Hair loss

Hair loss - why am i losing my hair?

Hair is an essential part of our identity and hair loss loss can therefore be very distressing. It can occur for many reasons and may present in a variety of ways from general thinning all over the scalp to patchy loss which is more focused to the front, side or back of the scalp.

It is important to diagnose the cause of your hair loss early to determine whether you need treatment to prevent further progression. Some forms of hair loss can also cause scarring of the hair follicles (and the hair is produced) which means delayed treatment might lead to permanent loss.

A Consultant Dermatologist will assess your scalp using an instrument called a dermatoscope to look at the follicles and any remaining hairs under high magnification. This is called trichoscopy. Sometimes a diagnosis is difficult to making on clinical assessment alone and you will be advised to have a skin biopsy to help confirm the cause. This is also useful to assess the how active your condition is and the amount of scarring if any.

Further information of the most common causes of hair loss can be found below. If you think you have any of these conditions, discuss this with your Dermatologist to assess the cause and provide you with treatment options.

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The NHS information website provides further information on hair loss. Visit the following link to find out more.

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Causes of hair loss

Male or female pattern loss "Androgenetic alopecia"

This is the most common cause of hair loss which presents as thinning of the hair.

Male pattern baldness is better recognised and involves recession of the front hair line and central thinning of balding. This is the type of hair loss experience by the footballer Wayne Rooney.

Female pattern baldness also occurs in some women and can start at a young age. There is less recession of the front hair line and instead thinning of the front and central scalp. The back of the scalp tends to be preserved.

Alopecia Areata

This is an autoimmune condition in which the bodies immune system attacks the hair follicles and causes the hair of fall out. It tends to come out in patches of complete loss rather than thinning. In more severe cases, there is widespread loss which can also affect other areas of the body including the eyebrows and eyelashes. The scalp itself usually looks normal and sometimes shiny.

Frontal fibrosing alopecia

This is a condition more commonly seen in Women, presenting as a recession of the front hair line which is progressive over time. On closer inspection, there may be scaling and redness about the hair follicles. Early treatment is important as this form of hair loss tends to cause scarring.

Traction Alopecia

This condition causes gradual hair loss due to long term pulling on the hair follicles from certain hair styles or practices where the hair is held tightly. This includes braids, pigtails or ponytails.

Lichen planopilaris

This is an inflammatory skin condition which can affect the skin (termed Lichen Planus) as well as the hair follicles and nails. The form which affects the hair is called Lichen Planopilaris in which there is "lichenoid" inflammation around the hair follicles which results in scarring and hair loss over time. You may notice stinging, pain or burning on the scalp. Scaling around the hair base may be seen. This can be confirmed on a biopsy. Diagnosis should be made early to ensure treatment can be commenced to halt its progress.

Concerned about hair loss?