Hair loss: How do you recognize the different forms?

Hair loss is any form of hair loss on the body. In this overview we focus on hair loss from the hairy scalp and face. To help you find out which types of hair loss there are, you can find an overview of many different types and causes of hair loss here.

Hair loss is often associated with several causes at the same time. Therefore, it can be very difficult to get a diagnosis that explains all your complaints, and also successfully treat your hair loss. Hair loss is almost always harmless, but it can cause serious psychological problems. That is why it can be nice to know which diagnosis applies to you and prevent hair loss if possible. Therefore, always consult your doctor if you are concerned or have psychological complaints. The doctor will ask you many questions and examine the scalp in detail to find out the various causes and make the most appropriate diagnosis and treatment.

Hair loss without skin abnormalities or complaints

Telogen effluvium: Temporary hair loss often spread throughout the scalp. This results from a temporary energy deficit in the body. It takes energy for the body to retain hair. By releasing the hairs, the body has energy for other more important processes in the body. This extra energy can be needed for several things:

• Stress: 1-6 months after a stress period (surgery, pregnancy, financial worries).
• Chronic disease.
• Covid infection: can cause hair loss up to 9 months after infection
• Diet especially with rapid weight loss: more than 1 kg per week
• Certain medications:
  • *drugsfor high blood pressure: ACE inhibitors, beta-blockers
    *chemotherapy
  • * antiepileptic drugs: carbamazapine, valproic acid
    * blood thinners: heparin, acenocoumarol, warfarin
    * hormones: oral contraceptives (“the Pill”), other hormone treatments such as testosterone
    * antidepressants: virtually all antidepressants can cause hair loss
    * retinoids: isotretinoin (against acne) and acitretin (against psoriasis) can sometimes also cause hair loss

Androgenetic alopecia is a form of hair loss caused by genetic factors and hormonal changes. It is more common in men and is also referred to as male pattern baldness. In women, it is often referred to as female pattern baldness. Androgenetic alopecia is a gradual process in which the hair on the crown and temples thins and eventually falls out.

• In men, this produces the typical inlets and bald spot on the crown.
• In women, a wider separation is often visible after menopause. Sometimes in women, inlets and a bald crown can occur, this is not very common. If you as a woman already suffer from this form of hair loss before the menopause, it may be useful to have a doctor do a hormonal examination to see why your hormone balance is already disturbed at a young age.

Norwood-Hamilton scale is a scoring system for expressing male pattern baldness in a number. The system is used, among other things, for studies into the treatment of baldness. See also other alopecia scoring systems

Alopecia areata: Is an autoimmune disease characterized by round patches of hair loss on the scalp. These spots can be small or spread to large areas. Alopecia areata can also affect the eyebrows, beard and other parts of the body. The cause of alopecia areata is unknown, but it can be treated with corticosteroids and other medications such as ciclosporin.

Alopecia totalis is a condition in which all the head hair falls out. It can also affect the eyebrows and eyelashes. Alopecia totalis is caused by an autoimmune reaction in which the body attacks and destroys hair follicles. It can be treated with corticosteroids and other medications, but there is currently no cure for this condition.

Alopecia universalis is a rare form of alopecia in which all body hair falls out, including eyelashes and eyebrows. It is caused by the same autoimmune reaction as alopecia totalis. It can be treated with medication, but there is currently no cure for this condition.

Traction alopecia: is caused by repeated pulling of the hair, often by wearing tight hairstyles such as braids and ponytails. This stress on the hair follicles can lead to permanent damage and hair loss. Traction alopecia can be prevented by wearing loose hairstyles and limiting the use of hair accessories that put too much stress on the hair.

Depending on your situation, the doctor will, if necessary, carry out additional examinations and provide further explanation. Only when the cause is known and everything is under control can the hair grow back. This requires a lot of patience. First you will experience that the hair loss stops. After that, the hair will only grow back. This can sometimes take months to a year or more.

Hair loss with redness and/or flaking and/or itching and/or burning sensation

Head dandruff (seborrhoic eczema): Here flaking is often in the foreground and hair loss is present to a lesser extent.

Contact allergy: If you suffer a lot of itching on your head, you may have a contact allergy to hair care products, for example. The itching is often in the foreground here. You have often experienced a reaction to a care product such as redness, swelling or itching. If necessary, contact allergy testing can be performed.

Fungal infection (mycosis capitis): this is most common in children with frizzy hair. These hairs are triangular in shape, so that the fungus can easily remain behind. Sometimes small pus heads may also be present. The lymph nodes in the neck are regularly enlarged.

Burning feeling scalp: Often the feeling of a burning scalp goes hand in hand with symptoms of stress. Often when the stress increases, so does the feeling of a burning scalp. Unfortunately, the only way to get rid of this is to learn how to handle the stress better. Ointments, creams and tablets will unfortunately not help with this.

Receding hairline with/without brow loss: this may be accompanied by redness around the hair follicles and/or itching, but need not be. Often patients first experience eyebrow loss and upon inquiry they notice that the hairline is slowly receding. This is characteristic of frontal fibrosing alopecia. A form of scarring hair loss that occurs mainly in post-menopausal women. It is seen as a healthy but annoying mistake of the immune system in which the hair follicles are attacked. Why this mainly happens at the eyebrows and forehead and not on the rest of the body is not known.

Redness and pimples on scalp with/without itchiness: These symptoms can belong to many different conditions. A hair loss condition that can cause pimples is folliculitis decalvans. This causes inflammation in the skin, where hair follicles can be lost. If you are unsure about this diagnosis, talk to your doctor. If necessary, treatment can be prescribed to reduce the inflammation.

Whatever form of hair loss you have, it is always useful to contact your doctor to receive appropriate therapy or information.

While you are here

Razor bumps, razor bumps in English and dermatologically also called pseudofolliculitis barbae. Pseudofolliculitis barbae is usually caused by shaving. It is seen more often, approximately 60% in dark-skinned men and 5% in white men. In women, razor bumps can sometimes occur in the armpits, pubic area and legs. More about razor bumps