The 4 Different Types of Hair Loss

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The way we experience hair loss is different from person to person. Some of us first spot hair receding around our temples, while others see a widening hair part or overall loss of fullness. No matter how it happens, it’s scary and it makes us feel out of control and alone. 

But hair loss is extremely common in men and women. Forty percent of women experience hair loss by age 40, with that percentage rising to 60% as we reach age 60. According to the American Hair Loss Association, a whopping 85% of men have significant hair thinning by age 50. Feeling less alone yet? Good. Let’s keep going. 

The clinical term for hair loss is alopecia, a condition that can occur anywhere on the body, including the scalp. While alopecia is a broad term, there are many subcategories within it. Below, we’ll show you the four different types of hair loss and what you can do to take control. 

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Androgenetic (androgenic) alopecia 

Androgenic alopecia is also known as male pattern hair loss/baldness or female pattern hair loss/baldness. This condition is two parts genetics, two parts hormones, and one part environment. It affects males starting as early as their 20s, while females are usually affected later in life during and after menopause. 

In males, the areas of the scalp most affected are the crown and vertex and the front hairline. Women tend to have androgenic hair loss that’s more spread out, but a widening part is most characteristic to this type of thinning.  

Androgenic alopecia is characterized by thinning around the crown and hair part in men and women.

The main culprit behind androgenic hair loss is thought to be a metabolite of testosterone called DHT (dihydrotestosterone). DHT does not have an important function in the body after puberty, but is still produced in many tissues, including the hair follicle, by an enzyme called 5-alpha reductase. The presence of DHT and its ability to stimulate androgen receptors in the hair follicle causes the hair follicle to shrink and eventually shut down, ceasing the production of hair. 

Treatment for this type of hair loss works best before the hair follicles shrink completely and become covered over by non-follicle containing skin. In the dermatologist’s office, the available treatments are a prescription medication called Propecia (finasteride), which aims to block the 5-AR enzyme and stop the formation of DHT,  hair transplantation, and topical minoxidil. There are also natural ingredients that can be beneficial for hormone-related hair thinning. These include saw palmetto (a key ingredient of Nutrafol), stinging nettle, African cherry tree bark extract, zinc, and pumpkin seeds.

Telogen effluvium

Telogen effluvium (TE) is a broad category of reactive hair loss. As the name suggests, it is defined by a large percentage of hair follicles entering the shedding (telogen) phase of the hair growth cycle and all falling out at once. The common experience is having clumps of hair come out in the shower or on the hair brush. Generally, this hair shedding occurs all over the scalp with no bare patches. 

Chronic stress can cause shedding to go on for a longer period of time.

TE is the hair follicles’ reaction to some form of trigger or stressor. This stressor can be physical or emotional in nature. Some examples are surgery, physical trauma, infection, medication changes, postpartum hormonal changes, crash dieting, low protein intake, anemia, thyroid hormone changes, the death of a loved one, and elevated work stress.

TE is considered to be acute if it resolves after six months and chronic if it continues longer than six months. By definition, acute TE is self-limiting. But while the shedding resolves after six months, it can take another six months for hair to start growing back (and even longer for those changes to be perceptible). 

Treatment of TE depends on the trigger. It is important to work with a health care practitioner to figure out what that trigger is and if it’s possible to resolve or remove it. Supporting the body naturally to make sure there is adequate nutritional intake (especially of protein) and supporting the stress response with counseling, meditation, or herbs can be helpful. Herbs that are beneficial include ashwagandha (which is in all of Nutrafol’s Core products), rhodiola, schizandra, and reishi mushroom.

Alopecia areata 

Alopecia areata is a type of hair loss thought to be caused by an immune-mediated attack on the hair follicles. Generally, alopecia areata shows up as a bald patch or patches on the scalp, ranging in size from that of a penny to a few inches wide.

Alopecia aereata is characterized by hair that comes out in clumps and patches.

As with all immune-mediated disorders, the occurrence of alopecia areata is due to a complex interplay between genetic predisposition and both internal and external environmental factors. The development of alopecia areata happens mostly when people are in their 20s and 30s. However, it can also develop in childhood and old age. Individuals who have other autoimmune conditions are at higher risk. 

How does this all go down in the body? Each hair follicle has what is known as immune privilege, meaning that it is isolated and protected from our internal immune system. Alopecia areata is thought to develop when this immune privilege deteriorates and the body’s own immune system is able to attack the hair follicle. What triggers this breakdown is mostly unknown, though proposed causes include emotional or physical stress, infections, and medications. 

Current treatment options include topical steroids, as well as injectable steroid applied directly on the patches. Immune system suppressants have also been used topically. On the natural side, ingredients that can help support your immune system and improve the body’s resilience to stress include ashwagandha, zinc, selenium, B complex vitamins, vitamin D, antioxidants, and vitamin A. 

Traction alopecia  

Traction alopecia is a hair loss that occurs due to tension put on the hair shaft and hair follicle for extended periods of time. This form of alopecia generally occurs from hairstyles that pull on the hair shaft, including tight braids, ponytails, buns, dreadlocks, or consistent use of tight headbands or head coverings.

Traction alopecia is caused by repetitive wearing of super tight braids, buns, and hair accessories.

The pattern of hair loss for traction alopecia depends on the type of hairstyle that caused it.  Generally, it’s localized to the area with the most tension on the hair shaft. For this type of alopecia, prevention is definitely the best cure: Avoid tight hairstyles and change up how you style your hair so that no one area experiences excessive tension. 

There are many different forms of hair loss and each one presents with its own pattern. Regardless of the type of hair loss one is experiencing, it is always a good idea to work with a healthcare provider to get down to the underlying cause of what is going on. Remember: You are not alone and there’s a whole plant kingdom of natural ingredients able to support your hair health. 

MEDICALLY REVIEWED BY
DR. MELISSA ANZELONE, ND

on April 8, 2020

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