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Am Fam Physician. 2003;68(1):107-108

What is alopecia?

Alopecia (say this: al-oh-pee-sha) is the medical word for hair loss. It generally refers to loss or lack of hair on part or all of the scalp. The hair loss can be temporary or permanent. It can be only on the scalp, or on other parts of the body, too. It can affect people of all ages.

What causes alopecia?

Alopecia can have many causes, including genetics, diseases and infections, and improper hair care. Some of the causes of hair thinning and hair loss on the whole scalp include the following:

  • Stressful conditions, physical or emotional, such as illness or surgery

  • Prolonged fever

  • Childbirth

  • Hormonal problems, such as thyroid disease

  • Drug treatment for cancer

  • Some prescription medicines

  • Unknown causes

With these disorders, the hair loss usually happens three to four months after the illness or stressful event. After a while, the hair grows back completely.

Local hair loss in one or more small parts of the scalp can be caused by any of the following:

  • Alopecia areata (patchy hair loss; the cause is unknown)

  • Traction alopecia (tight hairstyles such as cornrows or pigtails)

  • Trichotillomania (repeated hair pulling or nervous hair twisting or twirling)

  • Tinea capitis (ringworm or fungal infection)

The most common kind of alopecia is androgenetic alopecia (Say: an-droh-jen-et-ick al-oh-pee-sha). This hair loss causes a receding hairline and lack of hair on the top of the head. This balding usually is inherited.

Common balding also can affect women. These women may have a hormonal imbalance. In women, this kind of balding leads to hair thinning over the entire scalp.

How is alopecia treated?

Your doctor usually can find the cause of your hair loss based on your symptoms, medical history, and an office exam. Occasionally, blood tests or a biopsy of the affected area is needed.

Depending on the cause and your preference, alopecia can be treated with medicines, surgery, or hairpieces. Common baldness in both men and women may be treated with minoxidil (Rogaine), which is put on the affected area every day. After several months, both men and women can expect some hair to grow back, although the hair only lasts if you keep using minoxidil.

Men also can use finasteride (Propecia), which can improve hair growth in most men as long as it is used every day. Women should not use finasteride. Pregnant women should not even touch the tablets because the medicine can be absorbed through the skin and may cause birth defects in male babies before they are born.

Other treatments of alopecia focus on the underlying cause, such as correcting thyroid disease or hormonal imbalances, using antifungal medicine for ringworm, and changing hairstyles. Injecting steroids into patches of hair loss in alopecia areata may help, although the hair loss can come back.

Hair transplant surgery and use of a hairpiece are other options.

What can I do if I have alopecia?

If you notice hair loss or thinning, see your doctor. Be specific about when and where the hair loss started, any diseases you have, and any recent emotional or physical stress you have had. Although there is nothing you can do to prevent most types of hair loss, it is important that you keep eating a healthy diet and avoid anything that might irritate the affected area.

Where can I learn more about alopecia?

You can find out more about the different kinds of hair loss at these places:

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