Alopecia (hair loss)

What causes alopecia?

Alopecia can occur on its own, or alongside another health condition. It may also be temporary, lasting only a short while, or more permanent, meaning it doesn't go away on its own.

Temporary causes of alopecia include:

• telogen effluvium: a sudden increase in hair shedding
• alopecia areata: a common type of hair loss
• certain medications, including cancer treatments

More permanent causes of alopecia include:

• male pattern or female pattern hair loss
• injury to the scalp
• certain diseases that cause inflammation of the hair follicle, such as frontal fibrosing alopecia
• severe infection

Some examples of alopecia

There are several different types of alopecia. A few of the more common ones are explained below.

Alopecia areata

Alopecia areata is a common type of hair loss that can affect a person at any age.

It usually shows up as small, round bald patches on the scalp, though it can also affect the eyebrows and eyelashes. In some people, it spreads to cover the whole scalp, or even the entire scalp and body.

It's difficult to predict how much hair will be lost, or how quickly, if at all, it will grow back. There is also a chance that new patches of hair loss may appear later on.

Sometimes hair grows back white, and in some patches it may not grow back at all. Generally, the larger the area affected, the lower the chance of the hair growing back completely.

The exact cause of alopecia areata isn't fully understood, but it's believed to be an autoimmune condition, meaning the body's immune system mistakenly attacks its own hair follicles.

Telogen effluvium

Telogen effluvium refers to a sudden increase in hair shedding, and it's one of the more common causes of temporary hair loss.

It can be triggered by:

• illness
• stress
• a lack of certain nutrients, such as iron
• childbirth
• thyroid problems, whether the thyroid is underactive or overactive

Male and female pattern hair loss

Male pattern hair loss causes thinning or baldness in adult men, usually starting with a receding hairline and thinning at the top of the head.

Female pattern hair loss usually appears as thinning hair at the top of the head in adult women.

Both types are generally the result of a combination of hormonal and genetic factors.

Scarring alopecia

Scarring alopecia covers several different conditions that all lead to permanent hair loss.

One example is frontal fibrosing alopecia, a type of scarring alopecia that affects the hairline, causing it to gradually recede.

When to see a doctor

It's a good idea to visit your nearest doctor or health centre if you're worried about hair loss that seems unusual, sudden, or unexpected.

You should talk to your GP practice if hair loss is worrying you. They will usually ask about it and examine your hair to help work out the cause, and sometimes a blood test is needed as well.

Your GP practice may refer you to your local dermatology department, usually if they are unsure what is causing your alopecia or feel you would benefit from further help.

How alopecia is treated depends on what is causing it. Some hair loss doesn't need treatment, since it may be temporary and grow back on its own, or simply a normal part of getting older.

If treatment is needed, options can include steroid creams, steroid injections, or immunosuppressant treatments (medications that adjust or suppress the immune system).

These treatments don't always work fully, and they don't help everyone. Before visiting a private hair clinic, it's best to talk to your GP first, as they can discuss the treatment options most suitable for you.

If you have alopecia, you don't have to manage it alone. Support and helpful information are available to you.

Wigs

Wearing a wig or hairpiece can help you feel more confident while you wait for your hair to grow back. It can also help if your hair loss turns out to be permanent.

There are different types of wigs to choose from, including synthetic wigs and real-hair wigs.

Synthetic wigs:

• need to be replaced more often than real-hair wigs, usually lasting 6 to 9 months
• are easy to wash and maintain
• cost less than real-hair wigs
• can sometimes feel uncomfortable, itchy or hot to wear

Real-hair wigs:

• last longer than synthetic wigs, usually 3 to 4 years
• take more effort to maintain than synthetic wigs
• look more natural than synthetic wigs
• cost more than synthetic wigs

Alopecia UK has more information on wigs if you would like to read further.

Your mental health and wellbeing

Alopecia itself is not a serious threat to your health, but that does not make it easy to live with. It can be distressing and can affect your quality of life, and for some people this brings on feelings of anxiety or depression.

If you notice your mental health or wellbeing being affected, talk to your doctor. They may be able to point you toward the right support, such as local counselling services.

You can also seek out further mental health and wellbeing support on your own.

Alopecia support groups

Many people find it helpful to join a support group for those living with alopecia, or simply to talk with others who understand what you are going through.

Alopecia UK runs support groups for adults affected by alopecia. You can look for an alopecia support group near you.

When reaching out for support, avoid sharing personal information such as your name, location or details of your health conditions.