Alopecia primarily presents as gradual, partial, or complete hair loss. This condition can affect the scalp, eyebrows, eyelashes, and other body areas. In some autoimmune types, such as alopecia areata, individuals may also experience rare sensations like burning or discomfort on the scalp.

common symptoms

  • Gradual thinning of hair on the scalp

  • Development of a bald spot

  • Hair falling out in patches or strips

  • A receding hairline

Symptoms by Type of Alopecia

Symptoms vary depending on the type of alopecia. Generally, alopecia is classified into two categories: non-scarring and scarring.

Non-scarring alopecia means the hair follicles remain intact, offering a chance for hair regrowth. In contrast, scarring alopecia results in permanent hair loss due to follicle damage.

non-scarring types

  • Alopecia areata

  • Androgenetic alopecia (hair may not regrow if follicles are damaged)

  • Telogen effluvium

  • Traction alopecia

  • Trichotillomania

scarring types

  • Central centrifugal cicatricial alopecia (CCCA)

  • Frontal fibrosing alopecia (FFA)

  • Lichen planopilaris (LP)

Certain infections can also trigger alopecia and may fall under either category depending on severity and type.

Androgenetic Alopecia

This is the most common form of alopecia, caused by genetic factors. It affects all sexes but shows different patterns.

male-pattern hair loss

  • A bald patch forms at the crown of the head

  • Hair follicles become visibly shrunken

  • A receding hairline that creates an M-shape

female-pattern hair loss

  • Thinning near the front of the scalp and ponytail area

  • Increased hair loss after menopause

  • Widened part along the top of the scalp

Alopecia Areata

Alopecia areata is an autoimmune disorder where the immune system attacks the hair follicles, leading to unpredictable hair loss.

typical signs

  • A stinging or burning sensation may occur before hair falls out

  • Hair loss may affect the scalp, eyebrows, lashes, beard, nose, or pubic area

  • Hair may fall out in patches or bands

  • Nails may appear red or brittle

  • Short, fine hairs may appear on the scalp

  • Yellow or black dots may be visible on the scalp

Telogen Effluvium

This form of alopecia typically affects the scalp and results in widespread shedding, often triggered by physical or emotional stress.

possible triggers

  • Fever, surgery, childbirth, or severe infection

  • Nutritional deficiencies or thyroid conditions

symptoms

  • Dry, fragile hair that easily falls out

  • Hair loss in diffuse areas

  • Shedding of white bulb hairs

  • Sudden, noticeable hair loss

  • Hair color changes in severe malnutrition cases

This type is usually temporary, and hair often grows back with proper care.

Traction Alopecia

Caused by continuous pulling on hair follicles, traction alopecia commonly results from tight hairstyles.

common signs

  • Hair becomes finer and shorter over time

  • Scalp may feel sore or tender

  • Pimples or pustules may appear

  • Red or inflamed skin

  • Scaly or itchy areas around the follicles

Trichotillomania

This is a mental health condition where individuals feel compelled to pull out their hair.

key indicators

  • Repeated pulling of hair from the scalp, eyebrows, or body

  • Emotional distress or life disruption due to hair pulling

  • Lack of symptoms common in other forms of alopecia

  • Ongoing attempts to stop the behavior

Lichen Planopilaris (LP)

This inflammatory condition leads to scarring of the follicles and gradual hair loss.

symptoms include

  • Itching, burning, or sensitivity on the scalp

  • Permanent hair loss from scarring

  • Redness around the follicles

  • Raised, rough follicle bumps due to excess keratin

Frontal Fibrosing Alopecia (FFA)

A type of LP, this condition causes hair loss at the front and sides of the scalp. Early treatment can slow progression.

what to watch for

  • Facial bumps or skin irritation

  • Hair loss on the scalp, face, limbs, or pubic area

  • Rash close to the hairline

  • Pain or itchiness on the scalp

  • Loss or thinning of eyebrow edges

Central Centrifugal Cicatricial Alopecia (CCCA)

CCCA begins at the crown and can lead to permanent scarring if untreated. The exact cause remains unclear, but early diagnosis helps manage hair retention.

Alopecia Associated With Infection

Certain infections can contribute to hair loss. These may be fungal or bacterial in nature and impact the scalp.

types of infections

  • Folliculitis (inflammation of follicles)

  • Piedra (fungal infection in hair shafts)

  • Ringworm (scalp fungal infection)

  • Seborrheic dermatitis (scaly, oily skin condition)

associated symptoms

  • Scalp burning or itching

  • Sores or blisters

  • Scaly skin near hairless patches

When To See a Healthcare Provider

Alopecia can affect individuals of all ages. Early diagnosis and intervention can improve outcomes and treatment response.

consult a provider if you experience

  • Facial hair, acne, or changes in menstrual cycle

  • Sudden or unusual hair loss pattern

  • Bald spots in facial areas such as eyebrows or beard

  • Cold intolerance

  • Psychological stress or self-esteem issues

  • Pain or itching on the scalp

  • Visible signs of infection on the scalp

  • Unexpected weight gain or fatigue

A Quick Review

Alopecia often starts with gradual hair loss but may come with a range of other symptoms depending on the type. These can include bald spots, redness, pain, or hair thinning.

If you suspect you have alopecia, consult a healthcare professional or dermatologist for an accurate diagnosis and personalized treatment plan.