What is the most common type of hair loss?

Example of male pattern baldness (aka androgenetic alopecia) in a young man. Image by wikipedia user Welshsk.
Example of male pattern baldness (aka androgenetic alopecia) in a young man. Image by wikipedia user Welshsk.

The most common type of hair loss is androgenetic alopecia.  This diagnosis is also known as male pattern baldness when it occurs in men, and female pattern hair loss when it occurs in women.  As its name implies, androgens contribute to this type of hair loss, as do genetics.  That’s right — if your mom, dad, brother, sister, etc have a receding hairline or hair loss, you will be more prone to getting this type of hair loss.

Androgenetic alopecia commonly affects certain areas of the scalp.  For guys, this is often the hairline up front by the forehead and the back top of the head (see photo).  For women, it’s often the top of the head.  Women may first note that their part seems to be getting wider.  Affected individuals may also notice that the hair gets thinner in the affected areas.

So how can you treat androgenetic alopecia and prevent fuurther hair loss?  It depends on your gender.  For both men and women, an applied medication called minoxidil is available over the counter (more often known as Rogaine).  For men, finasteride (Propecia) or dutasteride are possibilities.  In the US, these medications are not used in women except in rare instances.  A medication called spironolactone is sometimes used in women who have adrogenetic alopecia.  Another option is hair transplantation.  Evaluation by an experienced physician is recommended if you are interested in a hair transplant. You want to make sure you are an appropriate candidate and that you get a good aesthetic outcome.  Regardless, if you are considering medications for androgenetic alopecia or hair transplantation, you should have a discussion with your physician to discuss whether you are the right candidate for these treatments and what to expect from these treatments.

Is stress causing you to lose your hair?

Diagram of the cross section of hair
Diagram of the cross section of hair

There’s a condition where  a stressful event such as surgery, trauma, childbirth, extreme weight loss, severe illness, extreme emotional stress or other causes of stress causes your hair to fall out.  This condition is called telogen effluvium.  Telogen is a phase of the normal hair cycle.  It also happens to be the cycle where hair is shed off the scalp.  In this condition, many of the hairs enter into this telogen phase at the same time and end up being shed around the same time.  The shedding usually happens a few months after the stressful event.  The good news is that after the stressful event is resolved, the hair usually grows back.

A dermatologist is a physician that specializes in skin, hair and nails.  If you are not sure what is causing your hair loss, get it checked out.  Sometimes the hair can be gently pulled or forcibly plucked to examine the stage of the hair.  In telogen effluvium, a larger than normal percentage of the hairs that are plucked for sampling would be in telogen phase.  The distribution of hair loss on your scalp and the skin of your scalp will also be examined.  Sometimes hair loss can be multifactorial.  In difficult cases of hair loss, biopsies (sampling) of the scalp may be necessary to help diagnose your hair loss.

Losing hair? It happens to both men and women.

Illustrations from the Nuremberg Chronicle, by Hartmann Schedel (1440-1514). Image part of US public domain.

While we often think of men as the ones with receding hairlines and as the ones who bald, women do too! Androgenetic alopecia is the fancy term we use to refer to this common pattern of hair thinning and hair loss. We also call it pattern alopecia, and either male pattern hair loss or female pattern hair loss. There is a genetic component to this so if your family members are affected, you’re more likely to be affected too.

Who should you see about this?

A dermatologist is a doctor who specializes in hair, skin and nails. He/She can evaluate your hair loss and determine whether you do indeed have androgenetic alopecia or if you have another cause of hair loss.

What treatments are there for androgenetic alopecia?

Hair loss can be extremely stressful! In men, options include minoxidil (aka Rogaine) and finasteride. In women, minoxidil (aka Rogaine) is an option. Hair transplantation can also be pursued (hair is taken, often from the back of your scalp, and transplanted to the bald areas).

You may have heard of home laser or light devices… so far, it seems that the jury is still out on these devices.

Keep in mind that these treatments might not return all of your hair to your scalp!