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Alopecia is a medical term for any degree of hair loss, either complete or partial in males or females, irrespective of the age or predisposing factors that may have contributed to the balding. Hair loss in general is not considered to be a medical disorder and occurs with age, particularly in males, but baldness could also be a sign of more serious underlying causes that may require further investigation.

What are the types of baldness?

Classification of Alopecia

Picture of complete baldness in an African woman after long term use of chemical hair relaxers

Baldness should be investigated to identify other possible causes other than age and genetic factors.

In most cases of alopecia, there is no evident changes in the scalp and the hair loss occurs gradually over time. This is called non-scarring or non-cicatricial alopecia. The common causes of baldness like male-pattern baldness, toxic alopecia, alopecia areata and trichotillomania (hair pulling) are all forms of non-scarring alopecia.

If the hair loss is due to a skin disease or other systemic conditions, there may be signs of scar tissue on the head, also known as scarring alopecia or cicatricial alopecia. There are usually signs of tissue inflammation, injury and destruction on the scalp (skin of the head), with the development of scar tissue over time in scarring alopecia.

Non-scarring alopecia can be further classified according to the cause of hair loss, medical history or predisposing factors.

Types of Non-Scarring Alopecia

1. Male or female pattern baldness is the most common type of baldness and is often due to genetic factors (family history of hair loss). Hormonal causes may contribute to this type of hair loss and initially, the loss may be gradual and sparse, often seen as ‘thinning hair’.
2. Alopecia areata is sudden hair loss in patches (bald spot) without any sign of other skin diseases and may be due to autoimmune causes.
3. Toxic alopecia is any hair loss that may occur as a result of certain drugs or serious acute systemic infections. It may also occur as a result of hair dye allergies or the use of chemical hair relxers or straighteners. Often these products causes contact dermatitis, followed by hair loss.
4. Hair pulling, medically known as trichotillomania, is often seen in children and my is caused by pulling their hair from the roots or breaking the hair follicles.

What causes baldness?

Causes of Alopecia

• Genetic factors
• Age
• Hormonal
• Drugs or metal poisoning
• Autoimmune conditions
• Burns or injury like sarcoidosis
• Infections, either bacterial or fungal (head fungus or tinea capitis).
• Syphilis

Common skin disease that affect the head, like seborrheic dermatitis which may cause dandruff , doe not often lead to baldness.

Always consult with a medical doctor or trichologist before commencing any therapy for baldness. Depending on the type and cause of alopecia, appropriate treatment, like minoxidil, may be considered.

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