Understand hair loss, identify the various types of hair loss, and learn about treatment options.

About Hair Loss - Alopecia

There are many types of hair loss; some types are temporary and some are permanent. Identifying the type of hair loss someone is experiencing will help determine if the hair loss is permanent and whether it is treatable. Most cases of hair loss are due to genetics, and are treatable if caught on time.

The average person loses about 50-100 hairs a day. This is normal. While there is no set number of hairs for determining an abnormal amount of hair loss, if someone starts noticing a large amount of hair on their pillow or comb, they should consult a physician. This is especially the case if they start experiencing bald patches or thinning hair which can be the signs of an underlying medical condition. There are many types of hair loss (also known as alopecia). Hair loss can be classified into two categories: cicatricial (scarring) alopecia and non-cicatricial (non-scarring) alopecia.

Identifying the Type of Hair Loss to Determine Treatment Options

Before a treatment method can be recommended, a physician should determine what caused the hair loss. During the evaluation process, a physician might ask whether the hair loss is sudden or gradual, if the patient is under any medication, has allergies, a family history of baldness, or if the patient has been dieting. If the patient is female, the physician might ask the patient about her menstrual cycle, if she is pregnant, or if the patient is experiencing menopause.

Oftentimes a physician will inspect the scalp for an indication of hair loss. This is usually done by conducting a pull test to determine the localization and severity of hair loss, or by inspecting the hair on other parts of the body. Sometimes a physician will collect a hair sample, conduct a blood test or remove a small part of the scalp to get the necessary evidence (or scalp biopsy). Because there are so many different causes for hair loss, it may take time to identify the hair loss to be able to find an appropriate solution.

Treatment for Hair Loss

Once underlying health issues for hair loss have been ruled out and cause of hair loss has been identified, then a person can consider treatment options for that particular type of hair loss that is medically accepted. There are many products on the market claiming to be effective to treat hair loss. It is important to understand what is medically accepted treatment for your type of hair loss.

Hereditary Hair Loss: Androgenetic Alopecia

Most hair loss can be attributed to heredity and is classified as androgenetic alopecia (AGA). It can be easily identified because it presents in distinct patterns. The pattern varies between men and women.

Androgenetic alopecia (also referred to as male-pattern baldness, female-pattern baldness, or hereditary hair loss) is a non-cicatricial alopecia and is the most common form of hair loss in both men and women.

Treatment Options for Hereditary Hair Loss

The trick to treating hair loss due to androgenetic alopecia (AGA) is to start early with prevention and intervention using medically accepted treatment methods. There are three FDA approved treatment methods for hereditary hair loss which include finasteride (men only), minoxidil and laser therapy. Side effects, efficacy and ease of use should be considered when selecting a treatment option. Learn more about the various treatment options to make your decision.

Types of Hair Loss

Non-Cicatricial Alopecia

Non-Cicatricial alopecias are non-scarring types of hair loss. Hair loss associated with Non-Cicatricial Alopecia is temporary in most cases with exception of pattern hair loss (androgenetic alopecia).

According to the American Skin Association, “Non-scarring alopecias are more common than scarring alopecias and include pattern hair loss (also known as androgenetic alopecia), alopecia areata, telogen effluvium, and trichotillomania as well as other less common conditions. Sometimes diseases such as secondary syphilis, thyroid disease, and systemic lupus erythematosus can lead to non-scarring hair loss also. Non-scarring hair thinning can also occur with natural aging, which is known as senescent alopecia.” It can also be caused by heredity, diet, behavioral problems, reactions to medications, or grooming habits.

Cicatricial Alopecia

Cicatricial or scarring alopecias are classified as either primary or secondary scarring alopecia. Primary scarring alopecia occurs when the hair follicle is the target of a destructive inflammatory process. Primary scarring alopecias are further classified by the type of inflammatory cells that destroy the hair follicle during the active stage of the disease (ie lymphocytic inflammation and neutrophilic inflammation). Primary scarring is caused by an underlying medical condition. In most cases, the hair loss is permanent. Secondary scarring alopecia is the destruction of the hair follicle caused by a non-follicle directed process or external injury. Refer to Appendices A and B on pages 14-15 for hair loss classifications to help identify.

How Hair Loss Occurs in Androgenetic Alopecia

How Does Hair Loss Occur in AGA?

Hair loss in androgenetic alopecia occurs through the natural process of miniaturization. Miniaturization is the progressive deterioration of a hair follicle. A healthy hair follicle is capable of producing healthy, terminal hair which is thicker and darker in appearance. Over time the follicle shrinks with each cycle of hair and is no longer capable of producing healthy terminal hairs; instead it produces thinner, weaker strands of hair, referred to as vellus hair. Eventually a miniaturized follicle dies and ceases to produce hair altogether, resulting in balding.

What Causes Miniaturization?

In follicles with a genetic predisposition for hair loss, a hormone called DHT (dihydrotestosterone) causes the growth phase of the hair cycle to become increasingly shorter. This shorter growth window produces hair strands that are shorter in length and increasingly thinner in diameter with each hair cycle. For those without AGA in their genes, DHT is not a threat to triggering pattern hair loss. Although it is medically benign, androgenetic alopecia can get progressively worse if left untreated.

Treating Hair Loss with Capillus®

No matter what the cause of hair loss, one thing remains certain: The best way to reverse the signs of thinning, shedding, and balding is to treat it early. Low-level laser therapy devices are recommended tools designed to help strengthen hair follicles and produce all-natural healthy hair from the inside, out.

Receive a free hair loss consultation. Visit our hair loss evaluation form to receive a complimentary diagnosis from a Capillus hair health expert. For immediate assistance, call 1-786-888-6249 or email us. To connect with a physician within the Capillus network in your area to set up a medical appointment, visit our Capillus physician locator and filter by physicians.

3 Source: “Do You Have Hair Loss or Hair Shedding?” American Academy of Dermatology. (Retrieved on 1/26/18)
4 Source: “Alopecia. American Skin Association. (Retrieved on 2/2/18)
5 Source: Shapiro, L. and Otberg, N. (2015). Hair Loss and Restoration. (2nd ed.). Page 148. CRC Press. ISBN 978-1-4822-3197-7.