The types of abnormal hair loss are mainly divided into:

1. Androgenetic Alopecia
Androgenetic alopecia or hereditary alopecia is the most common type of hair loss and is progressive. Men and women with androgenetic alopecia are born with hereditary hair follicles, also known as dihydrotestosterone (DHT) sensitive. This hormone causes the hair follicle to become miniaturized over time, resulting in thinner hair. Eventually, the hair follicles stop producing normal hair, leaving only “fluff”.

2. Alopecia Areata
Also known as ghost shaving, it is a sudden onset of plaque-like hair loss. The scalp is normal in the lesion, and there is no inflammation or subjective symptoms. With lymphocyte infiltration around the hair follicle, this disease sometimes is combined with other autoimmune diseases, so medically it is currently believed that the occurrence of this disease may have an autoimmune pathogenesis. In addition to genetic quality, it may also be associated with neurological trauma, mental disorders, infections, and endocrine disorders.

3. Telogen Effluvium
The reason for this is that many hair follicles suddenly enter the “quiet period” early, during which the hair becomes thinner overall. Telogen effluvium may be caused by many factors, including newborn hair loss, postpartum hair loss, mental and emotional factors, nutritional deficiencies, thyroid imbalance, surgery, medication, frequent staying up late, starting or stopping oral contraceptives, overeating, etc.

4. Anagen Effluvium
This is the sudden rapid shedding of hair in the growth stage. This may be due to chemicals or drugs used to treat tumors, such as antimetabolites, alkylating agents and mitotic inhibitors, or chemotherapy for cancer treatment or radiation therapy.

5. Cicatricial Alopecia
Most symptoms of this disease first manifest as small plaques of hair loss that may expand over time. In addition to genetic factors, it may also be caused by other factors such as chemical relaxants, tightly woven or excessively pulled hair, deep burns, electric injuries, radiation dermatitis, immune inflammatory diseases (lichenus, discoid lupus erythematosus, scleroderma, etc.), infectious diseases, cutaneous carcinoma and the like, which can seriously damage the skin tissue and the hair follicles, forming scars that make the hair follicles unable to regenerate, resulting in permanent hair loss.

6. Scalp Folliculitis
Scalp folliculitis is an inflammatory change around the follicular orifice caused by pyogenic cocci. It begins with a red-filled papule and then rapidly develops into a papular abscess. In the early stages, hair may still be in the hair follicle, but as the disease progresses, it will fall out. In severe cases, inflammation can destroy hair follicles and cause permanent hair loss.

7. Traction Alopecia
Traction alopecia is caused by damage to the hair follicle with long-lasting stretching. Repeatedly tied tight hair styles, such as ponytails or braids, can cause traction alopecia. This condition of hair loss usually occurs near the temple or along the hairline.

8. Trichotillomania
This is an impulsive control disorder that drives individuals to pull out their hair, and the patient is unconsciously urged to pluck their hair, eyelashes, beard, nose hair, pubic hair, eyebrows, or other body hair repeatedly. Usually, it can cause spotted baldness on the hair, eyebrows and/or eyelashes.

9. Trichorrhexis Nodosa, also known as Piedra
This can occur at any age in both sexes, but is more common in women. One or several yellow-white or gray-white nodules appear on the hair shaft, and the hair is brushed at the break. The hair looks like brushes embedded oppositely at the place where it is not completely broken. In addition to genetic and pathological factors, factors such as infection or nutritional deficiencies may also be associated with the disease. In some cases, excessive use of chemicals and heating styling tools can trigger this disease.

10. Tinea Capitis
Tinea capitis is a fungal infection and superficial fungal infection of the scalp, which can be divided into three types according to the pathogen and clinical manifestations: tinea favosa, tinea alba, and trichophytosis capitis. Frequently occurring in children, this highly contagious disease is mainly transmitted through contaminated hair tools and/or through contact with infected animals. Hair loss due to tinea capitis is mainly caused by tinea favosa or tinea alba. If it worsens, it is likely to cause permanent hair loss.

11. Scalp Inflammation
Scalp inflammation causes bacteria to breed and multiply, which fundamentally destroys the epidermal cell tissue, causing cells to break out and body fluids to spill or cell enlargement, as well as fissured capillary membrane and congestion, and local fever. The original epidermal tissue structure is destroyed by the bacteria which rob nutrients, phagocytize normal tissues, and affect cell metabolism and subcutaneous circulation. It causes the hair to loosen or even fall out, which leads to necrosis of epidermal tissue and damage to cells over a large area. A typical one is seborrheic scalp inflammation.

Male-pattern Alopecia

It is estimated that more than 64% of men are affected by male pattern hair loss or baldness before they are 30. In the case of male-pattern baldness, when the level of androgen in the blood is elevated, hair loss may begin at any time after puberty. The first change is usually a decline in the forehead area, which is seen in 96% of adult males, including those who are destined to not develop further hair loss.

Although the hair density of a particular hair loss pattern gradually decreases with age, it is impossible to predict what kind of hair loss pattern will eventually occur in the early stage of male baldness among young males. In general, those who have lost their hair by around 20 are those with the most serious hair loss. For some males, the initial male-pattern hair loss may be delayed until the age of 30 to 40. Male-pattern hair loss can also occur between late teens and 40-50 years of age, and is generally considered to be “male” baldness in androgenetic alopecia. In the past, it was generally felt that the older the age, the greater the chance of suffering from a certain degree of male baldness. However, now, more and more young people are suffering baldness.

Androgens (testosterone, dihydrotestosterone) are required for the development of male pattern baldness. The amount of androgens does not need to be greater than the normal amount to produce male pattern baldness (if androgens are present in normal amounts and there is a hair loss gene, male-pattern hair loss occurs). Testosterone is converted to DHT by the enzyme 5α-reductase. Treatment is effected by blocking the enzyme and reducing the amount of DHT. The receptor is present on cells that bind to androgen. These receptors have the greatest affinity for DHT, followed by testosterone, estrogen and progesterone. Upon binding to the receptor, DHT enters the cell and interacts with the nucleus, altering protein production through the DNA in the nucleus. Eventually, growth of the hair follicles stops.

The hair growth cycle is affected, and the percentage of hair and the duration of the growing period (hair re-growth) are reduced, resulting in shorter hair. With more hair (resting time) at rest, these hairs are more likely to fall out and be lost. Over time, the hair shaft in male hair loss is gradually miniaturized with a smaller diameter and length. For men suffering male-pattern baldness, all hair in the affected area may eventually (but not necessarily) participate in the process, and the hair that should cover the area over time may become vellus (i.e., very fine hair). The hair color production is also terminated with miniaturization, so the hair color becomes lighter. The miniaturized hair makes the area appear thin first. Over time, the related areas may completely lose all their hair follicles. Hereditary male-pattern hair loss is a hereditary disease in which genes can be inherited from the mother or father. There is a general saying that it’s only inherited from the mother. This is not true.

In conclusion, male-pattern alopecia AGA (androgenic alopecia) is a hereditary condition that occurs when androgen is present in normal amounts. The gene can be inherited from the mother or father. The incidence and severity of hair loss are unpredictable, but severity may increase with aging, and if it does, it will be gradual and ruthless.

For men, if your male relatives have male-pattern hair loss, you may have hair loss too.

According to the hair loss situation, CHTNC will take the lifestyle, health and personal preferences of the patient who suffers male-pattern hair loss into account before planning and applying the treatment program.

Female-pattern Alopecia

There are many causes of female-pattern hair loss, including androgens, undernutrition, long-term application of chemicals, hard pulling, disease, drugs, bodily functions, genetic factors, scalp inflammation and so on.

Some differences lie between male and female androgenetic alopecia. Men usually first lose their hair in a clear shape along the sides of the forehead, which will then become thin at the top of the head. For women, the pattern is different. In the past, in women, hair usually thinned while retaining the hairline, starting from the top of the head, about one centimeter behind the hairline.

Women’s hair usually thins evenly over the entire head or only in the top area, and often thins on both sides of the head. If men’s hair thins from the forehead hairline it will be more severe than if thinning starts from the middle. There is a difference between the two. Unlike men, women usually don’t lose all their hair in the affected area. Their hair tends to become more fragile and thinner, but they will not completely turn bald.

Depending on the degree of hair loss, results can be achieved by using one or more therapy. The hair loss experts at the center will consider the lifestyle, family planning and personal preferences of female patients who suffer female-pattern hair loss before planning their course of treatment.