Medical Dermatology

Alopecia (Hair Loss)

The average person has up to 150,000 scalp hairs. It is normal to lose 100 or more scalp hairs each day. Hair cycles between 3 stages of growth: anagen, catagen and telogen. Many things can alter normal hair cycling and can promote hair loss and thinning. Hair loss (alopecia) can be caused by genetic or environmental factors, and often a combination of these factors. Hair loss can be caused by certain illnesses, medications, and diet also plays an important role in healthy hair growth.

There are many causes and types of alopecia. Hair diseases and disorders are varied and may be accompanied by the following signs and symptoms depending on the type of hair loss pattern:

  • Non-scarring alopecia involves localized or diffuse loss of hair (scalp or other sites). Receding hair line, broken hairs, smooth scalp, inflammation, and possibly loss of lashes, eyebrows, or pubic hair may be features of this kind of hair loss. Some examples are Alopecia Areata and Telogen Effluvium.
  • Scarring alopecia is limited to particular areas and involves inflammation at the edge and follicle loss toward the center of lesions, violet-colored skin abnormalities, and scaling. Some examples include discoid Lupus Erythematosus, Lichen Planopilaris and Central Centrifugal Scarring Alopecia.
  • Hirsutism involves male-pattern “terminal hair” growth in women, irregular menstruation, lack of ovulation, acne, deepening of voice, balding, and genital abnormalities. However, terminal hair growth in a male pattern may also occur normally in some women with a genetic predisposition.
  • Hair shaft disorders can begin at birth or may be acquired in adulthood. These disorders may involve split ends, dry, brittle, and coarse hairs, hair color changes and easy breaking of hairs.