The Ultimate Guide to Common Types of Hair Loss

Let’s talk about hair loss (otherwise known as alopecia!). We all know by now that alopecia is a generic umbrella title for hair loss. The truth is, there are many different types of hair loss but they fall into two main categories. These two main categories are scarring hair loss and non-scarring hair loss. As I am sure you can imagine if you are going to have any type of hair loss you want a type that is non-scarring. So what do you say we finally break down the common types of hair loss once and for all?

All of the information in this article was gathered from UpToDate and from my own experience treating hair loss.

COMMON TYPES OF SCARRING HAIR LOSS

Discoid lupus erythematosus

This type of hair loss occurs more commonly in young adulthood and is more common in females. While having a history of lupus may clue you into this disease it can also occur independently. There are generally red plaques and discoloration associated with this disease process.

Lichen planopilaris (LPP)

LPP occurs most commonly with an associated symptom such as itching or tenderness. Some patients will describe a “creepy crawly” sensation like there’s something crawling on their scalp. (This is not to be confused with delusions of parasitosis where people actually believe there are bugs infesting their scalp and other parts of the body). You will see this more commonly in White and East Indian females.

Frontal fibrosing alopecia

I almost only see this condition in older women, generally those that are postmenopausal. It appears as if they have a receding hairline. There may be some associated erythema around the few hair follicles remaining. In more progressed conditions, the frontal scalp will be completely smooth and devoid of hair follicles.

Central centrifugal cicatricial alopecia (CCCA)

This type of hair loss is more common in Black females although I have also seen it in Black males. It typically presents as a patch of hair loss on the crown of the scalp that is enlarging over time. I find that a lot of my patients with biopsy-proven CCCA have a history of using certain hair care practices such as hot combs, chemical relaxers, or tight braids. However, there is not enough scientific-backed research to prove these hair care practices can cause CCCA. There may be a genetic component and possible autoimmune component as well.

Dissecting cellulitis of the scalp

This type of hair loss will appear in addition to acne-like bumps, abscesses, and keloidal scarring of the scalp. It is most common in young Black males. It may be associated with an autoimmune condition known as hidradenitis suppurativa which is when people develop recurrent abscesses commonly in areas of skin folds.

COMMON TYPES OF NON-SCARRING HAIR LOSS

Alopecia areata (AA)

AA will appear as your classic smooth circular patches of hair loss. Other times it may progress to alopecia totalis, which is when the entire scalp loses hair, or even more uncommonly alopecia universalis when all body hair is lost. This typically presents most commonly in childhood or young adulthood. However, I have seen it in all age groups. Hair pull test: positive.

Traction alopecia

Traction alopecia is when someone uses a tight braiding or tight ponytail hairstyle repeatedly over a long period of time. Anything that is causing traction can lead to this type of hair loss. The hair follicles are damaged over time. Hair pull test: normal or positive

Male pattern hair loss (androgenetic alopecia in men)

This is most common in adult or elderly men however younger men with a strong family history may start to experience this in their early 20s. It starts off subtly and continues to progress over time. Your classic areas that experience hair loss are the frontal, temporal, or vertex of the scalp. Hair pull test: normal

Female pattern hair loss

Similar to male pattern hair loss, female pattern hair loss is more common in adult females and will progressively worsen over time. Most often you will notice thinning on the crown of the scalp. Hormones can play a part in this type of hair loss. Hair pull test: normal

Telogen effluvium

I see a lot of women with this condition. It is a type of stress-related hair loss that typically occurs 3-4 months following a stressful event. These events could be anything that causes a lot of stress on the body such as: giving birth, a car accident, bad illness, hospitalization, death in the family, job loss, etc. Women will experience a sudden increase in hair shedding. Fortunately, it should resolve itself after 1-2 years. Hair pull test: positive.

FINAL THOUGHTS

The types of hair loss outlined in this article aren’t the ONLY ones out there. A dermatology medical provider can help you determine which type of hair loss you are experiencing. Sometimes that requires additional testing such as with a scalp biopsy and/or blood work. Once the specific type of hair loss is determined, treatment plans can be better individualized. Hair regrowth can be a lengthy process. On average hair only grows half an inch per month! I find that before and after photos are a great addition to clinical follow-ups, to help determine if a treatment is working or not. Have you experienced any of these forms of hair loss? Did you find a treatment plan that worked for you? If so, comment below and let us know what it was!

*Disclaimer: Opinions expressed are solely my own and do not express the views or opinions of my employer. Information on this website is for education and entertainment purposes only. Content is my opinion. It is not substituted for your own doctor’s medical care or advice. One should not make any health or medical-related decisions based in whole or in part on any content on this site. Content is not intended to replace the services of a licensed, trained health professional. Content may not apply to you as an individual. Although I will update my website with current information, this website is not a definitive guide to dermatology.