Types of Alopecia

Hair loss affects millions of people worldwide, yet many don't fully understand the various forms it can take. During Alopecia Awareness Month, we want to shed light on the different types of alopecia and help people recognize the signs and understand the causes. Whether you're experiencing hair loss yourself or supporting someone who is, knowledge is the first step toward proper care and management. 

While the term sounds a bit intimidating, alopecia is simply the medical term for hair loss, and it encompasses a wide range of conditions with different causes, patterns, and treatments. From temporary stress-related shedding to permanent genetic conditions, understanding these distinctions can help you make informed decisions about your hair health and seek appropriate medical care when needed. 

1. Androgenetic Alopecia (Male and Female Pattern Baldness) 

What it is: A genetically predetermined disorder caused by an excessive response to androgens, particularly dihydrotestosterone (DHT). This hereditary condition becomes increasingly common with age. In fact, research shows that by the time people reach their 80s, about 73% of men and around 57% of women are affected by some degree of androgenetic hair thinning. 

How it appears: In men, hair loss is most prominent in the vertex (crown), temples and frontal hairline. While female hair thinning patterns can vary, most women tend to retain their frontal hairline while experiencing more diffuse thinning primarily at the crown, creating a broader appearance of the front part of the hair. 

Key characteristics: 

• Gradual onset, usually beginning in the 20s or 30s 
• Follows predictable patterns 
• Hair follicles gradually shrink over time as hair cell production in the hair follicles decreases 
• Affected hairs become shorter, finer, and lighter before stopping growth entirely 

2. Alopecia Areata 

What it is: An autoimmune condition where the immune system mistakenly attacks hair follicles, causing sudden, patchy hair loss. The prevalence of alopecia areata appears to increase in adolescence (i.e., age 12-17 years) and reach a peak in young adulthood (i.e., age 18-44 years), with higher rates observed among females regardless of age group. Interestingly enough, this large study conducted in US from 2016–2019 found that about 62–67% of diagnosed cases were female, while 33–38% were male. 

How it appears: Smooth, round or oval patches of complete hair loss, most commonly on the scalp but can occur anywhere on the body. The skin underneath typically appears normal and healthy. 

Key characteristics: 

• Sudden onset of hair loss 
• Patches can be as small as a coin or much larger 
• Hair may regrow on its own, sometimes white or gray initially 
• Four out of five people suffering with mild alopecia areata (small patches) experience spontaneous hair regrowth within 12 months, even without treatment 
• Can be unpredictable, with periods of regrowth and loss 
• May progress to more extensive forms 

Common causes: Alopecia areata most often the result of intense, prolonged psychological stress. It is thought to be an autoimmune disorder in which the body attacks its own hair follicles.  

3. Alopecia Totalis 

What it is: A more severe form of alopecia areata and is the loss of all scalp and facial hair. It starts with small, round patches of hair loss that resemble alopecia areata, but progresses until there is no hair left above the neck.  

How it appears: Total absence of hair on the entire scalp, including eyebrows and eyelashes in many cases. 

Key characteristics: 

• Complete scalp hair loss 
• May develop from patchy alopecia areata or occur suddenly 
• Can be temporary or permanent but while alopecia areata (the patchy form) often sees spontaneous regrowth within months, alopecia totalis unfortunately show much lower rates of regrowth 
• Often more challenging to treat than localized alopecia areata 
• May cause significant emotional and psychological impact 

4. Alopecia Universalis 

What it is: The most extensive form of alopecia areata, involving complete loss of hair on the scalp and entire body, including eyebrows, eyelashes, and body hair. 

How it appears: Complete absence of hair anywhere on the body. 

Key characteristics: 

• Affects less than 1% of the population 
• Often develops from alopecia areata or alopecia totalis 
• Regrowth is possible but less common than with other forms 
• Requires comprehensive medical management 

5. Lichen Planopilaris & Frontal fibrosing alopecia 

What it is: Lichen planopilaris is a chronic recurrent rash due to inflammation. The rash is characterized by small, flat-topped, many-sided bumps that can grow together into rough, scaly plaques on the skin.   

Frontal fibrosing alopecia is a form of lichen planopilaris that is characterized primarily by slowly progressive hair loss and scarring on the scalp above the forehead. Many people with lichen planopilaris can experience frontal fibrosing, which is when the whole hairline, most noticeable in the front and sides, gradually recedes. This can surprisingly go unnoticed by many except for the redness and dryness experienced in the hairline. 

How it appears: Presents as smooth white patches of scalp and hair loss 

Key characteristics: 

• The skin in the affected area looks normal 
• Hairs can easily be pulled out 
• May be accompanied with tenderness or discomfort 

Common causes: Inflammation, most commonly seen in post-menopausal women but can be seen in pre-menopausal women and men. In fact, there is a strong gender bias in the prevalence of lichen planopilaris. A large US study, revealed the prevalence of lichen planopilaris in women, with 22.7 per 100,000 women compared to only 2.9 per 100,000 men.  

6. Central Centrifugal Cicatricial Alopecia 

What it is: Central centrifugal cicatricial alopecia is a type of inflammatory hair loss that can cause destruction to the follicles and lead to permanent scarring. 

How it appears: It starts in the central part (crown) of the scalp and radiates outward in a centrifugal or circular, pattern. It is usually gradual; however, some cases show rapid and comprehensive regression. 

Key characteristics: 

• Itching 
• Burning sensation 
• Pain 
• Acne-like bumps 

Common causes: A combination of genetics, autoimmune conditions, and infections (bacterial/fungal) play a role. 

7. Telogen Effluvium 

What it is: Temporary hair loss caused by stress, illness, hormonal changes, seasonal changes, or other disruptions to the hair growth cycle. It's the second most common form of hair loss. 

How it appears: Diffuse thinning across the entire scalp rather than in specific patterns. Hair may come out in larger amounts when washing or brushing. 

Key characteristics: 

• Usually occurs 2-4 months after a triggering event 
• Hair loss is typically temporary but if hair at the same time is thinning the process of growing the hair back can be difficult 
• Our comprehensive approach is particularly effective for telogen effluvium related thinning. Our Hair Gain Extract, a custom-formulated topical solution created specifically for each client based on their unique hair and scalp analysis, addresses the root causes of hair thinning and helps create an optimal environment for hair growth. Combined with our Hair Supplement, developed over a decade and comprising only well-studied ingredients at their most efficacious levels, this dual approach targets multiple triggers including stress, DHT sensitivity, and nutrient deficiencies. 
• Affects the hair's resting (telogen) phase 
• Can be acute (lasting less than 6 months) or chronic (longer than 6 months) 
• Hair usually returns to normal thickness once the underlying cause is addressed 

Common causes: Hormonal shifts (post pregnancy, perimenopause, menopause, hormonal replacement therapy, birth control, seasonal shedding), thyroid disorders, psychological or physiological stress, surgeries, weight loss, anemia. 

8. Anagen Effluvium 

What it is: Rapid hair loss that occurs during the active growth (anagen) phase of hair, most commonly caused by chemotherapy or radiation treatment. 

How it appears: Sudden, dramatic hair loss that can progress to near-complete baldness within days to weeks. 

Key characteristics: 

• Rapid onset and progression 
• Affects actively growing hairs 
• Usually reversible once the cause is removed 
• May initially regrow with different texture or color 
• Can be emotionally challenging due to sudden change 

Common causes: Chemotherapy, radiation therapy, or exposure to certain chemicals. 

9. Traction Alopecia 

What it is: Hair loss caused by repeated pulling or tension on the hair, often from tight hairstyles or head gear, hair extensions, or frequent use of heated styling tools. 

How it appears: Hair loss typically occurs around the hairline, temples, or wherever the most tension has been applied. May start as thinning and progress to permanent bald patches. 

Key characteristics: 

• Gradual onset related to styling habits 
• Initially reversible if caught early  when scarring in the hair follicles are minimal 
• Can become permanent if tension continues 
• More common in people who regularly wear tight braids or head gear, ponytails, or extensions 
• Often affects the frontal hairline and temples first 

While traction alopecia can be challenging to address once permanent scarring has occurred, our Hair Gain Extract can be effective in cases where the hair follicles are still viable and haven't been permanently damaged. If caught early enough, before scarring develops, our custom-formulated topical solution can help create an optimal environment for hair regrowth by addressing inflammation and supporting the healing process in affected areas. Additionally, in many cases, you may also be experiencing androgenetic alopecia alongside traction alopecia, which our methodology is specifically designed to address. If you feel that you are suffering from traction alopecia, we recommend that you book a consultation  with a hair specialist to get guidance on how to better preserve and nurture your scalp and hair. 

10. Trichotillomania 

What it is: Also known as a hair-pulling disorder or “trich”, involves recurrent urges to pull out one's own hair. It is a psychological condition involving the compulsive urge to pull out one's own hair, resulting in noticeable hair loss. 

How it appears: Irregular patches of hair loss with broken hairs of varying lengths. The pattern is often asymmetrical and may affect the scalp, eyebrows, or eyelashes. 

Key characteristics: 

• Compulsive behavior often triggered by stress or anxiety 
• May be unconscious or deliberate 
• Can begin in childhood or adolescence 
• Often accompanied by feelings of shame or guilt 
• Hair loss patterns are irregular and inconsistent 

Common causes: Severely stressful situations or events, family history- either genetics or having relatives with the disorder, other mental disorders such as depression, anxiety, or obsessive-compulsive disorder (OCD) 

Understanding the Emotional Impact 

Regardless of the type, hair loss can have profound emotional and psychological effects. It's important to acknowledge that alopecia affects more than just appearance—it can impact self-esteem, social interactions, and overall quality of life. During Alopecia Awareness Month, we recognize that support, understanding, and proper treatment are essential for managing both the physical and emotional aspects of hair loss. 

When to Seek Professional Help 

If you're experiencing any form of hair loss, it's important to consult with a dermatologist or hair specialist for proper diagnosis. Early intervention often leads to better outcomes, and a professional can help determine the underlying cause and most appropriate approach for your specific situation. 

Remember that hair loss is a medical condition, not a cosmetic issue, and deserves proper medical attention and care. With the right diagnosis and personalized approach, many forms of alopecia can be effectively managed. 

The Hårklinikken Approach to Hair Wellness 

At Hårklinikken, we understand that every individual's hair loss journey is unique, which is why we've developed a personalized approach that goes beyond one-size-fits-all solutions. Our commitment to helping people achieve healthier, fuller hair is rooted in decades of science-led research and a deep understanding requires more than surface-level treatments. 

Our Hair Gain Extract represents the cornerstone of our methodology—a custom-formulated topical solution created specifically for each client based on their unique hair and scalp analysis. Our methodology addresses the root causes of hair thinning and helps create an optimal environment for hair growth. Each formula is carefully crafted to work with your individual biology for optimal results.  

While we can help individuals with many different hair and scalp challenges, we understand that we have limitations in supporting those suffering from alopecia universalis, alopecia totalis, or other autoimmune hair loss or scalp disorders. Additionally, if you have a severe scalp condition or if we suspect that an underlying medical condition is the cause of your hair loss, we may refer you to a dermatologist or other specialist to ensure any possible issues are addressed first.