Hair loss

Understanding Hair Loss: Types, Clinical Features, and Treatments

 

Hair loss (alopecia) can be classified into several types, each with distinct clinical, histological, and dermatoscopic features.

 

Here’s an overview of the most common forms of hair loss and their treatment options.

 

1. Androgenetic Alopecia (AGA)

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Also known as male or female pattern baldness, AGA presents as progressive thinning and loss of hair in a characteristic pattern—receding hairline and vertex in men, and central scalp thinning in women.

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Treatment: Includes topical minoxidil and oral finasteride. Platelet-rich plasma (PRP) therapy, hair transplants, and low-level laser therapy (LLLT) are emerging treatments.

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2. Alopecia Areata (AA)

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Presents as sudden, patchy hair loss, usually in round or oval patches on the scalp or body. It can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis).

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Treatment: Intralesional corticosteroids, topical immunotherapy (e.g., diphenylcyclopropenone), and JAK inhibitors in severe cases. Minoxidil may also be used.

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3. Telogen Effluvium (TE)

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Diffuse hair shedding often triggered by stress, illness, hormonal changes, or medications. It is usually reversible once the trigger is addressed.

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Treatment: Addressing the underlying cause (e.g., stress management, treating nutritional deficiencies). In some cases, minoxidil can be used to stimulate regrowth.

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4. Traction Alopecia

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Clinical Features: Hair loss due to prolonged mechanical stress, often caused by tight hairstyles (e.g., braids, weaves). It commonly affects the frontal and temporal scalp.

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Treatment: Cessation of traction-causing hairstyles is key. Early intervention can lead to regrowth, but permanent scarring may occur in advanced stages. Topical minoxidil and corticosteroids may aid in regrowth.

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5. Cicatricial (Scarring) Alopecia

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A group of disorders where hair loss is due to irreversible damage to hair follicles. Examples include lichen planopilaris and frontal fibrosing alopecia. It presents with smooth, shiny patches where hair has been permanently lost.

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Treatment: Depends on the cause and includes anti-inflammatory agents like oral hydroxychloroquine, corticosteroids, and immunosuppressants. Early diagnosis is crucial to prevent further follicular destruction.

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Each form of hair loss requires a tailored approach based on its clinical and histological presentation. Early diagnosis and treatment are critical to managing progression and maximizing regrowth potential.