Types of Alopecia

There are three primary alopecia classifications, a rare form that is tied to inflammation, and other variants that are referred to less commonly in context with disease discussion.


Primary Types of Alopecia


Alopecia Areata Patchy: The most common variation, this results in patchy hair loss that is mainly on the scalp or areas of the body with hair. Localized cases with less than 50% involvement are typically self-limited. Many patients experience spontaneous regrowth in a few months, with or without treatment.


Alopecia Areata Totalis: This refers to cases in which the scalp incurs complete hair loss. The percentage of patients with this type appears to decrease with every decade of life. In an estimated 30% of patients, complete hair loss occurs within 6 months after onset of the disease.


Alopecia Areata Universalis: A rare form, this affects the entire scalp and body with complete hair loss. Studies indicate this type affects less than 1% of patients.



Rare Scarring Type of Alopecia


Cicatricial Alopecia: This refers to a group of rare disorders that destroy the hair follicles and replace them with scar tissue, thereby causing permanent hair loss. In more aggressive cases, the hair loss is accompanied by burning, itching, and pain. This type of alopecia is further classified by the type of inflammatory cells that destroy the hair follicle during the active stage of the disease. The inflammation can predominantly involve either lymphocytes or neutrophils. This type differs from the three primary types of alopecia in that a majority of patients have no family history of a similar condition.


The first step in the diagnostic process is a scalp biopsy. The type and degree of inflammation, location, and other changes to the scalp are required to accurately diagnose cicatricial alopecia. The biopsy helps determine the degree of activity and guide appropriate therapy.



Other Types of Alopecia


Alopecia Barbae: This type of alopecia only affects the beard and can present as a single bald patch or more extensive hair loss across the entire beard area.


Androgenetic Alopecia: This type of alopecia is commonly known as male pattern baldness or female pattern baldness, this is thinning of the hair to an almost transparent state that affects men and women. It is the most common type of progressive hair loss and is believed to have strong genetic and hereditary links.


Frontal Fibrosing Alopecia: This type of alopecia is a scarring type of alopecia that most commonly affects post-menopausal women. There is usually a band of symmetrical hair loss on the front and sides of the scalp near the forehead that worsens over time. About half of people with FFA experience eyebrow hair loss. Some may also experience eyelash loss and hair loss in other areas of the scalp and face. The cause is thought to be autoimmune and there is also a suspected hormonal component because it most commonly affects post-menopausal women.


Traction Alopecia: Traction alopecia is a type of alopecia in which hair is gradually lost by strain or force being applied to the hair follicles. This primarily happens through various hair styles and styling methods, including tight ponytails, braids, cornrows, chemical treatments, hair curlers and dreadlocks.



Stats and Facts About Alopecia Types


  • Alopecia progresses to alopecia totalis in an estimated 5-10% of patients.

  • When the condition progresses to alopecia totalis or alopecia universalis, the chance for full regrowth decreases substantially.

  • Androgenetic alopecia in men has been associated with coronary heart disease, high blood pressure, enlargement of the prostate, prostate cancer, diabetes, and obesity.

  • In women, androgenetic alopecia is associated with an increased risk of polycystic ovary syndrome (PCOS).



Additional Resources

What Is Alopecia?

Types of Alopecia

Causes of Alopecia 

Alopecia Treatments

Newly Diagnosed with Alopecia

Alopecia FAQ's

Understanding Traction Alopecia

Central Centrifugal Cicatricial Alopecia (CCCA)

7 Common Myths About Alopecia


 


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I wish you would include Frontal Fibrosing Alopecia in your discussion about types of alopecia. This condition affects mainly post menopausal women and involves the progressive loss of eyebrows, eyelashes and hair from the front hairline onwards. It is scarring alopecia so the hair does not grow back. Over ten years or so I have lost about 5 inches of hair from my front hairline and sides and have gone from wearing wide hair bands and caps to now wearing wigs. As far as I know there is no treatment but any information you can provide would be very useful. (Posted on 05/21/2019)

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