Hair Loss (cont.)
Nili N. Alai, MD, FAAD
Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
Alan Rockoff, MD
Dr. Rockoff received his undergraduate degree from Yeshiva College with the distinction of Summa Cum Laude. He received his medical degree from the Albert Einstein College of Medicine. His internship and two years of Pediatric residency were at the Bronx Municipal Hospital Center, followed by training in Dermatology at the combined residency program at Tufts and Boston Universities. Dr. Rockoff is certified by both the American Board of Dermatology and the American Board of Pediatrics.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What are causes of hair loss?
- How is hair loss classified?
- What is alopecia areata?
- What is traction alopecia?
- What is trichotillomania?
- What is tinea capitis?
- What is generalized (diffuse) hair loss?
- What is telogen effluvium?
- What is androgenetic alopecia ("male-pattern baldness," "female-pattern baldness")?
- What treatment is there for hair loss in men?
- What other options do I have for hair loss?
- Is hair loss in women different than men?
- What about pregnancy hair loss?
- What specific treatments are there for hair loss in women?
- What vitamins are good for hair loss?
- Can itchy scalp cause hair loss?
- How do I prevent hair loss?
- Hair Loss At A Glance
- View Hair Loss Pictures - Slideshow
- Hair and Scalp Pictures - Slideshow
- Take the Hair Loss Quiz!
- Hair Loss FAQs
- Find a local Dermatologist in your town
How is hair loss classified?
There are numerous ways to classify hair loss. One useful way has been to classify hair loss by whether the loss is localized (small area) and patchy or whether it affects large areas or the whole scalp (diffuse). Other medical classifications for hair loss include scarring versus non-scarring hair loss and are beyond the scope of this article.
Patchy hair loss
Some conditions produce small areas of hair loss, while others affect large areas of the scalp. Common causes of patchy hair loss are
- alopecia areata (small circular or coin size patches of scalp baldness that usually grow back within months),
- traction alopecia (thinning from tight braids or ponytails),
- trichotillomania (the habit of twisting or pulling hair out),
- and tinea capitis (fungal infection).
What is alopecia areata?
A common condition, alopecia areata usually starts as a single quarter-sized
circle of perfectly smooth baldness. Alopecia patches usually regrow in three to
six months without treatment. Sometimes, hair grows back in white. In another
variant, alopecia can produce two or three bald patches. When these grow back,
they may be replaced by others. The most extensive form is called alopecia
totalis, in which the entire scalp goes bald. It's important to emphasize that
patients who have localized hair loss generally don't go on to lose hair all
over the scalp. Alopecia can affect hair on other parts of the body,
Alopecia areata is generally considered an autoimmune condition, in which the body attacks itself (in this case its own hair follicles). Most alopecia patients, however, do not have systemic problems and need no medical tests. While alopecia areata has frequently been blamed on "stress," in fact, it may be the other way around; that is, having alopecia may cause stress.
Treatments for alopecia areata include injecting small amounts of steroids like triamcinolone into affected patches to stimulate hair growth. Although localized injections may not be practical for large areas, often this is a very effective treatment in helping the hairs return sooner. Other treatments such as oral steroids, immunosuppressives, or ultraviolet light therapy are available for more widespread or severe cases but may be impractical for some because of potential side effects or risks. In most mild cases, patients can easily cover up or comb over the affected areas. In more severe and chronic cases, some patients wear hairpieces; nowadays, some men shave their whole scalp now that this look has become fashionable.
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