types of alopecia

Types of alopecia

What is alopecia?

Everyone knows the term “baldness,” meaning hair loss, but the most accurate name for this disease is alopecia.

While it is true that it usually affects men more than women, the disease affects both genders, leading to serious changes in self-esteem and insecurity.

When hair loss exceeds 100 hairs a day, this can be called alopecia since each of us typically loses between 50 and 90 hairs a day. This loss not only affects the head, as we already know, but it can affect other areas such as:

While these are less visible areas than the head, the same problems can occur, and many people currently suffer from them. 

It is a very common medical problem that many people around the world suffer from. It is more than a purely aesthetic issue; it’s considered a disease by the WHO (World Health Organisation).

Alopecia doesn’t have one single cause or just one way of appearing: there are different types. There’s a wide range of causes of alopecia, ranging from genetic factors to poor diet and habitual stress. For some, issues with alopecia can be addressed by improving their quality of life, but for others, it will be necessary to have a transplant or hair treatment.

What types of alopecia are there?

There are up to 6 recognised types of alopecia, which are: Androgenetic, Areata,  Fibrosing, Diffuse, Scarring, and Universal.

  •  Androgenetic, also called male-pattern baldness, is the most common. This type of baldness usually occurs to a greater or lesser extent starting at the age of 50. About 50% of men and 10% of women suffer from it. The cause is mainly genetic, though it can also be hormonal. This genetic cause was originally attributed to maternal genetics; however, it has been shown to be unpredictable since genes are not inherited in exact proportions and are a combination of different family members, i.e., polygenic inheritance. As for the hormonal component, a phenomenon occurs where the male hormones or androgens act on hair follicles that are genetically predisposed to the condition, progressively causing their atrophy until the hair completely disappears. For women, hair loss is diffuse because they do not lose all their hair, and there doesn’t tend to be a receding hairline.
  • Alopecia areata is the second most common type of alopecia. This type of loss originates partially in the form of patches, though it can spread to the entire scalp or even to the rest of the body. Normally, this type of alopecia disappears and the hair grows again, and these patches may reappear in a future relapse.  In addition to genetic factors, this condition is usually related to autoimmune diseases such as celiac disease, diabetes, or arthritis.
  • Frontal fibrosing alopecia usually affects more women than men. This type of alopecia involves many unknowns, and its causes are still largely unknown. It is known that it may be related to menopause. Fibrosing alopecia mainly affects the hairline at the front, moving further and further back.
  • Diffuse alopecia is a reversible type of hair loss. It may be more or less intense, and it corresponds to an area of the scalp where hair is lost.
  • Scarring alopecia, as its name suggests, is a type of hair loss caused by a scar. In this case, a wound may be the cause of the destruction of the hair follicles, preventing the new appearance of hair in the area.
  •  Universal alopecia causes baldness due to an autoimmune disease that ‘attacks’ the hair follicles, preventing hair from being generated. With this type of alopecia, the patient’s antibodies attack the hair follicle, totally eliminating it. It is important to clarify that universal alopecia is a subtype of alopecia areata. It only differs in that it appears more aggressively.

Why is having a hair transplant the best way to deal with alopecia?

We cannot choose whether or not we have alopecia, but we can remedy it. The reasons for taking this leap are varied (and aren’t just for aesthetic reasons, as we all already know). Having hair on our heads protects us from inclement weather such as wind, rain, and sun. Prolonged exposure can damage our skin, even leading to burns, spots, or skin cancer in the worst cases, if there is direct sun exposure.

Causes of Alopecia Beyond Genetics

There may be multiple reasons for having alopecia, and they may appear one at a time or in combination. We must keep in mind that the number one reason we find ourselves in this situation is the feared genetics (looking at one’s father offers a rough idea of what the future may hold). 

But this is not the only reason; we may have alopecia due to other causes such as:

  • Telogen effluvium. This form affects us when we’re going through times with high levels of stress, which can be acute or chronic.
  • Traction alopecia. This is hair loss due to wearing hairstyles that stretch and pull the hair, such as ponytails, buns, etc. Helmets, caps, and so on may not be beneficial if they are over-used.
  • Seborrheic dermatitis. This cause may have a genetic factor, but it can also be affected by nerves, poor eating habits, etc.

Female-pattern alopecia

Alopecia is closely associated with men, and we sometimes forget that women also suffer from it, though in smaller numbers. In many cases, this disease hits them harder because of the social connotations placed on them. 

It’s also important to understand that, as a rule, female-pattern alopecia is different from the male-pattern variety. This is the case to such an extent that they have different scales: the female pattern is called the Ludwig scale, while male-pattern is called the Hamilton-Norwood.

For women, the most common types of alopecia are androgenetic, areata, and fibrosing. Besides the causes discussed above, it can also be aggravated during pregnancy, by hyperthyroidism or hypothyroidism, polycystic ovaries, and more.

A solution for alopecia 

Currently, the only way to get hair back in places where it is no longer growing is with a hair transplant. All other “remedies” can aim to prevent hair loss and prolong the time hair stays on our heads. The best treatments are: 

Some doctors recommend using certain drugs, such as minoxidil or finasteride, depending on each individual’s particular situation.

Here at the Insparya Research Centre in Portugal,  known as Insparya Science, our researchers are conducting experiments to clone follicular units using stem cells. While work is still underway, this could revolutionise the hair sector.

With just a few samples of follicular units, a host of units could be replicated, offering an excellent outcome for any case.

Alopecia areata of the beard

Alopecia can affect not only our scalps but also our beards. Alopecia areata of the beard is a type of alopecia that occurs when the body’s defences attack the hair root. So-called baldness can pose a problem for the manly aesthetic that many men seek and even impact their self-esteem.

In these cases, it is common to find 2-3 bald areas or more, but these do not usually extend to the scalp. Depending on the individual’s situation, the hair may grow back or not. At this point, a specialist doctor must assess how to address the issue.

Alopecia in children

When we talk about alopecia, we tend to think of adults, but unfortunately, young ones aren’t immune to its effects. There are two types of childhood alopecia that appear most often: areata and ringworm of the scalp. Fortunately, these are reversible in most cases.

Building good hair care habits for little ones is key for their proper hair development and keeping them from having alopecia. Everything from the temperature of their bathwater to how tight they wear ponytails and using a proper comb will play a key role.

Do you suffer from thinning hair on the scalp or a receding hairline?

Men are primarily affected by hair loss at the temples and on the crown (upper back of the head).

Usually, hairline recession is the first warning sign that you will have from this disease. It can begin as early as the age of 20 (though this can vary, depending on genetic predisposition and the type of alopecia you have). As we lose our hair, the hair also weakens and loses shine and density.

Hair loss advances progressively over time until it reaches the crown area. It is more difficult to repopulate this area because it is a convex shape requiring many follicular units to cover it. This is in addition to the orientation of the hair itself, which takes special care to get aesthetically good results.