Alopecia (Hair loss)

Alopecia is the medical term for hair loss. There are different types of alopecia. Some types can cause you to lose hair from a single area. Other types can cause hair loss from several areas of your head, face or body.

Common types of alopecia include:

• male pattern hair loss
• female pattern hair loss
• alopecia areata
• telogen effluvium

There are many causes of hair loss, including:

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

Androgenetic alopecia

Androgenetic alopecia is the name for both male pattern hair loss and female pattern hair loss. It is usually genetic and you may inherit it from one or both of your parents. It is caused by the effects of androgens (male hormones) on your hair follicles. Most of the time, hormone levels are normal, but your hair follicles are more sensitive to their effects.

Alopecia areata

Alopecia areata is an autoimmune disease that occurs when your immune system attacks the hair follicles on your head and body. It's not exactly clear what causes this, but it's thought to be related to a combination of genetics and environmental factors. In some people it might be triggered by extreme stress or anxiety.

Telogen effluvium

Telogen effluvium is when a shock to your body stops your hair growing temporarily. This can continue for a few months, and during this time more of your old hairs fall out than usual. Because it takes time for new hairs to grow, this causes temporary hair thinning or baldness. You may only notice the hair loss a few months after the trigger itself.

Triggers that can cause this can be physical or psychological. Sometimes, it isn't clear what triggered the condition.

Psychological triggers include:

• trauma
• grief
• major life changes
• stress

Physical triggers include:

• childbirth
• prolonged high fever
• surgery or physical trauma
• sudden weight loss
• nutritional deficiencies such as iron or zinc deficiency
• health conditions such as hypothyroidism or lupus
• starting or stopping some medicines

Other causes

Other causes of hair loss include:

• medicines such as cancer treatments
• infections such as tinea
• skin diseases such as psoriasis
• pulling out your hair, which may be due to a mental health condition
• chemicals, bleach, heat from a hair dryer or brushing your hair too much
• traction alopecia — if your hair is under tension in a tight hairstyle

Alopecia areata

Alopecia areata usually leads to one or more circular patches of hair loss, usually on your head. Bald patches can get bigger quickly. The skin in these patches looks normal and smooth. You may have some white or broken hairs in the bald patches.

Some people notice an itchy or burning feeling in the area, but most people don't notice any symptoms. You might have tiny pits in your nails.

The hair usually grows back, but it can take several months or even years. Sometimes your hair will fall out again and then grow back again. In some people, it may never grow back.

Occasionally, alopecia areata can be much more widespread.

• Alopecia totalis is when all the hair on your head falls out.
• Alopecia universalis is when all your hair falls out — on your head, face and body. If hair loss is very extensive, it's less likely that hair will grow back.

Alopecia areata is not life-threatening and does not cause pain, but it can cause distress due to the cosmetic effects.

Scarring alopecia

Some health conditions cause a form of alopecia where the hair follicle is destroyed and replaced with scar tissue. Skin in the bald patches may look red, swollen, scaly or blistered. If it's not treated early, it can lead to permanent scarring of the skin.

Talk to your doctor if you're worried about hair loss. Your doctor might refer you to a dermatologist. Often, they can diagnose what is causing your hair loss by asking about your symptoms and examining you.

If they are unsure about what's causing your hair loss, they might take a sample (biopsy) of skin or hair to examine more closely. Your doctor might refer you for blood tests to rule out possible health conditions that may lead to hair loss.

It is normal to lose around 100 hairs a day — you may see hairs in your brush or when you wash your hair.

If you think you are losing a lot more hair than usual or that it is falling out in clumps, you should talk to your doctor.

Treatment of alopecia depends on the cause. If you have an underlying infection or health condition, treating it may reduce hair loss. If it's caused by a medicine, you may be able to stop taking it.

If you have androgenetic alopecia, you can take medicines to slow down hair loss and potentially help hair regrowth. Medical treatments for females include minoxidil for your scalp or anti-androgen tablets such as spironolactone or cyproterone acetate. Treatments for males include minoxidil to stimulate hair growth or finasteride for reducing hormone levels.

If you are pregnant or planning to become pregnant, it is important to talk to your doctor, as some of these treatments are not recommended during pregnancy.

There is currently no cure or prevention for alopecia areata, but there are treatments that might help, such as:

• strong steroid creams or lotions
• steroid injections into the bald patch
• topical medicines prescribed by a specialist dermatologist
• ultraviolet (UV) phototherapy
• medicines to suppress your immune system (in severe cases)

If you have smaller patches of alopecia areata that are likely to grow back, you might choose not to have any treatment.

If you are experiencing telogen effluvium, it is likely that the hair loss will stop after the trigger is managed. It may be helpful to get psychological support.

Sometimes, treatment for hair loss doesn't work. You may need to learn to accept your hair loss. For many people, hair loss can be distressing and affects their self-image, self-esteem or mental health. You might find it helpful to see a psychologist for counselling or to join a support group.

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

• wearing a wig, scarf or hat to cover your scalp
• shaving the remaining hair on your head
• using hair products to add volume to your hair or getting eyebrow tattoos
• hair transplant surgery

You may choose to wear a wig to help you feel more comfortable with hair loss. There are many types of realistic wigs available. You may be able to get assistance with the cost of your wig or hairpiece if you have a referral from your doctor. Many state disability organisations and private health insurance funds provide coverage.

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

• The Australia Alopecia Areata Foundation (Opens in new tab) provides helpful information as well as support groups.
• Beyond Blue (Opens in new tab) can help you if you feel anxious or depressed. Call 1300 22 4636 anytime.

For more information on how to get a wig and financial assistance, visit the Australia Alopecia Areata Foundation Wigs page and download the Wigs document (Opens in new tab).

For more information on wigs for children with alopecia, visit the Variety Wig Grant (Opens in new tab) Info Sheet (Opens in new tab).