There are various types and variations of alopecia, a disease that occurs when the immune system attacks healthy hair follicles and causes hair loss. Ranging from mild to severe cases, each type of alopecia has its own characteristics and behaviors. Symptoms and methods of treatment may vary, according to your doctor.
Alopecia areata results in one or more small, round patches on the scalp or other areas of the body. Hair loss appears to be patchy, with spots that appear to be round or oval in shape. The most widely known form of alopecia, this form may progress into alopecia totalis, which results in hair loss across the entire scalp, or alopecia universalis which is hair loss throughout the entire body7.
Alopecia totalis is complete hair loss on the entire scalp. This form can begin as alopecia areata, with patches of baldness that spread over time and progress into complete loss of hair on your head4.
Alopecia universalis is complete hair loss throughout the entire body. More extreme than alopecia areata and alopecia totalis, this type of alopecia results in hair loss across the entire scalp and face, which includes the eyebrows and eyelashes, and likely in other areas including the arms, legs, chest, back, and pubic areas1.
Alopecia barbae is a form of alopecia specific to the beard. Similar to alopecia areata, hair loss occurs suddenly and begins with small, round patches of hair loss along the jawline and may result in complete loss of the beard2. Although the focus of this condition is the beard area, it may also appear in other areas on the face and scalp.
Traction alopecia is hair loss caused by tension on the scalp from repeatedly pulling or tightening the hair. You may develop traction alopecia if you style your hair in tight ponytails, buns, or braids and may increase your chances by often chemically treating or heat styling your hair.
This type of alopecia often begins with small pimple-like bumps on your hairline or scalp and progresses to broken and shedding hair, most commonly across the front and sides of your scalp depending on your hairstyle. If untreated, hair follicles may become so scarred and damaged that they are unable to produce new hair8.
Androgenetic alopecia, the main type of hair loss for men and women, is also known as male or female pattern hair loss.
According to Harvard Medical School, hair loss typically begins above the temples and the receding hairline eventually forms a characteristic "M" shape; hair at the top of the head also thins, often progressing to baldness for men. In women, androgenetic alopecia begins with gradual thinning at the part line, followed by increasing diffuse hair loss radiating from the top of the head. A woman's hairline rarely recedes, and women rarely become bald3.
Frontal Fibrosing Alopecia
Frontal fibrosing alopecia (FFA) causes hair loss at the front of the scalp, along the hairline, and near the temples. Most commonly seen in post-menopausal women, this type of alopecia may also cause pain and irritation, and additional hair loss on the eyebrows, underarms, and other areas. FFA is more likely post-menopause but may also affect men and women of all ages5.
Central Centrifugal Cicatricial Alopecia (CCCA)
Central Centrifugal Cicatricial Alopecia (CCCA) is a form of alopecia that results in scarring of the scalp that leads to permanent hair loss. CCCA is known to primarily affect middle-aged African American women, and in rare cases, may be seen in men and women of other ages and ethnicities6.
As noted by Stavonnie Patterson, MD, Assistant Professor in Dermatology at Northwestern University, hair loss typically begins at the vertex or mid-scalp and extends outward in a centrifugal manner. Early signs of CCCA are hair breakage which slowly progresses into severe hair loss and a shiny scalp due to follicular openings on the scalp. While some cases show little to no symptoms, common symptoms are scalp tenderness, itching, and burning6.
Diffuse Alopecia Areata
Diffuse alopecia areata is a form of alopecia that results in sudden and unexpected thinning and hair loss across the scalp. This type of alopecia often shows similar signs and symptoms of other forms of hair loss including androgenetic alopecia (male or female pattern hair loss) or telogen effluvium, making it more difficult to diagnose7.
Ophiasis alopecia areata is a unique form of alopecia that results in hair loss along the sides and lower back of the scalp (known as the occipital region) in the unique shape of a band. According to the National Alopecia Areata Foundation, this pattern of alopecia can be more difficult to treat, because it does not respond as quickly to medication7.