you have hair loss and your scalp is more exposed, you will need to protect your head from sun damage. Wear a hat or a scarf when you are outdoors to help protect your skin.

People with alopecia have a higher chance of experiencing mental health disorders. If you are finding it difficult to cope with hair loss, speak with your doctor or a mental health professional.

If you are finding it difficult to accept your hair loss, remember that you are not alone. There is help and advice available:

• The Australia Alopecia Areata Foundation (Opens in new tab) provides helpful information as well as support groups (Opens in new tab).
• Beyond Blue (Opens in new tab) can help if you feel anxious or depressed. Call 1300 224 636.

For more information on male hair loss (Opens in new tab), visit the Healthy Male (Opens in new tab) page.

The Jean Haile for Women's Health (Opens in new tab) page discusses the possible causes and treatment of hair loss.