Disorders of the Hair Explained

By some estimates, over 80% of men and women will experience significant hair loss in their lifetime. This can have serious impacts on our confidence levels and self-image.

But you may wonder what the main causes and disorders that lead to thinning, shedding, and other hair loss issues are. Identification and diagnosis are key next steps, aiming to treat and correct the root problem.

Let’s take a deep dive into the major contributors and see which disorders can be counteracted with the right response.

What Causes Hair Disorders?

A variety of factors contribute to the development of hair disorders; these are at the top of the list.

Genetics

Hereditary considerations are the number one factor predisposing us to hair disorders.

If you have relatives with a history of androgenetic alopecia and other conditions, your likelihood of developing them is much higher. Studies show that the AR gene, in particular, is connected with androgen response to DHT and influences key hair loss drivers.

Environment

Environmental concerns can contribute to the development of hair disorders.

The primary culprit is exposure to toxins, pollution, poor air quality, and second-hand smoke. These conditions can lead to sensitive scalp syndrome and cause damage to the DNA in scalp cells.

Lifestyle

Although not the number one factor, a healthy lifestyle, important to all aspects of our physical well-being, can also factor into hair loss. Lack of sleep, a sedentary lifestyle, and dietary deficiencies can contribute to hair loss and slower growth rates.

Common Hair Disorders Explained

You may be surprised by the sheer number of disorders affecting hair growth and reduction. Here are some of the most common.

Androgenetic Alopecia

Androgenetic alopecia is the most common contributor to hair loss. This genetically determined disorder, also known as male-pattern or female-pattern baldness, leads to permanent hair loss. Although most associated with middle age, the disorder can cause thinning as soon as puberty hits.

As the body produces testosterone, it also creates the byproduct dihydrotestosterone (DHT). DHT can bond to hair follicles, causing shrinking and reducing their ability to support healthy hair. It can also shorten the hair cycle’s anagen (growth phase), causing thinning and reducing density across the scalp.

The progressive thinning pattern of androgenetic alopecia is well known, beginning in the temples, receding the hairline, and moving to the crown. This results in the characteristic “horseshoe” or “M” shape described in the Norwood-Hamilton scale.

In women, the pattern is an overall thinning across the scalp rather than hairline recession.

Anagen Effluvium

Anagen effluvium is a type of hair loss affecting the anagen phase of the hair cycle. This disorder can lead to a significant loss of hair at once.

Typically the onset of anagen effluvium is the result of a stressor. These include chemotherapy, infection, or exposure to environmental factors such as toxins and pollutants.

This type of hair loss is generally temporary, and hair often returns to its natural cycle once therapies and exposures have reduced or ended.

Telogen Effluvium

At any given time, a healthy scalp produces hair in about 80-90% of the follicles on the head. Telogen effluvium is a disorder in which the number of hair follicles producing hair during the telogen, or resting phase, of hair growth is significantly reduced.

The usual signs of the disorder are increased shedding in different parts of the head. Typically the scalp will be affected more prominently than the sides or back of the head.

Telogen effluvium can be triggered by a physical stressor which causes changes in hormone production. These include surgery, giving birth, injury, or starting a new medication.

Fortunately, this condition is temporary, and the body will usually adjust to its hibernation in hair production.

Alopecia Areata

Alopecia areata is a hair disorder caused by an autoimmune response. In this condition, the immune system misidentifies hair follicle cells as dangerous and attacks them.

People immunocompromised from conditions such as thyroid disease, vitiligo, and extreme allergies are more likely to experience symptoms. Even eyebrows can be affected.

Alopecia areata has a distinctive pattern of hair loss, typically coin-sized patches on the scalp. This makes it easy to identify and diagnose. Although it most commonly occurs on the scalp, the beard, eyelashes, and other areas can also be affected.

Although there is currently no cure for alopecia areata, many people with the condition experience full recovery with no treatment. Medication is sometimes prescribed to stimulate regrowth but cannot prevent new patches from forming.

Cicatricial Alopecia

Cicatricial alopecia, or scarring alopecia, is caused by inflammation. The inflammation destroys hair follicles, which causes scarring and permanent loss of hair.

Cicatricial alopecia has a wide range of symptoms. These include progressive, permanent hair loss, scaliness on the scalp, burning sensations, and itchiness.

Unlike androgenetic alopecia, cicatricial is not found to be hereditary. It is much less common than the other hair disorders on this list and is not as well-researched.

Traction Alopecia

Traction alopecia is a hair disorder resulting from the pulling of the hair. Weaves, wigs, tight ponytails, buns, braids, and cornrows can all cause excess stress on the scalp. This can result in loosening hair shafts from their follicles, potentially leading to permanent loss.

Early signs include bumps on the scalp, progressing to missing patches of hair. Hair loss occurs in areas under the most tension, typically toward the front and sides of the scalp.

Traction alopecia is fortunately treatable, especially when identified early. Reducing the use of chemicals, alternating hairstyles frequently, and wearing loose buns and ponytails can prevent permanent loss from this disorder.

Other Disorders

Other hair disorders without formal classification can arise from different life events.

Surgery, change of medication, and giving birth can all trigger shedding and hair loss. Traumatic events, including accidents or other injuries, can also be contributors. Periods of hormonal imbalance can also affect the hair cycle, leading to increased thinning and shedding.