What Is Alopecia? Types, Symptoms and Treatment Costs

Hair loss is common as we age, but it can also be brought on by stress, hormonal changes and certain medical treatments like chemotherapy. It can also be caused by an autoimmune skin condition known as alopecia,¹ which affects around 2% of the population at some point in their lifetime.²

Read on to learn more about the different types of alopecia, common causes, symptoms and currently available treatment options.

What Is Alopecia?

Alopecia is the medical term for hair loss. It's often used by doctors as an abbreviation for alopecia areata, a common autoimmune skin condition in which the body attacks healthy hair follicles, causing hair loss on the scalp, face and sometimes other parts of the body, such as the armpits and legs. It can affect people of all ages, genders and races, and alopecia areata often develops early in life, with most people showing signs before age 40.

The pattern or extent of baldness depends on the type of alopecia. For instance, alopecia areata (areata means patchy) often causes round patches of hair loss, but can cause total baldness in some people.²

Types of Alopecia

There is more than one type of alopecia, including:

• Alopecia areata
• Androgenetic alopecia
• Alopecia totalis
• Alopecia universalis
• Chemotherapy-induced alopecia
• Diffuse alopecia areata
• Ophiasis alopecia
• Scarring alopecia
• Traction alopecia
• Telogen effluvium

Alopecia areata

Alopecia areata is caused by the immune system attacking healthy cells and tissues — in this case hair follicles. The condition causes round or oval bald patches about the size of a quarter. These patches can develop on the scalp or other parts of the body that grow hair.

Alopecia areata usually stays patchy, but can sometimes change into the following types of alopecia:³

• Alopecia totalis: Causes complete hair loss over the entire scalp
• Alopecia universalis: Causes hair loss across the entire body, including the eyebrows and eyelashes
• Diffuse alopecia areata: Causes sudden thinning of the hair all over the scalp
• Ophiasis alopecia: A rare type of alopecia areata that results in a band of hair loss along the sides and back of the head

Anyone can develop alopecia, but people with a family history of alopecia areata and other autoimmune disorders, such as thyroid disease or diabetes, have a slightly higher risk.²

Androgenetic alopecia

Androgenetic alopecia is commonly known as pattern hair loss. It affects up to 50% of males and females. This type of alopecia is caused by an excessive response to a group of sex hormones known as androgens. Genetics and age also play a role in male and female pattern baldness.⁴ In females, heavy periods and hormonal birth control pills can also cause it.⁵

Male pattern baldness causes a receding hairline and/or thinning or hair loss at the crown or temples. Female pattern baldness typically causes thinning at the top and crown of the head.⁴

Chemotherapy-induced alopecia

This type of alopecia happens when hair falls out due to certain types of chemotherapy drugs. Chemotherapy kills rapidly growing cancer cells, but in the process also kills other rapidly growing cells in your body, including those in the hair roots. Hair loss typically happens within two to four weeks after starting chemotherapy, but hair usually begins growing back within a few weeks of stopping treatment.⁶

Scarring alopecia

Scarring alopecia causes permanent hair loss due to hair follicles being destroyed and replaced with scar tissue. Scarring alopecia is either primary or secondary. Primary scarring alopecia is caused by an inflammatory or autoimmune condition, while secondary scarring alopecia occurs when the skin is damaged by burns, infections or tumors.⁷

Traction alopecia

Traction alopecia is caused by repeated strain on the hair from things like tight hairstyles and headwear, hair weaves and extensions, or chemical treatments. It can happen at any age, but it becomes more common with age as our hair follicles weaken over time.⁸

Telogen effluvium

It's normal to lose about 100 hairs per day. This is because most of our hairs are always in a growing phase known as the anagen phase, which continues for two to four years before moving to the resting phase, called the telogen phase.⁹

In a person with telogen effluvium, more hairs move to the resting phase, causing them to shed more than 100 hairs a day, resulting in thinning. This can be triggered by numerous factors and resolve once the trigger is taken away. Triggers include:⁹

• Psychological stress
• Hormonal changes, such as menopause and pregnancy
• Physical stress, such as surgery or injury
• Iron deficiency
• Weight loss
• Dietary changes
• Thyroid disease

Alopecia Symptoms

The main symptom of alopecia is hair loss, but the pattern of hair loss may differ depending on the type. Symptoms can include:¹⁰

• Round or oval patches of hair loss on the scalp, face or other parts of the body
• Thinning hair
• Significant hair loss in a short period
• Hair loss and regrowth at the same time

Here are other symptoms you may notice:¹⁰

• Gray or white hairs that remain where other hair is gone
• Itching or burning sensation in areas of hair loss
• Tingling, itching or burning before hair falls out
• Shorter hairs that stand up where hair that started growing broke off
• Nail changes, such as ridges or pitting, which happens in about 30% of people with alopecia areata
• Bleeding, blistering, tiny bumps and scaling or crusting (scarring alopecia)⁷

Alopecia and Mental Health

Alopecia doesn't only have a physical impact — it often has a psychological impact, too. Living with alopecia can be challenging for the person with the condition and their loved ones. It's often associated with feelings of frustration, sadness and anger, and can lead to isolation and depression.¹¹

Diagnosing Alopecia

If you're experiencing hair loss, a board-certified dermatologist can diagnose alopecia. They may use a combination of the following techniques and tests to diagnose the type of alopecia:¹⁰

• Medical history. Your medical history, including your symptoms, any existing conditions and medications you take, and any family history of alopecia and autoimmune disorders provide information that can help with diagnosis. You may also be asked about any life events or stressors that could potentially trigger hair loss.

• Physical exam. Your doctor will examine your scalp and other areas of your body to check the pattern of hair loss and look for other signs of alopecia that can help identify the type. They may also check your nails for ridges.

• Blood tests. Blood tests are used to look for conditions related to alopecia, such as iron deficiency, thyroid disease and other autoimmune diseases.

• Cultures. Swabbing the affected area checks for fungal and other infections.

• Skin biopsy. Your doctor may want to take a small skin sample for analysis to check for skin disorders that can cause hair loss.

Alopecia Treatment

Alopecia doesn't always require treatment depending on the type and a person's preferences. Treatment of alopecia also depends on factors such as your age and the location and extent of the hair loss.

Here are some common treatments for alopecia:¹²

• Topical treatments to stimulate hair growth include over-the-counter and prescription medications that you apply to the skin, such as minoxidil (Rogaine®) and finasteride (Propecia®).

• Oral medications used to treat different types of alopecia include corticosteroids, JAK inhibitors and antibiotics.

• Injection therapy for alopecia includes corticosteroids, immunotherapy drugs, iron infusions and vitamin injections.

• Hair transplants are surgical procedures that take skin grafts from parts of your body with healthy hair and transplant them to areas without hair.

• Wigs and hairpieces can be used to cover hair loss during treatment or instead of treatment, if that's your preference.

• Microblading is a cosmetic procedure that uses micropigmentation — similar to tattooing — to fill in sparse or missing eyebrows.

• Scalp micropigmentation (SMP) is a type of permanent makeup that uses microneedles to embed dots of pigment into the scalp to make thinning hair look fuller or create the appearance of a full head of buzzed hair on a partially or fully bald scalp.¹³

• Platelet-rich plasma (PRP), used to treat androgenetic alopecia, involves injecting your own platelets and plasma into your scalp to encourage cell growth.¹⁴

Alopecia Treatment Costs

The cost of different treatment options for alopecia can vary significantly. Below are the average price ranges for common alopecia treatments:

How to Pay for Alopecia Treatment

Alopecia treatment can be expensive. Here are some ways to pay for treatment.

Insurance coverage

Alopecia treatments are often not covered by insurance, in part because they include off-label drugs or procedures and wigs or hairpieces that are considered cosmetic.

That said, it's always a good idea to check with your insurance provider to see if they do offer partial coverage for hair loss treatments (including wigs) with a prescription.¹⁹

Financial assistance programs

There are financial assistance programs that help cover some or all of the cost of a wig or hairpiece for people with alopecia who meet certain requirements. For instance, some cancer centers and nonprofit organizations offer free wigs to people undergoing cancer treatment.²⁰

Flexible spending accounts (FSAs) and health savings accounts (HSAs)

You may be able to use your FSA or HSA to pay for alopecia treatment with a Letter of Medical Necessity (LMN) from your doctor, depending on the type of alopecia you have. Treatment for hair loss is not covered if it's deemed cosmetic.²¹

Payment plans and financing options

Some dermatologists and cosmetic and plastic surgeons offer payment plans so you can pay for cosmetic treatments and hair transplants over time. You can also use the CareCredit credit card to pay for alopecia treatments and procedures at locations that accept CareCredit.*

Coping With Alopecia

Living with alopecia can be difficult. Finding the right support and practicing self-care can help you or a loved one cope with alopecia.

Support groups

Joining an online or in-person support group connects you with others living with alopecia. It provides the opportunity to share your feelings and struggles with people with similar experiences.

Professional help

If you're feeling overwhelmed and having trouble coping with alopecia, consider seeking professional help. Your doctor can provide a referral to a mental health professional, such as a therapist, counselor or psychologist. Depending on your comfort level and schedule, online therapy is another option.

Self-Care Tips

Here are some self-care tips for dealing with alopecia:

• If you're comfortable, talk to friends, family and colleagues about your condition to help educate them on alopecia and its impact on your life.
• Reduce stress by engaging in relaxing activities, such as deep breathing, meditation and exercise.
• Protect your scalp and other areas of hair loss from the sun by applying sunscreen or wearing protective hats and clothing when outdoors.
• If your hair loss is affecting your self-esteem, consider cosmetic approaches, such as makeup, false eyelashes, head coverings and different hairstyles to enhance areas of hair loss or cover it.

Alopecia can affect anyone and cause hair loss on the scalp and other parts of the body. The decision to treat alopecia is a personal one, and if you choose to treat it, there are options available. Work with your doctor to find the treatment that's best suited to your needs.

Managing Health & Wellness Costs With the CareCredit Credit Card

If you are looking for an option to help manage your health & wellness costs, consider financing with the CareCredit credit card. The CareCredit credit card can help you pay for the care you want and need and make payments easy to manage.* Apply today and use our Acceptance Locator to find a provider near you that accepts CareCredit. Continue your wellness journey by downloading the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U hub for more great articles, podcasts and videos.

Author Bio

Adrienne Santos-Longhurst is a writer who has been covering health and lifestyle for almost two decades. Her work has appeared in Healthline, Insider, Medical News Today and more.