Hair loss can present in different ways depending on the cause. To determine your hair loss type, start by observing the progression and pattern.
What are common progressions and patterns of hair loss?
Gradual hair thinning on top of the head
Gradual hair loss is most often attributed to genetics and aging, known as androgenetic alopecia. Androgenetic alopecia presents in different ways for men (male pattern) and women (female pattern). In men, hair loss forms the shape of an "M," beginning at the temples to the crown. The first sign of hair loss in women is a widening hair part on top of the head. An increasingly common hair loss pattern in older women is a receding hairline (frontal fibrosing alopecia).
Gradual receding frontal hairline
Repetitive pulling on the hair, typically due to tight hairstyles such as ponytails, cornrows, or hair extensions, can induce traction alopecia. If the causative hairstyles aren't avoided, it could lead to permanent hair loss.
Sudden diffuse hair shedding (telogen effluvium)
A physical or emotional shock to the body can cause hair to loosen. Handful hair may be shed when combing, washing, or even after gentle tugging. This type of hair loss usually causes overall hair thinning but is temporary.
Diffuse hair loss related to treatments and medications.
Chemotherapy is a treatment that uses potent drugs to aggressively attack fast-growing cells in the body, such as cancer cells, to hinder their progress. These drugs can simultaneously attack other cells in the body during treatment, including those present in hair follicles. This can lead to hair loss, usually around 2 - 4 weeks after starting treatment, and continues for a few more weeks after the end of the treatment.
Sudden smooth circular or patchy bald spots
Quickly developing smooth, circular or patchy bald spots are usually a sign of alopecia areata. It can appear at any age but is more common in children and adolescents. While the exact cause is unknown, the hair will typically regrow in 10-12 months. For 10% of cases, the condition can involve larger areas of the scalp, eyebrows, and body and persist for longer periods.
Sudden scaly circular or patchy bald spots
Quickly developing scaly, round bald spots on the scalp are typical signs of a fungal infection (ringworm or tinea capitis). Ringworm of the scalp is more common in children and teens and is very contagious. Ringworm gets its name from its circular appearance - no actual worms are involved.
How do I treat my hair loss?
The optimal treatment for androgenetic alopecia includes a medicated or plant-based scalp treatment solution, a scalp treatment shampoo specially formulated for hair loss, and hair regrowth supplements. Collagen peptides can be an excellent addition to the treatment routine.
The first step to treating traction alopecia is to avoid the causative tight hairstyles. Topical treatment solutions such as minoxidil may speed up regrowth. Steroid creams or injections are often used to reduce the associated swelling and irritation of the scalp. In severe cases, the hair follicles may be too damaged for topical treatments to have any effect, and other treatments such as hair transplants may be considered.
The optimal treatment for telogen effluvium includes a plant-based scalp treatment solution, a scalp treatment shampoo specially formulated for hair loss, and hair restore supplements. Collagen peptides can be an excellent addition to the treatment routine.
While minoxidil isn't likely to prevent chemotherapy-induced alopecia, it can possibly decrease the duration. A study using topical Minoxidil 2% found that initial hair loss was delayed by up to 10 days, and hair regrowth time was reduced by up to 40 days.
While there is no formal FDA-cleared treatment for alopecia areata, there is evidence that in some people, the use of topical steroids, topical solution of minoxidil, plant-based scalp serums, and hair supplements can help restart hair regrowth faster. If you notice smooth, round bald areas on your scalp, refer to your dermatologist for a proper diagnosis.
Ringworm should be treated with oral medications. Left untreated, it can cause lifelong bald patches on the scalp. If you notice scaly, round bald spots on your scalp, refer to your local dermatologist for proper diagnosis and treatment.