Male Hair Loss: Causes, Forms, and Categories.

Male hair loss can have various causes and take on different forms. The term “alopecia” (hair loss) does not refer to a single, isolated condition but rather encompasses a range of situations resulting in hair loss.
Generally, we classify hair loss into two major categories: non-scarring alopecia and scarring alopecia.
This article provides an overview of the types of male alopecia in a concise and understandable way.
A. Non-Scarring Alopecia
1. Physiological Alopecia
This is the natural hair loss that occurs as part of the renewal process of our hair. Seasonal hair shedding also falls under this category.
2. Alopecia Areata
This is a rare autoimmune form of hair loss (affecting about 1% of the population) in which the immune system attacks hair follicles through T-lymphocytes, forcing them into the telogen phase.
The exact causes are unclear, though it appears to be linked to genetic, psychological, and immunological factors.
It mainly affects young people (ages 5 to 30), with progression varying greatly between individuals. It is characterized by areas of complete hair loss on otherwise normal skin.
Alopecia areata can affect not just the scalp but also the beard, eyebrows, eyelashes, armpits, or pubic hair.
3. Androgenetic Alopecia (Male-Pattern Baldness)
This is the most common form of hair loss in men, also known as male-pattern baldness.
The condition results from the chronic degenerative effects of androgens on individuals sensitive to these effects. There is a clear hereditary link to this sensitivity.
Androgenetic alopecia progresses gradually, beginning at the front and top of the scalp and spreading to the sides and back, leaving only the latter areas unaffected. It involves both hair thinning and shedding. The rate of progression varies greatly among individuals.
4. Diffuse Alopecia
Diffuse alopecia refers to hair loss observed across the entire scalp. It is not tied to a specific disease but rather a group of conditions that share a diffuse thinning pattern. Causes and mechanisms vary widely.
By onset type, diffuse alopecia is divided into:
• Acute: Sudden hair loss
• Subacute: Thinning over several months
• Chronic: Recurrent cycles of thinning
By hair growth cycle phase affected, diffuse alopecia is categorized as:
• Telogen Effluvium: Hair abruptly enters the telogen phase due to stress, hormonal changes, or illness.
• Anagen Effluvium: Hair follicle function halts in the anagen phase due to severe damage (e.g., chemotherapy, radiation).
• Mixed: A combination of telogen and anagen effluvium.
5. Traumatic Alopecia
Caused by trauma (e.g., burns), tension, pulling, or hair twisting (as in trichotillomania).
B. Scarring Alopecia
Scarring alopecia results from follicle destruction and replacement with scar tissue, causing permanent hair loss.
It can be classified as:
• Primary: Caused by endogenous factors where inflammation targets the follicle (e.g., lichen planopilaris, discoid lupus).
• Secondary: Caused by external factors like trauma.
Progression varies, ranging from slow and asymptomatic to rapid, accompanied by pain, itching, or burning sensations.