The drama of this year's Oscars has shined a spotlight on Jada Pinkett Smith and her journey of hair loss and alopecia. You may be familiar with the term alopecia from "traction alopecia" which can be caused by tension from braiding and weaving, but there are several types of alopecia with varying causes. Here is what you need to know, according to stylist and curl educator Janelle Sands and Sophia Emmanuel, IAT Certified Trichologist, licensed cosmetologist and hair loss specialist.
Hair loss can be a painful experience for women, especially without knowledge of treatment or even full understanding of what it is. Much of our lack of understanding is directly connected to the complexity of hair loss. Its causes, treatments, and everything in between requires individual, customized diagnosis and treatment. Before we dive into how hair falls, let’s first review how hair grows.
The Growth Cycle
Hair is produced from the hair follicles along the outermost layer of the scalp. As the body creates new hair cells, existing hair cells are pushed through the hair follicle and nourished by blood vessels to form keratin hair strands. This growth occurs in stages and each hair can be in different stages of the hair growth cycle at random.
- Anagen is the growth phase in which the cells are highly active resulting in hair growth that can last between 2-6 years based on your body.
- Catagen is the transition phase when growth stops and can last up to three weeks. 3% of all hairs are in this state at a given time. During this state the club hair, hair that is preparing to shed, begins is taking form.
- Telogen is the resting phase that can last about three months. This phase marks the full completion of the club hair that will shed up to 100 club hairs daily.
This natural process of growing, transitioning, and resting follows the natural cycle of the hair growth. Because of other variables, the hair growth process can be intersected, resulting in thinning of the hair. Although difficult to notice at first, continued thinning will be very noticeable and can affect a person’s confidence in themselves and their appearance.
Ask An Expert
Sophia Emmanuel, IAT Trichologist with Crown Worthy Trichology Studio, chimes in to explain hair loss in terms of alopecia, the Latin word for hair loss. Some forms of alopecia can be permanent and others temporary based on what occurs to the hair follicle.
Temporary Hair Loss
According to Emmanuel, “Temporary hair loss occurs with non-scarring alopecia. Non-scarring alopecia means that there are follicles present on the scalp, so hair re-growth is not a problem. Non scarring alopecia occurs when there is an imbalance in the body. Stress, medical issues, nutritional deficiencies, ring worm, hormonal imbalance, crash diets, and hereditary problems can cause non-scarring alopecia. Non-scarring alopecia is temporary because it corrects itself once the imbalance in the body is treated. Correction of non-scarring alopecia takes three months after treatment of the imbalance in the body. The key is to get to the root of the hair loss by having blood work done.”
Permanent Hair Loss
According to Emmanuel, “Permanent hair loss occurs when a scarring alopecia is present on the scalp. When there is scarring the hair loss is permanent because scar tissue on the skin of the scalp block the opening of the follicle. Scarring alopecia can be caused by auto immune problems, where a group of white blood cells attack other cells of the hair follicle and causes scarring. Other problems that cause scarring alopecia are wearing tight or heavy ponytails, braids and extensions, burns, blunt trauma to the head, surgery of the scalp, and scalp infections that go untreated.”
Androgenic alopecia refers to the genetic condition of male pattern baldness and female pattern baldness or hair loss caused when enzymes in the body turn the hormone testosterone into dihydrotestosterone also known as DHT. This hormone has the effect of shrinking the hair follicle. It aesthetically appears very differently in both men and women. For example, the Journal of Investigative Dermatology says that "the prevalence of mid-frontal hair loss increases with age and affects 57% of women and 73.5% of men aged 80 and over.”
Alopecia Totalis and Alopecia Universalis
This is a rapid, more severe form of androgenic alopecia, not limited to one region of the scalp and could spread among the entire scalp and other parts of the body including eyebrows, eyelashes, and body hair. While the cause is unknown it is believed to be stress related or an autoimmune disorder, which is when “the body’s immune system attacks and destroys healthy body tissue by mistake. There are more than 80 types of autoimmune disorders.” - The US National Library of Medicine
This is a permanent type of hair loss in which the hair follicles are destroyed, leaving scar tissue. There are two different types: primary and secondary. Its primary type can occur for reasons unknown and appears through inflammation of the hair follicles inhibiting cell development. Secondary cicatricial alopecia occurs from outside secondary sources of scarring hair loss such as a severe burn, infection, tumor, radiation, or other physical damage.
This form of alopecia occurs in an individual based on scalp interactions like braiding, weaving, or high tension styling that cause excessive pulling and result in hair breakage and scalp scarring. Harsh chemical treatments like relaxers, bleach, and other coloring procedures can also cause traction alopecia and can be either permanent or temporary based on the severity.
Treatment for alopecia
All forms of alopecia vary by severity and must receive consultation from a certified trichologist or dermatologist. Common forms of treatment include the use of the drugs minoxidil, finasteride, and/or spiranolaction. Cosmetic surgical procedures are also becoming more popular and effective for hair growth replacement.
Read more: Is Your Medication Causing Hair Loss?
Additional Reference: The Belgravia Centre
This article was updated in March 2022.