What’s alopecia?

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Alopecia is the medical term for hair loss or baldness. While most associate hair loss with male or female pattern baldness, there are actually numerous causes for alopecia. Hair loss is further classified by type or cause.

Androgenic alopecia is also called baldness. This form of hair loss usually occurs due to the loss of specific types of hormones called androgens. In males this can often mean total hair loss, although many men still retain some hair on the sides of their heads. Women rarely experience complete hair loss, but may lose hair in patches.

Alopecia areata is a type of hair loss that tends to occur in spots, as opposed to baldness. Alopecia areata monolocularis means that hair loss occurs in only one spot, usually on the head. Alopecia areata multilocularis means that hair loss occurs in multiple places and the loss may not be limited to the head.

Unlike the genetic causes associated with pattern baldness, alopecia areata is thought to be caused by an autoimmune disease. The antibodies react to the hair follicles as if they were foreign to the body and attack them. The problem can be addressed, especially if done in the early stages. Treatment includes the use of steroids and the drug minoxidil to help stimulate hair regrowth.

In some cases, certain conditions are associated with hair loss. Many autoimmune diseases, such as lupus and AIDS, can cause hair loss. Other times, too much thyroid or hypothyroidism is responsible for hair loss. Fungal conditions like ringworm can also cause baldness. Those who suffer from eczema may also experience some hair loss.

Some medications are associated with hair loss. This is especially true for drugs used for chemotherapy. Generally when chemotherapy ends, hair grows back. Other medications that can cause hair loss include:
Thyroid medications
Anticoagulants such as aspirin, heparin and warfarin
Antidepressants
Mood stabilizing drugs such as Tegratol® (carbamazepine)
Oral contraceptives

This is by no means an exhaustive list of potential medications that can cause alopecia. Also, these medications have a risk factor for causing hair loss, but not all people will experience baldness. In many cases, it is worth taking the risk, because the benefits of using the drug are quite high.
Hair loss can further be caused by patients suffering from a disease called trichotillomania. In this condition people have an urge to pull their hair out. This condition is a compulsion, and therefore generally cannot be resisted. As with trimming, it is thought that patients may pull out more hair in response to external stressors. Plucking can cause injury to the hair shafts, making it difficult for hair to regrow.

Children with trichotillomania have a very good chance of recovery through psychiatric counseling and medication. However, it’s not clear which psychiatric drugs work best. Adults may have a harder time recovering. One possible treatment, more applicable for men, is to keep the hair shaved so that the patient cannot pull out individual hairs. Additionally, tranquilizers can be used to temporarily relieve the craving.

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