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Alopecia

Alopecia is the general term for loss of hair, but there are various types and causes. The most well known types are male pattern baldness (androgenetic alopecia) and spot baldness (alopecia areata).

  1. Can have a number of possible causes
  2. Sudden hair loss can be caused by an underlying condition
  3. Unexpected hair loss should be discussed with a doctor

If you are experiencing sudden hair loss, it’s recommended that you speak to a doctor.  Our video doctor service enables you to speak to a GP about alopecia online, at a time of your choice.

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Description

What is alopecia?

Alopecia is an umbrella term for hair loss. It can be due to genetic factors, or related to a systemic illness. The main types of alopecia are male and female pattern baldness, alopecia areata, telogen effluvium (psychological trigger hair loss) and anagen effluvium (hair loss from treatment such as chemotherapy).

If you develop sudden or unexpected hair loss, you should talk to a doctor. It can sometimes be caused by an underlying illness, which may need treatment.

A follicle produces a number of hairs in several stages throughout life. The initial phase is called the anagen phase, and lasts for between 3-5 years, where hair grows around a centimetre every month (although this varies from person to person). This is followed by the catagen phase, which signals the end of the hair’s growth and its transition into the telogen phase, where the hair is dormant and does not grow. 

Male pattern baldness

In male pattern baldness, hair follicles become smaller over a long period of time, and the hair that grows from them also becomes thinner. Gradually, the hairs reach a point where they no longer grow beyond the surface of the head. This process, combined with dormant hairs falling out, means that baldness spreads. 

Alopecia areata

Alopecia areata presents itself in defined patches of baldness. It is thought to be the result of an autoimmune condition, although it is still not fully understood. In most cases, an initial bald spot will have developed by the age of 21, but the condition can develop later in life. In some cases, the condition may progress to alopecia universalis, where someone experiences total, and sometimes permanent hair loss, across the whole of their head.

Telogen effluivium (psychological trigger hair loss)

Telogen effluvium involves the triggering of hairs into the telogen phase quicker than usual, typically due to stress, trauma or hormonal imbalance. Anagen effluvium occurs when the anagen stage is halted, which is usually due to treatments such as radiotherapy or chemotherapy for cancer.

You can find out more about treatments for male pattern baldness on our page on male hair loss. 

If you’re experiencing sudden hair loss in patches, it’s best to talk to a doctor, so they can rule out any possible underlying cause.

Using our video doctor service is simple. Simply click ‘Book appointment’ to talk to a doctor online about alopecia at a time that suits you.

Page last reviewed:  12/06/2020
Diagnosis and treatment

How is alopecia diagnosed?

Alopecia can be diagnosed from a simple examination by a doctor. It can be caused by a number of factors, such as stress, an overactive immune system attacking hair follicles, or an underlying health issue. 

Depending on the type of alopecia, a doctor may take a few hairs to be examined under a microscope. This is in order to rule out the possibility of the cause of hair loss being due to another condition.

Will I need tests?

It usually depends on the type of hair loss present. If it is following a pattern consistent with androgenetic alopecia (male pattern baldness), you will not need tests in most cases, as a diagnosis will usually be made easily. 

However, should your doctor suspect that the hair loss is due to another condition, they may refer you for a blood test or a scalp biopsy. A scalp biopsy just involves removing a very small patch of skin to be examined.

What will a doctor normally advise?

Once again, it depends on the cause. 

Treatments are available for male pattern baldness, but these aren’t a necessity as the condition is a cosmetic one.

If a doctor suspects that a separate health issue could be causing alopecia, such as an underactive thyroid or lupus, further tests will be required, and a doctor will make a referral.

If alopecia is being caused by stress, taking measures to reduce stress can often enable the hair to grow back.

Symptoms of alopecia areata, where hair loss is caused by the immune system, often pass with time. However, in cases where hair loss persists, treatment might be an option. 

What treatments are there for alopecia?

Several treatments for male pattern baldness are available, such as minoxidil (Regaine) and finasteride (Propecia) but these are not provided on the NHS.

For alopecia areata, there are a number of particularly strong topical corticosteroids which can help hair to regrow (if they’re used for a number of months) but they don’t always work. A doctor will usually refer you to a dermatologist for this type of treatment. 

Page last reviewed:  12/06/2020
Questions and Answers

How is alopecia treated?

It depends on the cause.

In alopecia areata, hair can often return on its own, without treatment. In some cases however, topical medications may help to encourage regrowth. 

Hair loss caused by an underlying condition can often be helped by addressing the health issue responsible.

Medications are available for male pattern baldness, but not everyone chooses to use these.

What treatments are there?

Common treatments for male pattern baldness include minoxidil and finasteride. Minoxidil is a topical treatment applied to the scalp that is more effective in the early stages of baldness. Finasteride is an oral treatment that is available on a private prescription, and needs to be taken every day.

Corticosteroids and immunosuppressive therapy are options a dermatologist may consider when treating alopecia areata, but they aren’t guaranteed to work.

Are there side effects?

Yes. Because of how they work, corticosteroids and immunosuppressants can make someone more susceptible to colds or other infections.

Minoxidil can sometimes cause scalp irritation, whereas finasteride can result in a loss of libido. You’ll be able to find out more about the side effects associated with these in their respective patient information leaflets.

Can I consult a doctor about alopecia online?

Yes. Talking to a doctor about alopecia online is simple with our video doctor platform. Book an appointment at a time that suits you. Our doctors are able to discuss and assess your symptoms, and offer appropriate advice.

Page last reviewed:  12/06/2020

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