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Types of alopecia and how to treat them


TL;DR:

  • Androgenetic Alopecia:

  • Causes: Genetic predisposition; sensitivity to DHT; hormonal disorders.

  • Symptoms: Men: receding hairline, vertex hair loss; Women: diffuse thinning, intact hairline.

  • Diagnosis: Clinical history, scalp evaluation, videodermatoscopy.

  • Treatment: Minoxidil, finasteride, mesotherapy, or FUT hair transplants.

  • Alopecia Areata:

  • Causes: Autoimmune disease, linked to other autoimmune disorders.

  • Symptoms: Round hairless patches; possible nail changes; types include focal, total, generalized, and diffuse.

  • Diagnosis: Clinical evaluation, trichoscopy.

  • Treatment: Steroids, UV therapy, immunosuppressants; hair transplants are contraindicated.

  • Telogen Alopecia:
  • Causes: Stress, diet, illness, hormonal imbalances, medications.
  • Symptoms: Sudden hair loss months after stress, scalp burning/itching.
  • Diagnosis: Trichoscopy, blood tests (iron, thyroid hormones).
  • Treatment: Temporary condition; lifestyle changes, mesotherapy, and scalp treatments aid recovery.

A lush hairstyle is considered a sign of health and attractive appearance, so hair loss can become a cause of complexes. It is worth remembering that baldness has various causes, so different methods are used to treat it.

Androgenetic alopecia

Androgenetic alopecia is a common type of hair loss, not only in men, but also in women. As the name suggests, it is related to androgens – male sex hormones. However, their excess can also appear in women, so the risk of androgenetic alopecia is not exclusive to men. Causes: The main cause of androgenetic alopecia is genetics. The genes we inherit from our parents determine how sensitive our hair follicles are to the effects of dihydrotestosterone (DHT), a hormone that causes gradual miniaturization of hair follicles and eventually leads to atrophy. Hormonal disorders can also lead to androgenetic alopecia – the problem can occur in women with excessively high androgen levels. Symptoms: Symptoms of androgenetic alopecia differ in men and women. In men, it usually begins with a hairline on the forehead and temples, and then progresses to the top of the head. In women, androgenetic alopecia tends to manifest as a gradual thinning of the hair over the entire head, but the hairline usually remains intact. Diagnosis: To determine if you are suffering from androgenetic alopecia, your doctor will begin the diagnosis with a history. There may be questions about your history of hair loss, baldness in the family, chronic diseases. The next step is to evaluate the scalp and the pattern of baldness. In the past, mainly pull tests were used, when the doctor would check how much hair falls out with a gentle pull. Nowadays, however, better, painless ways are available, namely an examination with a videodermatoscope. It assesses the condition of the hair shafts, follicles and scalp, and does not require pulling out the hair. [read more url="https://otcoclinic.com/section/trichology/" text="Androgenetic alopecia diagnosis"]. Treatment: Theoretically, alopecia does not need to be treated – however, in such a case, one has to expect gradual hair loss until complete baldness. Typically, patients experience discomfort with hair loss, so it is worth going to the doctor and starting therapy. Androgenetic alopecia can be treated in various ways. The most commonly used drug is minoxidil, which helps increase blood flow to the hair follicles and can slow or even stop the balding process. Another drug, finasteride, works by blocking the conversion of testosterone into DHT. It's also worth trying aesthetic medicine treatments such as mesotherapy of the scalp. Unfortunately, not in every case such ways get rid of the problem – then the way out is hair transplantation. The term "transplantation" often causes anxiety in patients, but it is worth remembering that this type of treatment looks quite different today than it did a few decades ago. The effects are natural, as whole strands of skin are not transplanted, which could have given a doll-like effect, i.e. an overly straight, unnatural hairline. Nowadays, transplants are performed using the FUT method: we transplant the patient's own hair follicles from the donor area to the recipient area and set a natural, irregular hairline. No visible scars remain after such a procedure, and bystanders do not even guess that the hair is transplanted.

Alopecia areata

Alopecia areata, called alopecia areata in Latin, is an autoimmune disease, meaning that it results from an overreaction of the immune system, which begins to attack its own tissues – in this case, hair follicles. Causes: Despite intensive research, the causes of alopecia areata are not fully understood. We know that it is an autoimmune disease, but the exact factors leading to its development are unknown. It usually occurs in people with other autoimmune conditions, suggesting some genetic predisposition to this type of disease. Due to the unclear causes of alopecia areata, prevention cannot be implemented. In some patients, lost hair will regrow within 1-2 years, but with a more severe course the disease results in permanent baldness. The severe course is indicated by factors such as coexisting autoimmune diseases (e.g., Hashimoto's, diabetes mellitus, Crohn's disease, etc.), a family history of the disease, intense hair loss, nail changes or early onset of lesions. Instead of hoping that the hair will grow back on its own, it is advisable to see a doctor and start treatment. Symptoms: The most characteristic symptom of alopecia areata are small, round patches of hairlessness that appear on the head, but also on other parts of the body – beard loss, for example, is possible. The patches are usually not painful or itchy. It is worth knowing that alopecia areata can occur in different clinical varieties. It is better to see a doctor if you develop such symptoms, such forms of alopecia areata, as:

  • focal alopecia areata – foci of alopecia appear on the scalp or on the face, trunk, limbs.
  • Total alopecia areata – all hair on the head falls out, as well as eyebrows and eyelashes.
  • Generalized alopecia areata – involves all or almost all the hair on the body.
  • Malignant alopecia areata – hair falls out all over the body, the process is long-lasting and is not amenable to treatment.
  • snake alopecia (peripheral) – hair falls out at the hairline in the temporal, occipital and/or frontal regions.
  • Banded alopecia areata – this is the inverse of the nodular form, as the hair falls out from the center of the head and the alopecia gradually spreads outward.
  • Diffuse alopecia areata (reticular) – the hair falls out in such a way that separate foci of alopecia cannot be distinguished.

Symptoms may include not only hair loss, but also changes in the nails. Some patients develop brittleness, thickening or furrowing of the nails. Diagnosis: The symptoms are so characteristic that the doctor recognizes alopecia areata based on the clinical picture. If there are worrisome symptoms, it is a good idea to see a dermatologist for treatment for trichoscopic examination, which will assess the condition of the scalp. [read more url="https://otcoclinic.com/section/trichology/" text="Diagnosis of alopecia areata"]. Treatment: Treatment of alopecia areata is complicated and can be lengthy, as it is aimed at relieving symptoms rather than eliminating the cause (since it is unknown). The most common treatment is the administration of steroids, which help reduce the immune system's response. There are also other methods, such as ultraviolet light therapy. In some cases, when alopecia areata is very advanced or unresponsive to other forms of treatment, alopecia areata treatment may include the use of more aggressive immunosuppressive therapies. At our clinic, we conduct clinical trials for alopecia areata – so our patients get a chance to try innovative treatments, and we get to know the disease better and are able to fight it more effectively.

Hair transplants are not performed for alopecia areata: this type of alopecia is a contraindication to this procedure. Stimulation of the immune system causes inflammatory infiltrates to form around the hair follicles. This makes it unfortunate that a hair transplant would not take anyway.

Telogen alopecia

Telogenic alopecia is one of the most common types of baldness and is related to the hair growth cycle. It results from an extended resting phase, when hair falls out but does not grow back. Fortunately, it is not an irreversible process. Causes: Telogen alopecia can result from many factors. It occurs virtually only in women, but of course there may be exceptions. It usually results from such factors as:

  • Postpartum,
  • Prolonged stress, traumatic experiences,
  • Surgery, serious trauma,
  • Overly restrictive diet, starvation,
  • Deficiencies of zinc, B vitamins,
  • Anemia,
  • Certain medications (e.g., oral retinoids, oral contraceptives, antibiotics, beta-blockers, antiepileptic drugs, thyroid medications),
  • Diseases running with high fever,
  • Hyperthyroidism or hypothyroidism,
  • Lupus](https://otcoclinic.com/section/trichology/).

It is very common that several, simultaneous factors lead to telogenetic alopecia. Symptoms: Telogenic alopecia is characterized by rapid hair loss, which usually begins several months after a stressful event. Hair may fall out when combing or washing, and sometimes even during normal activities or sleep. They are found on the pillow, clothes, and floor in much larger numbers than usual. Sometimes there may also be burning or itching of the scalp. Diagnosis: If you observe increased hair loss, it is a good idea to come in for a trichoscopic examination. Using a videodermatoscope, the doctor assesses the condition of the scalp, hair shafts and follicles. Helpfully, he or she may also order laboratory tests such as blood count, iron, ferritin and thyroid hormone levels (fT3, fT4, TSH). [read more url="https://otcoclinic.com/section/trichology/" text="Diagnosis of telogen alopecia"]. Treatment: Fortunately, telogen alopecia is usually temporary and hair starts to grow back after a few months. However, it is worthwhile to take care of a healthier lifestyle and consult a trichologist. Treatments are available to help hair thicken faster and regain a healthy appearance. A specialist may advise oxygen infusion, XL Hair or Dr. Cyj Hair Filler mesotherapy, Dermapen or needle mesotherapy. Such treatments are a special dose of nourishment, thanks to which it is possible to accelerate hair regrowth. There is no single cause and type of baldness, so with the problem of excessive hair loss it is worth going to a trichologist. Only after determining what type of baldness we are dealing with, can an effective treatment be planned.

Conclusion

Hair loss can stem from various causes, requiring tailored solutions for each type. Androgenetic alopecia, alopecia areata, and telogen alopecia all have distinct symptoms, causes, and treatments. Whether it’s hormonal imbalances, autoimmune issues, or stress-related factors, early diagnosis and expert guidance are critical. While some conditions are temporary, others need ongoing care or advanced treatments like mesotherapy or hair transplants. By understanding your specific condition and acting promptly, you can take control of your hair health and restore confidence in your appearance.