Hair loss is technically known as alopecia (synonyms: Alopecia androgenetica, Alopecia diffusa; Alopecia hereditaria; Alopecia seborrhoica; Alopecia; Alopezia; Alopezia areata; Alopecia; Defuvium; Diffuse effluvium; Effluvium; Effluvium capillorum; Effluvium capitis; Hair loss; Hair loss; Seborrheic alopecia; Senile alopecia).
Normally, each person loses up to 100 hairs per day (more if shampoo is used). However, if the loss is more severe, this is called baldness or hair loss. The following forms of alopecia are distinguished:
- Alopecia areata* (ICD-10-GM L63.-) – this is a round, localized pathological hair loss.
- Alopecia androgenetica* (AGA, synonym: male-type alopecia) (ICD-10-GM L64.-) – Leads in about 80% of men to “Geheimratsecken” or in the pronounced case to a “bald head“; in women, an androgenetic alopecia (alopecia androgenetica) can also occur; For more, see under causes.
- Other hair loss without scarring (ICD-10-GM L65,.)
- Telogen effluvium (ICD-10-GM L65.0).
- Anagen effluvium (ICD-10-GM L65.1)
- Alopecia cicatrica (scarring alopecia; hair loss with scarring) (ICD-10-GM L66.-) – associated with inflammation, fibrosis, and loss of hair follicles; irreversible.
* Non-scarring alopecia; much more common; reversible.
Other forms of alopecia include:
- Alopecia totalis (total alopecia) – complete hair loss of the scalp hair.
- Alopecia universalis – hair loss of the entire body hair [autoimmune disease].
Alopecia with and without scarring can be divided into:
- Focal hair loss
- Diffuse hair loss
Sex ratio: overall, men are more often affected by alopecia than women (2-3: 1). Alopecia androgenetica affects up to 80% of Caucasian men and 42% of women. Alopecia areata affects both men and women equally.
Frequency peak: alopecia androgenetica increases with age.Alopecia areata occurs predominantly in the 2nd and 3rd decade of life.
The lifetime prevalence (disease incidence throughout life) for alopecia areata is 1.7% (in Germany). The prevalence is 0.1-0.2%. The prevalence for alopecia androgenetica is 50% in European men. In African and Asian men, the prevalence is low.
The incidence (frequency of new cases) for alopecia areata is approximately 1-10 cases per 1,000 population per year (in Germany).
Course and prognosis: Alopecia androgenetica is a naturally progressive disease.The course of alopecia areata is chronic and is associated with relapses and remissions (temporary or permanent remission of disease symptoms). In the first 6 months, the bald patches spontaneously regress (spontaneous remission) in about 30% of those affected. Within one year, the rate is 50% and after 5 years 75%. For hereditary alopecia, the later the onset of alopecia, the slower it progresses.
If the cause of alopecia is known, successful therapy is possible. The hair loss can then be treated in a targeted manner, and those affected gain a completely new outlook on life.
Comorbidities (concomitant diseases): Based on epidemiological studies, it has been proven that early onset male pattern hair loss (alopecia androgenetica) is associated with some serious somatic diseases such as. e.g., cardiovascular disease (CVD), benign prostatic hyperplasia (so-called benign (benign) prostate enlargement), and prostate carcinoma (prostate cancer) [2-4}, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS).