Alopecia

What is alopecia?

We all have thousands of hairs growing on our body. Each of our individual hairs grow out from a hair follicle, which is the root of the hair. Normally, our hair goes through phases:

• Anagen phase – where the hair grows to its full length, which can take years

• Catagen phase – the resting phase of the hair, where it stays at its full length

• Telogen phase – the phase where the hair has reached its end and falls out of the follicle. This is normal, and it’s estimated we lose about 50 to 100 hairs every day without realising.

In some cases, this cycle is cut short and our hair may start to fall out quicker than we want it to. This is called alopecia, and although it’s more noticeable on the head, it can happen anywhere on the body.

What are the symptoms of alopecia?

• A quick loss of an area of hair, usually on the head, beard, eyebrows or eyelashes

• A circular patch of hairless skin

• Loss of colour of a patch of hair

• Of those hairs that remain, they may be broken strands with a thick end and thin base – these are called exclamation point hairs

• Tingling or itching in the area where the hair loss happened

• Hairs growing back white or grey

• In some cases, you may have nail changes, which can indicate that there may be an underlying condition

How common is alopecia?

As there are many types of alopecia and a high variety in severity, it’s difficult to tell how common it is. Alopecia areata affects about 1 in every 1,000 people, whereas androgenic alopecia happens in half of all men over the age of 50 and half of women over the age of 65, mostly occuring after menopause.

What causes alopecia?

Usually, your hair will fall out without leaving a scar on the skin, also called non-scarring alopecia. There are 6 types of non-scarring alopecia.

Alopecia areata

Alopecia areata is the temporary or permanent loss of patches of hair on the head, face or anywhere on the body, without an obvious reason. It’s usually because the body is attacking your hair follicles, calling the hairs to fall out.

Although there are many causes for this to happen, the most common are stress and inflammatory diseases, or it can be passed on from your parents. It is, most likely, an autoimmune disorder but we still don't know exactly why it happens.

Androgenic alopecia

Androgenic alopecia is hair loss because of changes in hormone balances in your body. It is the most common cause of hair loss. This can be because of normal ageing, which is why men tend to lose their hair, or because of other conditions like polycystic ovarian syndrome, diabetes or cancer.

Telogen effluvium

Telogen effluvium is when the telogen phase of our hair cycle happens prematurely, usually because of stress, illness, drug use or a poor diet.

Traumatic or traction alopecia

Traumatic or traction alopecia is when hair is lost because of repeated pulling on the hair.

Tinea capitis

Tinea capitis is a fungal infection that can cause a rash and alopecia, leaving a rounded hairless shape on the head.

Anagen effluvium

Anagen effluvium is the loss of the hair that’s still growing. This happens in people with cancer who are having chemotherapy.

How is alopecia diagnosed?

When you see a GP, they will ask you a few questions and look at the areas where the hair has fallen out, as this can give clues about the type of alopecia. They’ll also do a hair pull test, where they run their fingers through your hair to see how many hairs they pull out.

If they suspect another medical problem, they may also want to take a blood test and look at the area with a dermatoscope.

How is alopecia treated?

Most cases of hair loss don’t need treatment, as it’s either temporary and should grow back, or because of normal ageing.

If you have alopecia, there are lifestyle changes that may help you:

• Protect your hair and head from the wind by wearing a hat and scarf 

• Try to keep stress levels down

• Avoid using harsh chemicals and pulling when styling your hair

• Avoid any foods that may trigger your inflammation and autoimmune symptoms

• Follow a healthy diet

If you’re feeling down or anxious about your hair, talking therapy or joining a support group could help you cope. Alopecia UK also has a lot of useful resources.

When should I seek help?

You may want to see a GP if:

• You lose your eyelashes

• You feel tired all the time

• Your muscles ache

• Your nails feel brittle

• You get any new rashes

How can Livi help?

A Livi doctor can talk to you about your symptoms and give you advice on the next best steps.