Alopecia

Specialty of Dermatology

What is alopecia?

Alopecia is the medical term for hair loss. It is an umbrella term which includes many different types which each have their own causes and treatments. Types of alopecia include male and female pattern baldness, scarring alopecia, alopecia areata, anagen effluvium, telogen effluvium, alopecia totalis, alopecia universalis, alopecia barbae, androgenetic alopecia and traction alopecia. Male pattern baldness is the most common form of alopecia; it affects around half of all men by the age of fifty, though many will have experienced hair loss to some extent by their early thirties.

What causes alopecia?

It generally starts with the hairline receding, followed by the thinning of the hair on the crown and temples. Alopecia is often hereditary. Female pattern baldness can also occur, though it is not as common and, in general, hair only thins on top of the head. There are numerous other causes of hair loss including problems with the immune system (such as hyperthyroidism and diabetes), skin conditions which can destroy hair follicles (such as lupus), chemotherapy and radiotherapy, hormonal changes, emotional stress, intense physical stress (such as childbirth), changes in diet and long-term illnesses (such as cancer). The position and the extent of hair loss also varies greatly and will depend on the type of alopecia and its cause. It may affect only the scalp, or the entire body. Hair may grow back after a short period of time, or it may never.

How is it treated?

Hair loss doesn’t necessarily need treating as it does not pose a health risk. However, it can cause distress and it can be difficult to come to terms with as it is considered to be an important part of overall identity. People may be unhappy with their physical appearance which can sometimes lead to depression. There are a number of tests which are used to diagnose alopecia including a scalp biopsy, the pluck test, the pull test and trichoscopy. In some cases, those affected may choose to wear a wig as a day-to-day solution. Other solutions will depend on the type of alopecia the patient has. 

Minoxidil or finasteride can be used to treat male pattern baldness, alopecia aleata is usually treated using steroids, and there are surgical options such as hair transplants and hair implants. Therapy and support may also be key in providing those affected with long-term coping strategies. Some people embrace their baldness by shaving off their remaining hair.

What type of specialist treats alopecia?

Generally, the specialist who treats alopecia is a dermatologist. However, if surgery is the decided course of treatment, a specialist hair transplant surgeon or plastic surgeon would be consulted. 

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