Alopecia Areata, Totalis, Univeralis (Hair Loss): Definition, Causes, Treatment

Definition: what is alopecia?

Alopecia is the medical term for losing your hair. Baldness, or androgenetic alopecia is the most frequent type and men are more affected than women.

The normal growth cycle of hair is split into three distinct phases and it lasts between two and five years. The first phase, known as anagen, is the active hair growth phase and is the longest phase, lasting for many years.

During the catagen phase, which only lasts around three weeks, the hair stops growing and the roots embed into the scalp. The last phase is the telogen phase which ends with the hair falling out and the cycle starts again.

In cases of alopecia, the anagen phase is considerably shortened. Therefore, the hair doesn’t grow for as long and it falls out more often. This leads to bald areas on the head, particularly around the temples and the crown.

Different types of alopecia

Alopecia is usually seen in terms of a spectrum which can be divided into categories. These categories depend on the extent of hairloss (complete or partial) as well as parts of the body that are affected.

There are three distinct categories:

- Alopecia areata: hair falls out partially in patches that can vary in size. Alopecia areata can occur anywhere on the body such as arms, legs, face or scalp. The most commonly reported form of alopecia areata is on the scalp.

- Alopecia totalis: hair on the head falls out in its entirety including the scalp, eyebrows and facial hair. Causing entire loss of hair on the head, the appearance of alopecia totalis is often mistaken for effects caused by chemotherapy.

- Alopecia universalis: there is little to no hair growing on the head as well as other parts of the body such as arms, legs and pubic area. This is the most advanced form of alopecia.

Causes of alopecia

The main cause of alopecia is family history. This means that those who have a family member affected by baldness are more at risk of being affected themselves later. Certain genes in these people are therefore involved in passing on alopecia.

A high level of stress can also play a role in the intensity or making symptoms start to appear. In addition, an excessive exposure to UV rays, secondary effects of some medication or hormonal changes are other causes associated with alopecia.

For women, an iron deficiency caused by heavy periods or multiple pregnancies can be the cause of alopecia. This is also the case for some illnesses that cause the body to secrete too many male hormones.

Treating alopecia

In order to treat alopecia efficiently, it is first of all important to determine the causes. Treatment isn’t always necessary, especially in cases of transient hair loss.

Medication can help to slow down how often the hair falls out and to boost regrowth, but doesn’t restore the original hair. Some of these medications include minoxidil which is a lotion, and finasteride which is a tablet. They can be used at the same time as other hair supplements.

Another option is surgery such as small hair transplants. Hair is removed and then put on the bald areas. This technique is strongly discouraged for young people because their alopecia is still developing.

For women, treatment depends on the cause of the alopecia and can include correcting the iron deficiency or addressing the excessive amount of male hormones.