As part of a healthy hair cycle, we would expect to lose between 50-100 hairs every day, depending on our brushing and washing regime. These hairs are normally automatically replaced but when the rate of shedding outweighs the number of hairs growing back then this can result in overall hair loss.
There are many different types of hair loss depending on the presentation of how shedding occurs and the underlying factors.
Common types of hair loss and their causes
- Male pattern hair loss (MPHL) or androgenetic alopecia. This is the most common form of male hair loss affecting approximately 50% of men aged over 50. It is caused by an excess of testosterone which is a type of androgen, a male sex hormone. There is no cure but it usually progresses very slowly. Hair is lost from the top of the head with a receding frontal hairline.
- Female pattern hair loss (FPHL) or androgenetic alopecia. This is the most common form of hair loss in women caused by both genetic and/or hormonal imbalances. Again, this is due to the effects of the male hormone testosterone which is present in females too. The onset is usually from age 50 onwards although it can start earlier for some women. There is widespread thinning of the hair on the crown of the scalp with the frontal hairline remaining unaffected. Progression is usually slow but with no cure.
- Frontal fibrosing alopecia (FFA). This is a type of scarring hair loss which mainly affects the hair margin at the front of the scalp but also sometimes with loss of hair from the scalp near the ears and eyebrows. It can affect anyone but is more common in post-menopausal women, thought possibly due to hormones and an overactive immune system which attacks the hair follicles.
- Alopecia areata. This is a non-scarring type of hair loss which can develop in anyone at any age, with 20% of sufferers having a family history of the condition. Alopecia areata mostly presents as small, round, coin-sized patches of hair loss on the scalp but other areas can be affected including the beard, eyelashes, eyebrows, rest of body and limbs. Hair may regrow but, depending on the severity, this is not guaranteed. It is often associated with inflammation and an overactive immune system
- Traction alopecia. This is a type of hair loss resulting from constant pulling, typically seen when hair is regularly pulled tight in hairstyles such as ponytails, with hair extensions or attachment of weaves and dreadlocks. The repeated pulling of hairs results in damage and the development of bald patches. It can be reversed with healthy hair regrowth if the pulling has only been short-term and damage isn’t too severe.
- Chronic telogen effluvium. This is a loss of hair from all over the scalp with a gradual thinning and loss of hair volume over time. Sufferers start to notice that they are losing more hair than usual when washing or brushing their hair and it can be seen on the pillow, in the shower or on a hairbrush or comb. Hair loss can be very sudden with the onset being up to three months after the trigger. It may be related to chronic illness, trauma or stress, marked weight loss, skin disorders, hormone imbalance, childbirth or perhaps medication-related. Some people will never know the exact cause of their hair loss.
Whilst all of these types of hair loss are different in their presentation and underlying factors, they can all be extremely distressing and upsetting for the individual concerned. If you are worried about your hair loss, you can seek help and support from your GP who may refer you to a local Dermatologist.