Types of hairloss in females

Females generally suffer from 2 types of hairloss. 1 is patterned and other variants are non-patterned.

Female Patterned Baldness:

Female patterned baldness is one of the most common forms of hair loss after male patterned baldness. It is also known as AGA (Androgenetic Alopecia). Like males it does not quite progress to a state of complete baldness.  However, any which way you look at it, hair loss in women has much impact on a woman’s psyche. It is often distressing and is accompanied by low self-esteem, a forlorn sense of being less attractive along with a lot of anxiety, in social circles. Women affected by hair loss may show hair thinning on the scalp when hair is parted in the midline. The exposed area resembles a ‘Christmas Tree.’ A small percentage of women with hair loss may also show male patterned baldness.

Following are most commonly found symptoms:

• Gradual hair loss with loss of density over time.
• Hair strands love to stay on your hair brush; pillow; the sink or the floor more than your scalp.
• Scattered hair loss.
• Hair strands appear thinner than before.
• The volume of your hair has reduced.
• Your plait or ponytail appears thinner or the bun smaller than before.
• Leaving the hair loose may not cover the gaps on the head.
• The partition at the top portion of your head appears to be wider than before.
• Family history of hair loss.

There is a distinctive relationship, in women, between their mother, sisters, aunts and grandmothers – when it comes to hair thinning patterns. The problem tends to run in families and is passed on from one generation to the other.  Unlike men, genetic hairloss in women affects the back of the head and also the sides. Hence they do not go bald like men, but lose hair diffusely all over the scalp. This happens because DHT (dihydrotestosterone) – sensitive hair follicles in women are spread diffusely all over the scalp.  Females have oestrogen which is a hair-protective hormone in females. When this hormone falls below normal levels and ups the level of male hormone, testosterone in the body which results in hair loss in women. Female patterned baldness (FPB), like male patterned baldness, is triggered by hormonal imbalance in the body. Conditions, such as ovarian cysts (or, PCOS), or menopause are exclusive triggers for female patterned baldness. The inference is obvious- Hair plays a vital role in a woman’s life. A head full of lustrous locks for a woman exemplifies beauty, feminine grace and poise.

Non-Patterned Types of hairloss include…

Alopecia Areata

Alopecia areata is one of the most common forms of patchy hair loss. It manifests as small, bald patches on the scalp. They may appear suddenly or in a relatively short span of time. Patchy hairloss is not life threatening but it can cause significant damage to one’s self image.

Alopecia areata is an autoimmune condition, in which White Blood Cells (WBC) attack and destroy our hair follicles. This causes the hair to rapidly fall out resulting in the formation of bald patches. Alopecia areata is non-contagious and does not spread because of using common combs, hair brush or contact with a person suffering from it. It affects both sexes and all ages. 

Total hair loss of hair on scalp is called Alopecia Totalis and complete loss of hair all over the body including eyebrows, eyelashes and other parts of the body is called Alopecia Universal. The exact reason why WBC’s start behaving this way is not understood, although the following may be implicated:

• 1/5^th of individuals with patchy hairloss may have family history of this type of hair loss.
• Persons having thyroid disorders are more prone to develop patchy hair loss.
• Anemia and Stress could trigger patchy loss of hair.

Post treatment when hair begins to grow back in the bald patch, it is light in color and thin initially. Over a period of time, the thickness gets better, just as normal colour is regained. When patchy hairloss presents with large patches or does not respond to treatment, the individual may resort to wearing a wig or hairpiece.

Scarring Hair Loss

Many skin conditions can lead to scarring. When the skin gets scarred, hair follicles in the skin are replaced by scar tissue permanently. This is known as scarring hair loss or cicatrical alopecia. Hair loss over such area is permanent and irreversible. Scarring hair loss can affect both men and women and people across all ages. In some cases, it forms slowly, in other instances; it may appear instantaneously, following a scalp injury. The condition typically occurs when the hair follicle is destroyed and is replaced with scar tissue.

Some skin conditions that can trigger scarring hair loss are as follows:

• Lichen Planopilaris: This condition is marked by purplish, raised, itchy, flat-topped lesions that heal with a scar.
• DLE (Discoid Lupus Erythematosus): This is marked by irregular patches of dark and pale white skin, along with redness, scales, scarring and hair follicles devoid of hair.
• Kerion: Raised spongy lesions on the scalp with pus discharge. These are formed in response to a fungal infection of the hair follicle.

Scarring hair loss may also result as a ‘secondary’ response to any of the following:

• Acne (Pimples) can affect the scalp also. This is more common at the back of the scalp.
• Injury to the scalp.
• Parlor burns: From hair dyes and chemicals used on the scalp or severe local burns from heating instruments in the parlour. This is quite common; it is also easily avoidable.

Your trichologist will examine your scalp to check for any scarring. In rare cases, a biopsy may be performed to confirm the diagnosis.

Trichotillomania

A rather strange type of hairloss results from compulsive or compelling hair pulling. This is a psychological disorder. It is called Trichotillomania (TTM) – “Tricho” for hair and Mania for such a self inflicted fad.

It most often affects women more than men. It also affects young children and teenagers, most often girls than boys- primarily in response to anxiety, peer and parental pressure. Sometimes, the affected individual may also eat their hair!

Individual who suffer of Trichotillomania repeatedly pull their own hair from scalp, eyebrows or eyelashes. There is a strong urge to pull hair this gives relief or comfort from anxiety or stress. There is a patchy bald area on the scalp or other areas of the body. There could be thin or missing eyelashes or eyebrows. Individuals would also chew or eat the pulled out hair or play with pulled hair. Hair loss is stopped once the hair pulling obsession is controlled and treated.

Telogen Effluvium

Telogen effluvium is a type of hairloss in which the falling phase or shedding phase of hair is extended beyond normal time period. The causes of this type of hairloss may be hormonal, nutritional, drug associated or stress associated. If there is sudden loss of hair after delivery or after acute illness then it is termed as acute telogen effluvium. If there is continuous hairloss for more than 6 months then it is termed as chronic telogen effluvium.

Treatment will depend on the causative factor.