Alopecia
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Alopecia is a medical term for hair loss. It can happen on your scalp or other parts of your body. Hair loss can be temporary or permanent, and it can affect people of all ages.
Key facts
- Alopecia is very common and affects millions of people worldwide.
- There are different types, including androgenetic alopecia (male or female pattern baldness) and alopecia areata (patchy hair loss).
- Hair loss is usually not a sign of a serious illness, but it can be upsetting.
Yes, alopecia is extremely common. About 50% of men and 40% of women will experience noticeable hair loss by age 50.
Alopecia can affect anyone – men, women, children, and older adults. Different types are more common in certain groups, such as male pattern baldness in men and alopecia areata often starting in childhood or young adulthood.
Symptoms
- Hair loss accompanied by a sudden, severe headache or vision changes – this could signal a medical emergency like a stroke or giant cell arteritis.
- Rapid, dramatic hair loss with painful, swollen scalp or fever – seek emergency care.
- ⚠Sudden hair loss with intense itching, burning, or redness of the scalp.
- ⚠Hair loss that starts after starting a new medication or treatment (like chemotherapy) – speak to your doctor the same day.
- ⚠Patchy hair loss with scaly, flaky skin that might be a fungal infection.
Common symptoms
- Gradual thinning of hair on the top of the head (common in both men and women).
- Sudden patchy bald spots, often about the size of a coin (alopecia areata).
- Full-body hair loss (rare, but can happen in severe alopecia areata).
- Loosening of hair, where clumps come out when you brush or wash (telogen effluvium).
Symptoms in children
- Patchy bald spots on the scalp, especially in alopecia areata.
- Broken hair or ‘exclamation mark’ hairs near the bald patches.
- Itching or tingling on the scalp before hair falls out.
Symptoms in older adults
- General thinning of hair, especially on the crown and front of the scalp.
- Slower hair growth and smaller hair strands over time.
- Hair loss on other body parts like eyebrows or eyelashes is less common.
Causes
Main causes
- Genetics – family history of baldness (pattern hair loss).
- An overactive immune system attacking hair follicles (alopecia areata).
- Hormonal changes – e.g., pregnancy, menopause, thyroid problems.
- Physical or emotional stress, which can trigger temporary shedding (telogen effluvium).
- Certain medical conditions such as lupus, diabetes, or iron deficiency anemia.
- Medications and treatments including chemotherapy, blood thinners, and some antidepressants.
Risk factors
- A family history of hair loss.
- Age – risk increases with age for pattern baldness.
- Major stress or a traumatic event.
- Rapid weight loss or poor nutrition.
- Certain hairstyles that pull on the hair (traction alopecia).
- Hormonal imbalances or autoimmune diseases.
When to see a doctor
See a doctor urgently if:
- If you have sudden, patchy hair loss and your scalp is painful, red, or swollen.
- If hair loss is accompanied by symptoms like fever, fatigue, or unexplained weight loss.
- If you notice hair loss after starting a new medication – do not stop the medication without consulting your doctor.
Book a routine appointment if:
- If you are bothered by gradual hair loss and want to explore treatment options.
- If you notice a bald spot that is getting bigger over weeks or months.
- If hair loss is affecting your confidence or emotional well-being.
Diagnosis
A doctor, usually a dermatologist, will examine your scalp and hair. They will ask about your medical history, family history of hair loss, and any recent stresses or illnesses.
Tests that may be done
- Blood tests to check for thyroid problems, iron levels, or hormone imbalances.
- A scalp biopsy – taking a tiny piece of scalp skin to examine under a microscope.
- A pull test – gently pulling a small amount of hair to see how many come out.
- A light microscopic exam of hair strands to look for breakage or abnormalities.
What to expect at your appointment
Your doctor will take a careful history and do a physical exam. Tests are usually simple and not painful. Blood tests might be done to rule out other causes. The results can help determine the best treatment plan for your type of hair loss.
Treatment
Treatment depends on the type and cause of hair loss. Some types, like telogen effluvium, often get better on their own. Others, like pattern baldness or alopecia areata, may need ongoing treatment to slow loss or promote regrowth.
Self-care at home
- Be gentle with your hair – avoid harsh brushing, tight hairstyles, and hot styling tools.
- Use mild shampoos and conditioners suitable for your hair type.
- Eat a balanced diet rich in protein, iron, and vitamins (but special supplements are not proven to help unless you have a deficiency).
- Manage stress through relaxation techniques, exercise, or talking to a counsellor.
- Consider using a wig, scarf, or hair topper if hair loss affects your confidence.
Medical treatments
Medical treatments for hair loss include topical applications that you put on your scalp, oral medications that affect hormones or inflammation, injections of steroids into the scalp for patchy alopecia, and light therapy. These treatments are prescribed by a doctor and can help slow hair loss or stimulate regrowth. Your doctor will discuss the options that are right for your situation.
When is surgery considered?
Surgery, such as hair transplant, may be an option for certain types of permanent hair loss like male or female pattern baldness. This involves moving hair follicles from one part of the scalp to the areas with thinning hair. It is not suitable for everyone and requires a consultation with a specialist.
Living with this condition
Living with hair loss can be challenging, but there are many ways to cope. Try different hairstyles, use hair accessories, or explore wigs and hairpieces. Focus on the things you can control, like your overall health and how you choose to respond to your appearance.
Lifestyle tips
- Avoid smoking, as it can worsen hair loss by affecting blood flow to hair follicles.
- Limit or avoid alcohol and recreational drugs, which can affect hormone levels.
- Protect your scalp from the sun with hats or sunscreen if you have significant hair loss.
- Stay active – exercise helps reduce stress and improves circulation.
Diet and exercise
A balanced diet with enough protein, iron, zinc, and vitamins (especially B vitamins and vitamin D) supports healthy hair growth. Exercise regularly to reduce stress and improve blood flow. There's no miracle diet, but good nutrition helps your body function well, including hair growth.
Mental health and emotional wellbeing
Hair loss can affect self-esteem and cause anxiety or depression. It's normal to feel upset. Talk to friends, family, or a mental health professional. Counselling or support groups can help you manage these feelings.
Prevention
Some types of hair loss, like pattern baldness, cannot be prevented because they are genetic. However, you may be able to reduce the risk of some temporary hair loss by managing stress, eating well, avoiding tight hairstyles, and treating underlying medical conditions early.
Complications
If left untreated
- For some types, such as pattern baldness, hair loss may become permanent if not treated.
- Untreated autoimmune-related alopecia may lead to more widespread hair loss, including eyebrows and eyelashes.
- Severe or prolonged hair loss can lead to low self-esteem, social anxiety, and depression.
Long-term outlook
The outlook for most types of alopecia is positive. Many people see regrowth within a few months to a year, especially with treatment. Even if hair loss is permanent, there are effective ways to manage it, and you can still live a full and happy life. Research continues to improve treatments, so there is reason for hope.
Find support
International organisations
Local organisations
- NHS – Hair loss ↗ · United Kingdom
Helplines
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Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.