How many types of female alopecia are there?

Women can experience alopecia at all stages of their lives (both at early and late ages) in very different ways and for very different causes. That is why there is not only one type of female alopecia , but there are several types. Although the best known is, perhaps, androgenic alopecia , in this article I want you to know all the possible types of female alopecia .

Before starting, it is important that you know that alopecia can be classified as scarring and non-scarring . In the first case, hair loss is permanent and, in the second, it is reversible.

Non-scarring alopecia

In non-scarring alopecia, the hair follicle is not permanently damaged, so spontaneous growth or growth in response to treatment is possible . Within this type of hair loss we find, in turn, different manifestations of female alopecia .

Female androgenic alopecia

Androgenic or androgenetic alopecia is the classic term used to refer to the progressive loss of hair in the frontal and/or upper area of ​​the scalp . Although both genders can experience this type of hair loss, it manifests itself with different characteristics in one or the other. That is why, to differentiate them, dermatologists refer to female androgenic alopecia as “female pattern hair loss (FPHL) or “female pattern alopecia.”

The term "andro" indicates its hormonal origin and "genetic" a hereditary contribution.

In women, this condition can occur both before and after menopause , with the latter being the most common. Likewise, in both cases they can appear with or without an increase in androgens, which are the male sex hormones, thus being called androgen-dependent or androgen-independent FPHL, respectively.

Although, as we have mentioned, the front and upper scalp are the main affected sites, sometimes diffuse hair loss occurs throughout the scalp , except in the posterior area, which usually remains relatively intact.

Women with female androgenic alopecia may notice this hair loss in different ways:

These characteristics are generally noticed over the course of months or years.

Alopecia areata

In alopecia areata, the body's immune system mistakenly attacks the hair follicles . Fortunately, follicles retain their ability to regrow hair and, in most cases, hair loss is not permanent.

It can develop at any age, although most people first develop alopecia areata before the age of 30 . It usually affects women and men in similar proportions. A person who has a close relative with alopecia areata also has a slightly increased risk of developing it.

The scalp is the most common site of hair loss, but any area of ​​the body can be affected . In fact, a small minority of patients lose all the hair on their head (alopecia totalis) or all the hair on their head and body (alopecia universalis) due to alopecia areata.

This type of hair loss usually manifests itself as smooth, round patches of hair loss that develop over a period of a few weeks. However, in most cases, this is followed by new growth over several months.

Female diffuse alopecia

This type of female alopecia encompasses various types of hair loss called effluvium. Below, I explain their differences.

🍃 Anagen effluvium : occurs as a result of an acute interruption of the hair growth phase (anagen) and results in extensive hair loss. This fall usually occurs within two weeks following an event that causes it. Treatment with chemotherapy drugs is one of the main causes of anagen effluvium.

🍂 Telogen effluvium : various circumstances are capable of disrupting the biological clock of the hair follicles, causing an abnormally high number of hairs to simultaneously enter a loss phase. When this occurs, hair loss is called telogen effluvium. Generally, hair loss is diffuse and affects the entire scalp, causing a decrease in hair density. We can find two types of telogen effluvium.

• Acute telogen effluvium – can occur at any age, including childhood. It usually develops within two to three months after a trigger and reverses once the trigger is removed . Some examples of factors that can stimulate acute telogen effluvium are physical or psychological stress , certain illnesses, childbirth, dietary restriction, COVID , and some medications. However, some studies suggest that a cause cannot be identified in 1/3 of patients. The most important thing is that the telogen effluvium usually subsides and the hair gradually regains its density . However, the recovery period is usually 6 to 12 months.
• Chronic telogen effluvium : Hair loss persists for more than six months, with a fluctuating course that can last for years, occurring seasonally. It is less common than acute effluvium and is most frequently diagnosed in women between 30 and 60 years old. The onset is generally abrupt, where the hair falls out diffusely. A correct diagnosis in time is important to be able to treat some of the causes of chronic telogen effluvium . Like acute effluvium, the prognosis of the disease is good and, although restoration of hair growth can be slow, hair usually recovers in its entirety .

Traction alopecia

Traction alopecia is a form of hair loss that occurs as a result of prolonged tension on the hair follicle or shaft . Normally, it is detected in the most frontal and lateral part of the scalp. This alopecia can occur due to hairstyles such as tight ponytails or braids, although it can also occur as a result of hair extensions or other regular use of hair accessories.

Although this type of female alopecia is initially reversible, hair loss can become permanent if the stress continues for a long time.

Scarring alopecia

They are inflammatory disorders of the scalp that lead to permanent hair loss. As in non-scarring alopecia, we also find different types of hair loss.

Frontal fibrosing alopecia

Frontal fibrosing alopecia is a form of scarring female alopecia that is increasingly common and whose cause continues to be a subject of research. It is common in women between the 6th and 7th decade of life. Patients present with band alopecia that most frequently affects the frontal area of ​​the scalp . Eyebrow hair loss is also common and can precede hair loss on the scalp.

It is common to observe that small rough papules ("pimples") appear on the face, with a predilection for the temple area. Likewise, the veins on the forehead can be seen more obviously.

The main goal of treatment is stabilization of the disease, so early diagnosis and treatment is crucial to stop hairline recession and prevent further hair loss.

Central centrifugal cicatricial alopecia

It is a scarring alopecia that occurs more frequently in women of African descent. Hair loss begins at the crown of the head and, over time, spreads centrifugally (outward) , resulting in permanent hair loss in that area. Patients may sometimes experience itching or pain on the scalp.

As you have seen, hair loss disorders can be due to multiple causes, such as, for example, hair cycle disorders, inflammatory conditions that damage hair follicles, or hereditary or acquired factors in the hair shaft.

The most important thing when you suspect female alopecia is to consult your dermatologist to make a correct diagnosis and be able to prescribe the appropriate treatment for each condition .