Author

Dr Harpreet Kalra

Published

29 August 2026

Updated

29 August 2026

Hair loss can creep in over several years or become obvious within a few weeks. The word alopecia simply means hair loss; it is not one diagnosis. Some forms are inherited, some involve the immune system, and others follow illness, medication, hormonal change, repeated tension or damage to the scalp.

Finding the cause matters because the next step is different for each condition. A receding hairline may be suitable for treatment once the pattern is stable. Sudden patches, a painful or inflamed scalp, or rapid shedding should be assessed by a GP or dermatologist before a commercial treatment is considered.

What is alopecia?

Alopecia can mean partial or complete loss of hair from the scalp or body. It affects men, women and children, and it does not always look the same. One person may notice gradual thinning around the temples or crown. Another may find a smooth, round patch with very little warning.

Doctors also distinguish between non-scarring and scarring hair loss. In non-scarring alopecia the follicles remain in the skin, so regrowth may still be possible. Scarring alopecia damages the follicles and replaces them with scar tissue. Once a follicle has been destroyed, it cannot produce another hair.

An assessment considers where the loss has occurred, how quickly it started and whether the scalp is itchy, tender, sore or scaly. Family history, recent illness, medicines, nutrition and hormonal symptoms may also be relevant. A GP or dermatologist may sometimes recommend blood tests, a closer scalp examination or a small biopsy before confirming the cause.

Pattern hair loss and sudden hair loss

Pattern hair loss develops gradually. In men, the first change may be recession at the temples, thinning at the crown or both. In women, reduced density over the top of the scalp and a wider parting are more common, while the front hairline may stay in place.

The Norwood–Hamilton scale is often used to describe male pattern hair loss, while the Ludwig scale records female pattern thinning. These scales describe what is visible; they do not decide the treatment. Age, rate of change, donor density and the likely future pattern still need to be considered.

Sudden loss looks different. Alopecia areata can cause one or more defined patches, while telogen effluvium tends to cause general shedding across the scalp. Illness, rapid weight loss, iron deficiency and other medical changes can all be involved. Some non-scarring forms recover after the trigger settles, while others can return after regrowth.

The NHS advises speaking with a GP to understand the cause before approaching a commercial clinic. This is particularly important when hair loss is sudden, patchy or accompanied by redness, scaling, pain, scarring, or loss of eyebrow, eyelash or body hair.

What kinds of alopecia are there?

Hair loss is grouped by its cause and by what happens to the follicles. The following names describe some of the forms patients are most likely to come across. They are not interchangeable, and the same treatment will not suit all of them.

Pattern hair loss is not caused by poor hygiene, wearing a hat or washing the hair too often. A family history can come from either side. Illness or another cause of shedding may make thinning more obvious, but inherited pattern loss has its own genetic and hormonal basis.

Treatment is individual. A clinician may discuss hair-loss medication where it is appropriate, although it does not work for everyone. A transplant may be considered when the loss is stable enough to plan around and the donor area can support the proposed number of grafts. Surgery moves existing follicles; it does not stop untreated hair from continuing to thin.

Because the follicle is not permanently destroyed, hair can regrow. The timing is difficult to predict, and new patches can appear after earlier areas have recovered. New hair may initially look fine or pale before returning closer to its previous colour and texture.

A GP or dermatologist can often recognise the condition from its appearance, though tests may be needed when the diagnosis is unclear. Treatment depends on age, extent and duration. Dermatology options can include corticosteroids, contact immunotherapy or specialist medicines, but no treatment guarantees lasting regrowth. The British Association of Dermatologists provides further patient guidance.

Alopecia barbae

Alopecia barbae is alopecia areata affecting the beard or moustache. It usually appears as one or more smooth patches where the hair has fallen out, while the skin itself may look normal.

Beard hair can return, but the course remains unpredictable. A patch may fill in and later recur, or another patch may appear elsewhere. Sudden beard loss should be assessed rather than diagnosed from photographs alone, since a clinician may need to rule out infection and other causes.

Hair transplantation is not normally used for active alopecia areata or alopecia barbae. The same immune process can affect transplanted follicles, so diagnosis and disease activity come before any discussion of surgery.

The appearance depends on the cause. Some people notice itching, soreness, burning, scaling or small spots around the follicles. In other cases the first obvious sign is a smooth or shiny area where the hair has disappeared. Early diagnosis matters because treatment is aimed at settling the inflammation and protecting follicles that remain.

A dermatologist may examine the scalp with magnification and sometimes take a small biopsy. Hair transplantation is not considered while a scarring condition is active. It may be discussed in selected cases after the disease has remained quiet, but survival of the grafts can be less predictable than it is in ordinary pattern hair loss.

Medical treatment

Minoxidil may be discussed for male or female pattern hair loss. Finasteride is used for male pattern baldness but is generally not recommended for women. These medicines are not suitable for everyone, do not guarantee a result and usually need continued use to maintain any benefit. A qualified prescriber should explain the possible side effects and whether treatment is appropriate.

Alopecia areata is treated differently. Depending on the extent, a dermatologist may discuss corticosteroid creams, scalp applications or injections, contact immunotherapy, or other specialist treatment. Scarring alopecia also needs specialist care, with treatment aimed at controlling inflammation and protecting follicles that have not yet been destroyed.

Can alopecia be treated with a hair transplant?

A hair transplant is mainly considered for stable, permanent pattern hair loss where there is a healthy donor area at the back and sides of the scalp. It redistributes existing follicles; it does not cure the condition or stop non-transplanted hair from thinning.

The NHS notes that transplantation is not usually suitable for alopecia areata. Active scarring alopecia is another reason to delay surgery. In selected cases, surgery may be discussed only after a specialist has confirmed that the condition has remained inactive and the risks have been explained.

Assessment therefore comes before graft numbers. The clinician needs to examine the pattern and speed of loss, the scalp, previous treatment and the quality of the donor hair. Sometimes the sensible outcome is monitoring or a dermatology referral rather than surgery.