For both men and women, hair loss can be devastating and lead to loss of confidence and self-esteem. There are a variety of causes of hair loss that should be excluded before a diagnosis of male or female pattern hair loss is made. There are a number of non‑surgical options for managing scalp alopecia, including topical and oral medications. Strip follicular unit transplants and follicular unit extraction are both good methods of performing hair transplant surgery, and there are advantages and disadvantages to both. While it is loss of scalp hair that is often most noticeable and distressing, eyebrow and eyelash hair loss is also very obvious in both sexes, as is loss of beard and moustache hair in men as a result of injury or surgery. These can also be treated with hair restoration surgery.
For both men and women, hair loss can be devastating and lead to a loss of confidence and self‑esteem. Hair restoration can be beneficial, but as with all medical specialties, treatment should be tailored to the individual’s needs and the correct diagnosis for the hair loss needs to be determined through a detailed history, thorough examination and appropriate investigations. The average human has over 5 million hair follicles, of which only approximately 100 000 are located on the scalp1. While it is loss of scalp hair that is often most noticeable and distressing, eyebrow and eyelash hair loss are also very obvious in both sexes, as is loss of beard and moustache hair in men. Hair loss can be localised or generalised, part of a medical condition, a side-effect of medications, the result of a dermatological condition, or genetically pre-determined. Hair restoration can be achieved through medical treatment, surgery and non-surgical alternatives.
Types of hair loss
Hair loss is also known as alopecia and on the scalp can be patterned or unpatterned. Unpatterned hair loss can be further subdivided into scarring and non-scarring alopecias. Examples of scarring alopecia include trauma, infection, and inflammatory conditions such as lichen planopilaris, discoid lupus, frontal fibrosing alopecia and central centrifugal cicatricial alopecia. Examples of non-scarring alopecia include alopecia areata, the side-effect of medication, telogen effluvium (after an illness), anagen effluvium (after radiotherapy or chemotherapy), trichotillomania, traction alopecia, metabolic disorders (such as iron deficiency, diabetes, thyroid disease), and hair shaft abnormalities (such as trichorrhexis nodosa).
Lateral eyebrow loss is common in hypothyroidism, and both eyebrows and eyelashes are lost in alopecia universalis. Beard and moustache hair loss can be caused by non-scarring alopecias, but are more commonly linked to scarring alopecia, especially from traumatic injuries. Patterned hair loss is the most common form of alopecia and manifests as male pattern hair loss (MPHL ; which can be graded according to a variety of severity scales, such as the Norwood Classification) and female pattern hair loss (FPHL ; which can be graded, for example, by the Ludwig Classification).