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Chronic Alopecia


What is chronic alopecia?

Chronic alopecia is a condition where you lose your hair. It may happen on any part of the body. Many conditions can affect the hair follicles and reduce hair growth. Chronic alopecia may be a symptom of an illness, an infection, or another condition.

What are the types of chronic alopecia?

There are many types of chronic alopecia. With some types, the hair loss is temporary and hair grows back. With other types, hair loss may continue or get worse. Some conditions result in permanent hair loss.

  • Alopecia areata: This condition affects any part of the body, including the scalp. It may be caused by your immune system attacking your hair follicles. It may start with patchy hair loss. Many people will recover from this condition within a year. Alopecia areata may come back or progress into a more severe hair loss.
  • Androgenic alopecia: This is also known as male pattern baldness and affects the scalp. It is a genetic condition where the hair follicles get smaller and produce less hair over time. It usually starts between 12 to 40 years of age and is more common in men.
  • Telogen effluvium: This is when hair sheds more than usual and leads to hair thinning. It can be caused by many things including certain medicines, injury, and physical or mental stress.
  • Traumatic alopecia: Injury from chemicals, scarring, or tension on your scalp or hair follicles may cause hair loss in these areas. Trichotillomania is a behavior disorder in response to mental stress. It results in a strong urge to pull out your hair.

What causes chronic alopecia?

  • Diseases: Autoimmune diseases are when your immune system attacks some part of your body. If your immune system attacks your hair follicles, it can lead to hair thinning or loss. Other diseases may also damage your hair follicle and cause hair loss, such as cancer or thyroid and pituitary gland problems.
  • Hereditary: Your risk for alopecia may be increased if you have a close family member with the same condition.
  • Medicine or chemicals: Certain medicines used to treat cancer, seizures, and thyroid or blood diseases may cause damage to your hair follicles. Exposure to heavy metals or taking certain hormones will also damage your scalp and hair.
  • Stress: Stress on your body or mental stress can cause hair loss. A high or prolonged fever, chronic illness, dieting, or malnutrition may cause hair loss.
  • Trauma: Braids, brush rollers, curling irons, or brushes with square or angular tips may cause chronic alopecia. Frequent use of harsh chemicals on your hair may injure your scalp.
  • Infections: Many infections can cause hair loss. These include tuberculosis, sarcoidosis, or syphilis. Viral infections, such as herpes zoster or AIDS, may also cause the condition. Fungal infection of your scalp also leads to hair loss. All of these infections may destroy hair follicles and lead to permanent baldness.
  • Surgery or procedure: Chronic alopecia may happen after you have a major surgery or radiation therapy.

What signs or symptoms may be related to my chronic alopecia?

In addition to hair loss, you may have the following signs or symptoms:

  • Burning, tingling, or itchiness on your scalp
  • Hair that easily breaks
  • Problems with your fingernails or toenails, such as notching or pitting
  • Scales or flakes from the areas of hair loss
  • Swelling and redness on your scalp

How is chronic alopecia diagnosed?

Tell your healthcare provider when you first noticed the condition, how long it lasted, and how much hair you have lost. Tell him if you have other signs or symptoms, such as scaling and itchiness. Tell your healthcare provider about any dietary changes, physical stress, or recent procedure or surgery you have had. Tell him about your medical history, including medicines you have taken or are taking. He may also need to know about how you take care of your hair and what products you put on it. Tell your healthcare provider if a family member or a close relative has ever had the same condition.

How is chronic alopecia be treated?

The treatment for hair loss depends on the cause of your condition. Sometimes your hair loss may get better on its own and no treatment is needed. If your hair loss is related to a medicine you are taking, talk to your healthcare providers. There may be other medicines you could take instead that will not cause hair loss. If your hair loss is severe, you may need one or more of the following treatments:

  • Medicines:
    • Hair growing agents: This medicine helps promote hair growth. It must be used continuously until new hair grows on the affected area.
    • Steroids: Steroid medicine helps decrease inflammation and damage to the hair follicle. Corticosteroids may be used to treat alopecia areata.
    • Estrogen: This is a female hormone that is used for women with hyperandrogenism (high levels of male hormones). Estrogen can reduce the effects of male hormones on hair growth. This treatment is used in women with male pattern baldness.
    • Immunologic agents: This medicine affects the immune system cells that may be attacking hair follicles. This treatment is used to treat alopecia areata. Your healthcare provider may start treatment with a small dose at first and slowly increase the dose with each treatment. The frequency of treatment may be reduced once your healthcare provider sees improvement in your condition.
  • Hair transplant surgery: This surgery is generally done on the scalp. It removes hair follicles from one part of your head and puts them into the bald area. This is usually done only if your condition is severe and when medicines fail to improve your hair loss. Ask your healthcare provider for more information about hair transplant.

What can I do to manage my chronic alopecia?

  • Avoid hair and scalp trauma: Use a soft-bristled hair brush to protect your scalp from damage. Avoid the overuse of chemicals such as permanent wave solutions on your hair. Avoid hairstyles that pull your hair too much.
  • Eat a healthy diet: Ask your healthcare provider if you need to be on a special diet.
  • Reduce stress: Try to get enough sleep and daily exercise. Learn new ways to relax, such as deep breathing, meditation, and listening to music. These may help you cope with stressful events.

What should I expect with time or treatment?

Relief from chronic alopecia depends on the cause of your symptoms, your treatment, and other factors. It is a long-term condition and one that may go away and come back. Children who have the condition before puberty will have poor or slow improvement. Those who have a strong family history of baldness may also have the condition early and for a long period. Chronic alopecia may continue even with treatment.

When should I contact my healthcare provider?

  • You feel anxious or fearful with sweating and a fast heartbeat.
  • You have a change in your appetite, or you sleep a lot more or less than usual.
  • You have new signs or symptoms even with treatment.
  • You have problems thinking and concentrating.
  • Your scalp is very itchy.
  • You feel that you cannot cope with your condition.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel like hurting yourself or others.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.