Although many people associate hair loss, or alopecia, with men, it commonly occurs in women as well. According to the American Academy of Dermatology, at least 50 percent of all women in the United States will experience it in some form before they reach 50 years old. Hair loss can have a significant emotional impact in women, causing psychological stress and loss of self-esteem.
Androgenetic Alopecia
Androgenetic alopecia, or female-pattern hair loss, is a familial condition that can manifest as early as the teenage years. This usually involves loss of hair on the top and sides of the scalp, with sparing of the frontal hairline and the back of the scalp. In the March 2003 issue of American Family Physician, Dr. Carolyn Thiedke describes female-pattern hair loss as the most common cause of alopecia in women. Minoxidil is currently the only medication approved by the United States Food and Drug Administration to treat this condition.
Telogen Effluvium
Telogen effluvium is caused by the abrupt shift of a large percentage of hair follicles from the growing phase to the shedding phase. This results in hair loss of up to 300 strands per day, generally spread over all areas of the head. Several events can precipitate telogen effluvium, including severe emotional stress, major illness or surgery, pregnancy, thyroid disorders, iron deficiency, and some drugs, such as heparin and lithium. In the October 2007 issue of The New England Journal of Medicine, Dr. Jerry Shapiro reported that telogen effluvium usually occurs around three months after the causative event and lasts up to six months after removal of this cause.
Anagen Effluvium
Anagen effluvium results from the immediate destruction and loss of hair, due to the interruption of the growing, or anagen, phase of hair growth. This occurs most commonly after exposure to toxic chemicals or medications, usually drugs used in chemotherapy.
Cicatricial Alopecia
Cicatricial alopecia, also called scarring alopecia, results from conditions that damage the scalp and the hair follicles. The scalp usually appears abnormal, with bald spots, red plaques and pimple-like lesions. Conditions associated with cicatricial alopecia include autoimmune diseases such as discoid lupus erythematosus, infections such as syphilis and tuberculosis, and scalp trauma.
Traction Alopecia
Traction alopecia results from social and cosmetic practices that damage hair follicles over time. According to the American Hair Loss Association, the most common hair styling causes include braiding, cornrows, tight ponytails, and use of extensions. Hair processing, such as bleaching, coloring and relaxing can also cause traction alopecia. The pattern of hair loss may vary, but usually occurs on the sides and front areas of the scalp. Removal of the cause of traction often cures the problem, although in rare instances, infection and scarring may result in permanent damage and hair loss.
Trichotillomania
Trichotillomania is a compulsive behavior that involves repeated hair plucking, resulting in a patchy type of hair loss. Treatment of this condition usually requires a combination of drugs and behavioral therapies addressing the psychological or emotional reasons behind the compulsive hair pulling.
References
- "American Family Physician" Alopecia in Women; C. Carolyn Thiedke, MD; March 2003
- American Academy of Dermatology: Hair Loss in Women-More Than Meets the Eye
- American Hair Loss Association: Causes of Hair Loss
- "The New England Journal of Medicine" Hair Loss in Women; Jerry Shapiro, MD; October 2007
- "American Family Physician" Diagnosing and Treating Hair Loss; Anne L. Mounsey, MD and Sean W. Reed, MD; August 2009
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