It’s a topic that touches many of us, directly or indirectly: hair loss. The medical term for it is alopecia, and it’s far more nuanced than simply thinning hair. It can manifest in various ways, from a single patch on your scalp to more widespread shedding across your head and body. You might be wondering, ‘How does one get alopecia?’ It is, in fact, the result of a multifaceted interaction of factors rather than a single factor. Genetics play a major role in one of the most common types, also known as male or female pattern hair loss. This is where androgens, typically thought of as male hormones, play a role. Even with normal hormone levels, some hair follicles are just more sensitive to their effects, leading to gradual thinning over time. It’s something you can inherit from either parent, or sometimes both.
Then there’s alopecia areata, which is quite different. This is an autoimmune condition. Imagine that your immune system, which is supposed to protect you, attacks your hair follicles because it thinks they are foreign invaders. The exact trigger for this isn’t always clear, but it’s believed to be a combination of genetic predisposition and environmental factors. Sometimes, a significant shock to the system, like extreme stress or anxiety, can be a catalyst.
Additionally, telogen effluvium may occur. This is essentially a temporary pause in hair growth caused by a shock to your body. This shock may be psychological or physical. Consider significant life shifts, significant loss of a loved one, surgery, childbirth, a prolonged high fever, or even a sudden and drastic weight loss. Nutritional deficiencies, like low iron or zinc, or certain health conditions such as hypothyroidism, can also contribute. Even the introduction or withdrawal of particular medications can be a trigger. The interesting and occasionally discouraging aspect of telogen effluvium is that you may not notice hair loss until a few months after the initial trigger event, as new hairs take time to grow and old hairs fall out. There are additional causes besides these. Certain medications, particularly those used in cancer treatments, can lead to hair loss. Infections like tinea (ringworm) on the scalp, or skin conditions like psoriasis, can also affect hair growth. There is also the condition known as traction alopecia, which occurs when your hair is constantly pulled tight, such as when you wear a hairstyle that is extremely restrictive. And sadly, sometimes hair pulling can be a symptom of underlying mental health conditions.
What does it appear to be? One or more smooth, circular bald patches, typically on the head, are common signs of alopecia areata. There, the skin appears normal, but you might notice broken hairs or even tiny nail pits. For some, the hair grows back within months or years, but it can also fall out again, or never return. Alopecia totalis (loss of all hair on the head) or alopecia universalis (loss of all hair on the body) can occur in more severe cases. While not life-threatening, the cosmetic impact can be significant.
Scarring alopecia is another form where the hair follicle is destroyed and replaced by scar tissue. If not treated promptly, the skin may appear red, swollen, or blistered, and permanent hair loss may result. Talking to a doctor is the best first step if you’re worried about losing hair. They can help diagnose the cause, which is crucial for understanding potential treatments and managing expectations. Because some types of alopecia can be treated, but they don’t always work, and for many people, learning to live with hair loss is part of the journey.