Navigating the Different Types of Alopecia


Massachusetts Congresswoman Ayanna Pressley stunned the public last week when she revealed a bald head in a video declaring she had alopecia. Alopecia, an autoimmune skin disorder, causes hair loss and affects over 6 million people in the United States across age, ethnicity, race, and gender, according to the National Alopecia Areata Foundation

Pressley described her hair loss as rapid, which can be common and distressing for many patients. “A person’s hair is such a large part of their appearance to the outside world and their identity. I hear many of my patients describe the significant emotional stress that their hair loss causes them,” says Dr. Vlad Ratushny, MD, PhD, a dermatologist at Massachusetts Dermatology Associates and MassDerm Hair Transplant Institute in Beverly, Massachusetts.

Pressley’s video galvanized many people, women of color, in particular, to discuss their hair loss stories on social media, opening up honest conversations about alopecia. There are a several types of alopecia areata; here are a few and how to spot them:

Alopecia Areata

Alopecia areata is an autoimmune type of hair loss. Dr. Ratushny says, “Alopecia areata can present with round circular patches of hair loss that develop on the scalp, but they can develop anywhere else on the body, including beard hair in men. Your dermatologist may identify features called ‘exclamation point hairs’ when they examine your scalp closely if you have alopecia areata.

Alopecia Totalis

This is a subtype of alopecia areata in which one loses all the hair on your scalp. “Treatments for alopecia areata and alopecia totalis involve using either topical or injectable medications such as steroids to suppress the body’s inflammatory response that’s causing hair loss. Nonetheless, treatment success and disease progression is variable and patient dependent.”

Alopecia Universalis

Alopecia Universalis causes all the hair on the scalp and whole body to fall out. It’s easy to minimize the significance of your body hair, but it is ultimately protective. “Your hair can act as a sensing organ and prevent you from harm such as hitting your head when it gets too close to a ledge or a sharp object,” says Ratushny.

Traction Alopecia  

Although not a subtype of alopecia areata, traction alopecia is a type of hair loss that’s prevalent in African American women. It can occur after the follicles have been pulled on consistently due to hairstyles like braid extensions and weaves. Research shows it has more to do with the hair care practice, not the hair type.   

Treating alopecia, once fully diagnosed, can be a trial and error process that may be successful and may not. Dr. Ratushny adds, “It’s all about working with your dermatologist and finding the right treatment course for you.”  

For more information on hair loss and alopecia, speak with your dermatologist.

*The content on this website is for informational purposes only and is not medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.

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