The term “alopecia” is from the ancient Greek
word for “fox” and was coined by Hippocrates ca.
400 BC to describe the pattern of hair loss seen on men’s
heads, which was similar to that on foxes’ coats. Today,
the term alopecia essentially means baldness, and the many
types of alopecia are differentiated by their cause and/or
appearance.
| Alopecia folliculitis |
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An inflammatory reaction also known as “acne
devalcans,” this form of alopecia results in erythema
( redness ) and pustules on the scalp. It can lead to
scarring and may result in permanent hair loss. Treatment
with antibiotics has been shown to be successful.
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| Aplasia cutis congenital |
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Also called “ACC,” this congenital condition
is characterized by areas of the scalp on which skin is
absent, leading to non-inflamed lesions that may heal
and scar before birth or remain eroded or ulcerated. Smaller
defects heal with time and form a hairless scar; surgical
repair of multiple defects is common.
|
| Cicatricial alopecia |
|
Also called “scarring alopecia”, this condition
is caused by physical damage to the skin and hair follicles.
Causes include fungal
infections, discoid
lupus erythematosus ( DLE ), and physical injury due
to burns, abrasions or frostbite. Skin cancer that destroys
hair follicles also causes cicatricial alopecia. |
| Congenital triangular alopecia |
|
Of unknown origin, this type of alopecia first appears
in children from birth to age several years as a triangular
patch of hair loss at the temples caused by incomplete
embryonic skin differentiation. It does not progress,
and treatment consists of follicular grafting to the
affected region.
|
| Follicular degeneration |
|
A form of cicatricial alopecia. |
| Hemochromatosis |
|
People with hemochromatosis have a gene that prevents
normal breakdown of iron in the body, leading to unnaturally
high iron levels that in turn can cause hair loss. Treatment
consists of periodic phlebotomy ( blood-letting ), diet
modification, and monitoring for complications of iron
overload.
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| Loose anagen hair syndrome |
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Anagen is the growing phase of the hair life-cycle,
and at any time about 90% of scalp hairs are in this phase. People affected by this condition easily lose
hair even with mild tugging on the hairshaft caused by brushing. Some studies have shown improvement when
this condition is treated with 5% minoxidil ( see Rogaine ).
|
| Syphilitic alopecia |
|
This kind of alopecia is associated with secondary
syphilis, a sexually transmitted bacterial infection
that can cause hair loss up to two years after infection,
presenting in small, patchy areas. Diagnosis is made
with blood tests, and penicillin is used to treat the
condition.
|
| Stress alopecia |
|
As the name suggests, this form of alopecia is caused
by psychological stress or anxiety. It is considered a
form of telogen effluvium,
and causes anagen-phase
hairs to convert prematurely into telogen-phase
hairs, which leads to hair shedding. Minimizing the source
of stress often eventually results in hair regrowth.
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| Surgery-induced alopecia |
|
Permanent hair loss may occur at the site of surgical
incision and can develop extensively following some forms
of plastic surgery. Surgery that involves significant
blood loss can cause telogen effluvium,
another form of hair loss.
|
| Toxic alopecia |
|
A form of anagen effluvium,
toxic alopecia refers to hair loss resulting from ingestion
of toxic substances or drugs such as anti-cancer agents;
exposure to ionizing radiation; or overdoses of Vitamin
A. Like telogen effluvium,
anagen effluvium is often self-correcting within a few
months.
|
| Traction alopecia |
|
Pulling a hair out by the follicle causes traction alopecia
or temporary hair loss lasting several months. Stressful
hair-styling methods ( e.g., hair weaving, tight ponytails
or braids ) may cause this result. On a more positive
note, hair waxing and plucking also lead to traction alopecia,
and regrown hair repeatedly pulled, plucked or waxed eventually
stop growing.
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| Trichotillomania |
|
This condition promotes hair loss through self-inflicted,
compulsive plucking or pulling out of the hair on the
head, eyebrows or lashes. It is fairly common, affecting
up to 2% of the population and may be successfully treated
with tricyclic antidepressants or selective serotonin
reuptake inhibitors ( SSRIs ).
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