Hair loss 

Introduction 

Alopecia

Alopecia affects hair growth and can lead to permanent hair loss. A dermatologist explains the causes, progression of the condition and treatment options.

Media last reviewed: 19/03/2013

Next review due: 19/03/2015

Who is affected?

Male-pattern baldness is more common than female-pattern baldness, affecting around half of all men by 50 years of age.

Female-pattern baldness becomes more common in women after the menopause (when a woman's periods stop at around age 52).

Alopecia areata can occur at any age, although it is more common in people aged 15-29. It affects one or two people in every 1,000 in the UK.

Scarring alopecia occurs in both males and females, but is less common in children than adults. It accounts for about 7% of hair loss cases.

Anagen effluvium affects most people who have chemotherapy to some degree.

Male-pattern baldness

Read about male-pattern baldness, the most common type of hair loss, which affects 6.5 million men in the UK

Alopecia is the general medical term for hair loss.

Types of hair loss

There are many types of hair loss with different symptoms and causes. Some of the more common types of hair loss are described below.

Male- and female-pattern baldness

Male-pattern baldness is the most common type of hair loss. As well as affecting men, it can sometimes affect women (female-pattern baldness). It can be particularly difficult for both men and women to cope with.

Male-pattern baldness follows a pattern of a receding hairline, followed by thinning of the hair on the crown and temples. During female-pattern baldness, hair usually only thins on top of the head.

Male- and female-pattern baldness is also called androgenic or androgenetic alopecia. Male-pattern baldness is a condition that runs in families, but it is not clear if this is the case with female-pattern baldness.

Alopecia areata

Alopecia areata is patches of baldness that may come and go. It can occur at any age, but mostly affects teenagers and young adults. Six out of 10 people affected develop their first bald patch before they are 20 years old.

Alopecia areata is thought to be caused by a problem with the immune system (the body's natural defence against infection and illness). It is also believed that some people's genes make them more susceptible to alopecia areata, as one in five people with the condition have a family history of the condition. In many cases the hair grows back after about a year.

Scarring alopecia

Scarring alopecia, also known as cicatricial alopecia, is hair loss that can occur as a result of complications from another condition. In this type of alopecia, the hair follicle (the small hole in your skin that an individual hair grows out of) is completely destroyed. This means your hair will not grow back.

Conditions that can cause scarring alopecia include lichen planus (an itchy rash affecting many areas of the body) and discoid lupus (a mild form of lupus affecting the skin, causing scaly marks and hair loss).

Anagen effluvium

Anagen effluvium is widespread hair loss that can affect your scalp, face and body. One of the most common causes of this type of hair loss is the cancer treatment chemotherapy.

It may be possible to reduce hair loss from chemotherapy by wearing a special cap that keeps the scalp cool. However, scalp cooling is not always effective and not widely available.

In most cases, hair loss in anagen effluvium is temporary. Your hair should start to grow back a few months after chemotherapy has stopped.

Telogen effluvium

Telogen effluvium is a common type of alopecia where there is widespread thinning of the hair, rather than specific bald patches. Hair is shed from the scalp, usually as a reaction to stress or medication. This type of hair loss tends to improve without treatment after a few months.

Read more about the symptoms of hair loss and the causes of hair loss.

How is hair loss treated?

More common types of hair loss, such as male-pattern baldness, do not need treatment because they are a natural part of ageing and do not pose a risk to your health.

However, any type of hair loss can be distressing, so you should see your GP if you are worried about it.

Your GP should be able to diagnose your type of hair loss by examining your hair, and they can also discuss possible treatments with you. It is advisable to visit your GP before you try a private consultant dermatologist (skin care specialist).

If you wish to seek treatment for male-pattern baldness for cosmetic reasons, two medications called finasteride and minoxidil can be used. Minoxidil can also be used to treat female-pattern baldness.

However, these treatments are not effective for everyone and only work for as long as they are continued. These treatments are also not available on the NHS and can be expensive.

Alopecia areata is usually treated with steroid injections, although it is sometimes possible to use a steroid cream, gel or ointment. A treatment called immunotherapy may also be used. This involves stimulating hair growth by causing an intentional allergic reaction in the affected areas of skin.

If you have significant hair loss of any type, you may decide to wear a wig. Wigs are available on the NHS, but you may have to pay for one unless you qualify for help with charges.

There are also some surgical options for hair loss, including a hair transplant and artificial hair implants.

Read more about diagnosing hair loss and treating hair loss.

Emotional issues

Hair loss can be difficult to come to terms with. The hair on your head can be a defining part of your identity. It reflects the image you have of yourself and how you want others to see you.

If you start to lose your hair, it can feel as if you are losing part of your identity. This can affect your self-confidence and sometimes lead to depression.

Speak to your GP if you are finding it difficult to deal with your hair loss. They may suggest counselling, which is a type of talking therapy where you can discuss your issues with a trained therapist.

You may benefit from joining a support group or speaking to other people in the same situation – for example, through online forums.

A number of charities, such as Alopecia UK, have support groups and online forums where you can talk to others who are experiencing hair loss.

Page last reviewed: 12/11/2012

Next review due: 12/11/2014

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Comments

The 3 comments posted are personal views. Any information they give has not been checked and may not be accurate.

betula said on 26 June 2014

I saw my GP about my thinning hair. She was very sympathetic and I had blood tests to assess my iron levels and thyroid function. They were normal which was a great relief but at the same time I do not have a reason for the thinning of my hair. This is stressful in itself. Could it be genetic? I feel that it may cost the NHS too much to arrange for hormone tests for me for such a condition as hair thinning as it seems less serious than many other conditions that people suffer. However, hair thinning can cause alot of distress. In my case, I do not want to go out.
I am thinking about seeing a private consultant. It would be very useful to have further resources on this page such as contact details for NHS consultants offering private appointments.

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shanodin said on 14 May 2013

I have a friend who suffered with alopecia since she was a teenager. She found it so difficult especially when it came to going out, school prom, that kind of thing, because there is so little awareness of this and it's hard to get a suitable wig when you're a teenager. Eventually she found a wig provider who actually seemed to understand and care about how my friend was coping with her condition Getting a wig has really helped her. I know some people aren't keen on wigs but I definitely think they are a great product if you have permanent hair loss because my friend was like a new person, so much more confident and happy. It made her much more capable of going to university as well because she was so nervous before, but with the wig she became a lot more social. Definitely try out a wig for alopecia or other permanent hair loss :)

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Sammy77 said on 18 September 2011

I've had my hair thinning for the last 4 years and my hair is finally starting to thicken up again but slowly and I'm not sure if I'll ever get back what I've lost. I wanted to help anyone else out there who is searching for something to help cover up loss while waiting for medical treatment to work. I was recommended a cosmetic product called Nanogen by a friend. It is a powder you can get from Boots that instantly covers up any thin areas. It does grow back your hair but it looks a million dollars in a flash. It has been a lifesaver at work and at family functions.

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