Different Types of Hair Loss and Treatment Solutions

Understanding Hair Loss: Beyond Simple Balding

Hair loss affects millions of people regardless of gender, though the patterns and underlying causes often differ significantly. A dermatologist identifies the type of hair loss, which guides treatment.

Major Types of Hair Loss

Androgenetic Alopecia (Pattern Hair Loss)

The most common form of hair loss, affecting both men and women:

In men: Typically begins with recession at the temples and/or thinning at the crown
In women: Usually presents as diffuse thinning across the top of the scalp with preservation of the frontal hairline

Key mechanism: Sensitivity to dihydrotestosterone (DHT), which causes miniaturization of hair follicles over time, leading to progressively thinner and shorter hairs until follicles eventually become dormant.

Telogen Effluvium

A temporary form of diffuse hair shedding triggered by:

Major physical stress (surgery, illness, childbirth)
Significant weight loss
Nutritional deficiencies
Certain medications
Hormonal fluctuations

Key mechanism: A larger percentage of hairs than normal enter the telogen (resting) phase of the hair cycle simultaneously, resulting in increased shedding 2-3 months after the triggering event.

Alopecia Areata

An autoimmune condition characterized by:

Well-defined circular patches of complete hair loss
Unpredictable pattern of remission and recurrence
In severe cases, can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis)

Key mechanism: The immune system attacks hair follicles, causing inflammation and disruption of hair growth.

Traction Alopecia

Hair loss resulting from physical stress on hair follicles, often due to:

Tight hairstyles (ponytails, braids, buns)
Hair extensions or weaves
Frequent use of hair tools that pull on the hair

Key mechanism: Constant tension damages follicles and can eventually lead to permanent hair loss if the pulling force continues over years.

Scarring (Cicatricial) Alopecia

A group of disorders that destroy hair follicles and replace them with scar tissue, including:

Lichen planopilaris
Frontal fibrosing alopecia
Discoid lupus erythematosus
Folliculitis decalvans

Key mechanism: Inflammation damages the stem cell reservoir of the follicle, resulting in permanent destruction and inability to regrow hair.

Ingredients Prescribers Use

These are ingredients a prescriber may order. Your prescriber chooses the ingredients and strengths. Compounded medications are not FDA-approved.

For Androgenetic Alopecia

Topical Ingredients

A prescriber may combine:

Minoxidil: At the strength the prescriber writes
Finasteride: A 5α-reductase inhibitor, used topically off-label
Dutasteride: Another 5α-reductase inhibitor, used off-label for hair loss
Corticosteroids: Such as fluocinolone, when the prescriber adds one
Other ingredients: Such as caffeine or melatonin, when the prescriber adds them

Oral Options

A prescriber may also order an oral medication:

Finasteride: At the strength the prescriber writes
Dutasteride: Off-label for hair loss
Spironolactone: Used off-label by some prescribers for female pattern hair loss

For Telogen Effluvium

Care usually starts with finding and addressing the trigger, such as illness, a medication, or low iron. Your prescriber decides whether any treatment is needed.

For Alopecia Areata

A dermatologist may prescribe:

Topical or injected corticosteroids
Minoxidil
Topical immunomodulators, such as tacrolimus
JAK inhibitors, including FDA-approved oral products for severe alopecia areata

See a Dermatologist Early

If you notice unusual hair loss, see a dermatologist. Some types, such as scarring alopecia, cause permanent damage, so an early diagnosis matters.

Working With Your Prescriber

Your prescriber may also check hormones, iron and other labs, and review your scalp care. Response to any hair loss treatment varies and takes time to judge, so keep your follow-up visits. If your prescriber writes a compounded formula, they can send it to us and we will prepare it as written.