The Many Types of Hair Loss: What’s Behind the Shedding?

3rd April 2025

Hair loss isn’t just about losing strands—it’s about losing confidence, wondering why it’s happening, and searching for answers. It can creep in slowly or appear out of nowhere, leaving many feeling frustrated and unsure of what to do next. But not all types of hair loss are the same, and understanding the different types of hair loss is the first step toward finding the right path forward. Whether it’s a passing phase or something more persistent, knowing what’s behind the shedding can help you take control and explore the best options for keeping your hair healthy and strong.

Androgenetic Alopecia: The Most Common Culprit

Androgenetic alopecia (AGA) is one of the main types of hair loss, commonly referred to as male pattern baldness (MPB) and female pattern hair loss (FPHL), is the most prevalent form of hair loss. It is a genetically inherited, hormonally driven, progressive hair loss that leads to follicular miniaturization. This process reduces the size of hair follicles, shortens the growth phase, and eventually results in thinning hair and scalp exposure.

Pathophysiology of Androgenetic Alopecia

AGA occurs due to an increased sensitivity of hair follicle androgen receptors (ARs) to DHT, a metabolite of testosterone produced by the enzyme 5-alpha reductase (5-AR). DHT binds to these receptors, leading to:

Follicular Miniaturization: Progressive reduction in hair follicle diameter, length, and duration of the anagen phase.
Anagen Shortening: The active growth phase of the hair cycle is reduced, leading to faster shedding and delayed regrowth.
Increased Telogen Phase: Hair remains in the resting phase longer, resulting in higher daily shedding rates.
Loss of Terminal Hair: Thick, pigmented terminal hairs are gradually replaced by vellus-like, non-pigmented, finer strands.

Male Pattern Baldness (MPB)

MPB typically follows a predictable pattern, classified using the Norwood-Hamilton Scale (I-VII):

Stage I-II: Minimal or early temporal hairline recession.
Stage III-IV: Deeper recession at the temples, initial vertex (crown) thinning.
Stage V-VI: Severe frontal recession with extensive vertex involvement.
Stage VII: Complete loss of hair on the vertex and frontal regions, with only a horseshoe pattern of hair on the occipital and temporal regions.

Female Pattern Hair Loss (FPHL)

Unlike MPB, FPHL does not present with a receding hairline. Instead, it is characterized by diffuse thinning, typically at the crown and along the central parting. The Ludwig Scale classifies FPHL into three grades:

Grade I: Thinning along the part line with increased scalp visibility.
Grade II: Widening of the part line with moderate diffuse thinning.
Grade III: Significant loss of density at the crown with visible scalp exposure.

Treatment Options

While androgenetic alopecia is one of the most progressive types of hair loss, several treatments can slow or manage this type of hair loss.

FDA-Approved Medications

Minoxidil (Rogaine) – A topical solution that prolongs the anagen phase, promoting hair regrowth.
Finasteride (Propecia) [For Men Only] – An oral medication that inhibits 5-alpha reductase, reducing DHT levels.
Spironolactone (For Women Only) – An androgen-blocking medication used off-label for female pattern baldness.

Low-Level Laser Therapy (LLLT)

Uses red light wavelengths to stimulate follicular activity and improve hair density.
FDA-cleared for both men and women, with moderate effectiveness in early-stage hair loss.

Platelet-Rich Plasma (PRP) Therapy

Involves injecting growth-factor-rich plasma extracted from the patient’s blood into the scalp.
Enhances hair follicle function and prolongs the anagen phase.

Hair Transplant Surgery

Follicular Unit Extraction (FUE) and Follicular Unit Transplantation (FUT) are surgical methods to relocate healthy hair follicles from donor areas.
Offers a permanent solution for advanced cases but requires a qualified surgeon.

Telogen Effluvium: Stress and Sudden Shedding

Telogen effluvium (TE) is a temporary, non-scarring form of diffuse hair shedding that occurs when a significant number of hair follicles prematurely enter the telogen (resting) phase. Unlike androgenetic alopecia, which is progressive, TE is often triggered by physiological or emotional stress and results in increased daily hair shedding rather than localized thinning or bald spots. While distressing, TE is typically reversible, provided the underlying cause is identified and addressed.

How Stress Triggers Telogen Effluvium

In telogen effluvium, a higher-than-normal percentage of follicles shift from anagen to telogen due to a physiological or psychological stressor. This leads to a sudden increase in daily shedding, often 100-300 hairs per day instead of the normal 50-100 hairs. Shedding usually occurs 2-3 months after the triggering event, as telogen hairs take time to detach and shed.

Common Causes of Telogen Effluvium

Several factors can disrupt the hair cycle, triggering TE:

Physical Stress & Trauma

Severe illness or high fever (e.g., COVID-19, influenza, infections).
Major surgery or anesthesia – a common cause of post-surgical hair shedding.
Rapid weight loss – sudden calorie deficits deprive follicles of essential nutrients.
Nutrient deficiencies – low levels of iron, zinc, vitamin D, or biotin can trigger TE.

Emotional Stress & Psychological Factors

Severe anxiety, depression, or chronic stress increase cortisol levels, disrupting hair growth.
Traumatic life events, such as loss of a loved one or extreme work stress, can induce shedding.

Postpartum Hair Shedding (Postpartum Telogen Effluvium)

During pregnancy, high estrogen levels prolong the anagen phase, leading to thicker hair.
After childbirth, estrogen drops, triggering synchronized follicular entry into telogen.
Hair shedding peaks 2-4 months postpartum and resolves by 6-12 months postpartum.

Hormonal Changes & Medical Conditions

Thyroid disorders (hypothyroidism, hyperthyroidism) disrupt hair cycling.
Discontinuation of birth control pills can cause temporary hormone fluctuations.
Menopause and perimenopause may lead to increased shedding.

Medications That Induce TE

Beta-blockers (e.g., metoprolol, propranolol).
Retinoids (e.g., isotretinoin for acne).
Antidepressants (e.g., fluoxetine, sertraline).
Anticoagulants (e.g., heparin, warfarin).

Phases of Telogen Effluvium Recovery

Stage	Timeline	What Happens?
Triggering Event	0 Weeks	Stressor occurs (illness, surgery, stress, etc.).
Shedding Begins	2-3 Months	Hair starts falling out more than usual.
Peak Shedding	3-6 Months	Noticeable diffuse hair loss across the scalp.
Stabilization	6-9 Months	Shedding slows as new hairs start entering anagen.
Regrowth Phase	9-12 Months	Hair volume returns to normal.

How to Support Hair Regrowth & Recovery

Supporting hair regrowth after telogen effluvium requires a targeted approach that focuses on addressing the root cause, optimizing nutritional intake, and adopting gentle hair care practices.

Identify and Address the Underlying Cause

Review recent stressors, illnesses, surgeries, or medication changes.
Correct nutritional deficiencies through blood tests and supplementation.
Manage stress levels through relaxation techniques, therapy, or exercise.

Optimize Diet and Nutrition

Increase protein intake (hair is 90% keratin, a protein).
Iron and ferritin levels: Aim for serum ferritin >50 ng/mL for optimal hair regrowth.

Include essential nutrients like

Biotin (Vitamin B7) – Supports keratin production.
Zinc – Essential for follicular function.
Vitamin D – Deficiency is linked to hair loss.
Omega-3 fatty acids – Found in fish and flaxseed, support scalp health.

Gentle Hair Care Routine

Avoid excessive heat styling, tight hairstyles, or harsh treatments (e.g., bleach, perms).
Use sulfate-free shampoos to reduce scalp irritation.
Minimize mechanical stress (gentle brushing, avoid excessive washing).

Scalp Health & Topical Treatments

Minoxidil 2% or 5% (Rogaine) can be used in persistent cases.
Scalp massages improve circulation and stimulate follicles.
Caffeine-based shampoos may help prolong the anagen phase.

Understanding Autoimmune Hair Loss

Autoimmune hair loss occurs when the immune system mistakenly attacks hair follicles, disrupting the natural growth cycle and leading to excessive shedding or bald patches. Unlike other types of hair loss, such as androgenetic alopecia, autoimmune-related hair loss is driven by inflammatory responses that prematurely push hair into the telogen (resting) phase.

Alopecia Areata: When the Immune System Attacks

Alopecia areata (AA) is an autoimmune type of hair loss that causes sudden, unpredictable hair shedding due to immune system dysfunction. The body’s immune cells mistakenly attack hair follicles, leading to inflammation and disruption of the hair growth cycle.

T-cell mediated autoimmunity: The immune system mistakenly targets the anagen (growth phase) follicles, causing sudden hair loss.

Inflammatory response: Cytokines and immune cells attack hair follicles, leading to premature entry into the telogen (resting) phase.
Hair follicle miniaturization does not occur, which means regrowth remains possible.

Potential Triggers

Genetic predisposition – Family history increases susceptibility.
Environmental factors – Viral infections, stress, or trauma may act as triggers.
Other autoimmune conditions – Associated with thyroid disease, vitiligo, and rheumatoid arthritis.

Types of Alopecia Areata

Alopecia areata can present in different patterns, varying in severity and extent of hair loss. Some individuals may experience small, isolated patches, while others may face more widespread thinning or complete hair loss.

Patchy Alopecia Areata (Most Common Form)

Presents as oval or round bald patches on the scalp.
The skin appears smooth, with no signs of inflammation.
In some cases, hair regrows spontaneously within months.

Alopecia Totalis (Complete Scalp Hair Loss)

A more severe form where all scalp hair is lost.
Regrowth is less predictable and often requires treatment.

Alopecia Universalis (Complete Body Hair Loss)

The most extensive form, affecting scalp, eyebrows, eyelashes, and body hair.
Highly resistant to treatment but not necessarily permanent.

Ophiasis Pattern Alopecia Areata

Band-like hair loss along the lower scalp (occipital and temporal areas).
More resistant to regrowth than the patchy form.

Available Treatments and Potential for Regrowth

While alopecia areata has no definitive cure, various treatments can stimulate regrowth and suppress immune activity.

First-Line Treatments (For Patchy AA)

Topical Corticosteroids (Clobetasol, Betamethasone): Reduce follicular inflammation.
Intralesional Steroid Injections (Triamcinolone): Stimulate regrowth within 4-6 weeks.
Topical Minoxidil (5%): Enhances follicular activity, often used in combination therapy.

Systemic Immunomodulatory Therapies (For Extensive AA)

Oral Corticosteroids (Prednisone): Effective but not for long-term use due to side effects.
JAK Inhibitors (Baricitinib, Tofacitinib, Ruxolitinib): Suppress immune overactivity; high response rate, but relapse is possible.

Other Therapies:

Diphencyprone (DPCP) & Squaric Acid Dibutyl Ester (SADBE): Topical immunotherapy to redirect immune response.
Low-Level Laser Therapy (LLLT): May support follicular regeneration but with limited efficacy.
Platelet-Rich Plasma (PRP) Therapy: May aid regrowth in early-stage cases.

Traction Alopecia: Styling Habits That Hurt

Traction alopecia is a mechanical hair loss condition caused by prolonged tension on hair follicles due to hair practices. Unlike genetic hair loss, traction alopecia results from external stress on the scalp, leading to gradual follicular damage. If detected early, the condition is reversible, but long-term tension can cause permanent scarring and follicular atrophy, making regrowth impossible.

How Tight Hairstyles and Extensions Contribute to Hair Loss

Certain hairstyling practices create excessive strain on the scalp, leading to inflammation and eventual follicular weakening. The repeated application of tight hairstyles, heavy extensions, and hair accessories contributes to progressive thinning, hairline recession, and breakage.

Chronic Tension on Hair Follicles

Constant pulling on hair strands disrupts normal follicular function, pushing hair into the telogen (resting) phase prematurely.
Over time, sustained tension can cause perifollicular inflammation, leading to follicular miniaturization and reduced hair density.
Folliculitis (scalp inflammation) may develop, increasing scalp sensitivity and irritation.

Hair Extensions and Weaves

Sewn-in, glued, or clip-in extensions add excess weight, placing undue stress on natural strands.
Tightly installed weaves pull on the scalp, leading to gradual thinning at the edges and temples.
Bonding adhesives and heat styling further weaken the hair shaft, increasing the risk of traction alopecia.

Repeated Use of Hair Accessories

High ponytails, buns, and braids, when worn daily, create localized stress on follicles.
Rubber bands, tight clips, and metal fasteners cause breakage and weaken hair near the roots.
Wearing tight headbands or wigs with stiff elastic bands can lead to thinning around the hairline and scalp perimeter.

Recognizing Early Warning Signs

Traction alopecia does not happen overnight—it develops progressively as follicles become damaged from repeated stress. Detecting symptoms early can help prevent irreversible hair loss.

Gradual hair thinning, especially along the hairline, temples, and crown.
Redness, tenderness, or small bumps along the scalp, indicating inflammation.
Short, broken hairs around frequently styled areas.
Receding edges and increased scalp visibility.
Itching or burning sensation where hair is pulled tightly.

Prevention and Best Practices for Protective Styling

Traction alopecia is largely preventable with the right hair care routine. By reducing tension, strengthening follicles, and choosing gentle styling techniques, individuals can maintain healthy hair growth and minimize damage.

Reduce Tension on Hair Follicles

Loosen tight hairstyles – Avoid excessive pulling on the scalp when styling.
Rotate hairstyles – Change up parting positions and styles frequently to avoid constant strain in one area.
Use soft, snag-free hair ties – Silk scrunchies and fabric-covered bands minimize breakage.

Be Cautious with Hair Extensions & Weaves

✔ Opt for lightweight extensions to reduce tension on natural hair.
✔ Limit wear time to 6-8 weeks to prevent prolonged stress on follicles.
✔ Avoid glue-in extensions and tightly sewn weaves, especially on fragile areas like the hairline.

Strengthen Hair and Scalp Health

Maintain a balanced diet rich in protein, iron, and biotin to support strong hair growth.
Regular scalp massages promote blood circulation and strengthen roots.
Use gentle, sulfate-free shampoos and hydrating conditioners to prevent dryness and breakage.

Seek Professional Help If Needed

Consult a dermatologist or trichologist if thinning persists despite changing styling habits.
Consider low-level laser therapy (LLLT) or platelet-rich plasma (PRP) therapy to stimulate regrowth in early cases.
In severe cases, hair transplant procedures may be required to restore lost density.

Scarring Alopecia: The Irreversible Type

Scarring alopecia, also known as cicatricial alopecia, is a group of rare but serious hair loss disorders in which hair follicles are permanently destroyed due to inflammation and fibrosis (scarring). Unlike non-scarring hair loss conditions, where follicles remain intact and capable of regrowth, scarring alopecia results in permanent bald patches because the follicular structure is replaced with scar tissue.

What Sets Scarring (Cicatricial) Alopecia Apart?

Scarring alopecia differs from other types of hair loss in several ways:

Permanent hair loss: Once follicles are replaced by scar tissue, regrowth is no longer possible.
Inflammation-driven destruction: The immune system attacks the hair follicles, leading to gradual scarring.
Smooth, shiny scalp appearance: Unlike androgenetic alopecia or telogen effluvium, scarring alopecia leaves the affected areas without visible follicular openings.
Symptoms beyond hair loss: Many patients experience redness, burning, itching, or tenderness in affected areas before hair loss becomes noticeable.

Types of Scarring Alopecia and Their Causes

Scarring alopecia is classified into primary and secondary forms based on whether the condition originates from within the follicle or as a result of external damage.

Primary Scarring Alopecia (Autoimmune & Inflammatory Causes)

In these cases, the immune system directly attacks the hair follicles, causing irreversible scarring and hair loss.

Lichen Planopilaris (LPP)

A chronic autoimmune disorder that destroys follicles through inflammation.
Presents with patchy hair loss, redness, burning, and scaling.
More common in middle-aged women.

Frontal Fibrosing Alopecia (FFA)

A variant of LPP that causes progressive recession of the hairline and eyebrows.
Often linked to hormonal changes and postmenopausal women.

Discoid Lupus Erythematosus (DLE)

A form of cutaneous lupus that affects the scalp, leading to scaly, inflamed plaques.
If untreated, scarring results in permanent bald patches.

Central Centrifugal Cicatricial Alopecia (CCCA)

Affects Black women disproportionately, causing gradual hair loss at the crown.
May be linked to genetics, scalp inflammation, or hairstyling practices.

Secondary Scarring Alopecia (External Damage to Follicles)

This type occurs when external trauma or skin conditions destroy the hair follicles.

Traumatic Scarring Alopecia

Results from burns, radiation, infections, or surgical scars.
Hair follicles are permanently damaged, leaving bald, fibrotic patches.

Infections (Folliculitis Decalvans & Fungal Infections)

Folliculitis decalvans is a bacterial infection that causes pustules and scarring.
Tinea capitis (scalp ringworm) can lead to scarring if untreated.

Treatment Strategies for Managing and Slowing Progression

Although scarring alopecia is irreversible, treatment focuses on controlling inflammation, preserving existing follicles, and slowing disease progression.

Anti-Inflammatory Medications

Corticosteroids (Clobetasol, Triamcinolone, Prednisone) – Reduce scalp inflammation; injections and oral use for severe cases.
Hydroxychloroquine (Plaquenil) – Modulates immune response in LPP, FFA, and DLE.
JAK Inhibitors (Tofacitinib, Ruxolitinib) – Emerging treatment for LPP and CCCA.
Mycophenolate Mofetil & Cyclosporine – Suppress autoimmune activity in severe cases.

Antibiotics & Antimicrobial Therapy:

Doxycycline, Minocycline – Reduce inflammation in folliculitis decalvans.
Griseofulvin, Terbinafine – Treat scalp ringworm (tinea capitis) to prevent scarring.

Supportive & Cosmetic Treatments:

Platelet-Rich Plasma (PRP) Therapy – May promote follicular stability in early cases.
Hair Transplant Surgery (FUE) – Only for stable cases; limited success due to scarring.
Scalp Micropigmentation & Wigs – Cosmetic solutions for irreversible hair loss.

Hair loss can be frustrating, but understanding what’s behind it is the first step toward taking control. Whether it’s temporary or more persistent, every type of hair loss has its causes—and ways to manage it. Staying informed, exploring your options, and caring for your hair and overall well-being can make all the difference. No matter the challenge, there’s always a path forward with confidence.

Restore confidence and find the perfect fit for your hair needs with HairWeavon—your trusted hair specialist!