Aside from female pattern hair loss, women’s hair can also become diffuse or thinner for other reasons. These would include iron deficiencies, thyroid imbalances, polycystic ovaries, anxiety, depression etc. Any of these symptoms can cause an increased rate of hair fall over the whole scalp and subsequently lead to thinning of the hair.

It is therefore extremely important to seek help from a registered trichologist in order that a thorough consultation is completed, the correct diagnosis made, treatment started and the necessary blood tests advised.

Remember, less can be achieved the longer the condition is allowed to continue unaided.


This condition features as oval or round bald patches on the scalp and/or beard. There may be one or more patches. A patch can get bigger and encroach on another patch, creating an even larger bald area. There are three stages to this complaint.

A patch first appears completely bald, slightly pale and smooth with a soft, pliable feel to it.

The second stage is for the weakened follicles within a patch to produce a short, stubbly “sick” hair that does not usually grow to more than ½ cm in length. It is a weak and badly formed hair being thin at the root and thicker at the tip. These hairs are known as “exclamation mark” hairs. The patch can still expand during this period.

In the third stage, these exclamation hairs should fall out and normal regrowth should begin to take place. New hair can either grow back with colour, or begin white before resuming with colour or begin white and stay white (quite rare).

Some people may only suffer for a few months from start to end, but others can be unfortunate and have problems for a year or more.

Essentially, this is an autoimmune disorder with enzymatical changes taking place mainly due to nervous system upset of one form or another. This causes the body’s defence mechanism to attack the hair. The onset of Alopecia Areata can occur within days of the changes to the nervous system, or take longer.

In my experience, nearly all the patients I have consulted with this condition have suffered some form of shock or trauma.

This type of hair loss is treatable with one usually attaining full regrowth as the follicles only become dormant but not dead. Although regrowth times do vary from one person to another, and there are never any guarantees, one can certainly be optimistic.


This is a worse complaint than areata although occurring for the same reasons. Large bald patches can form on the scalp, continually joining eachother until total scalp baldness takes place. It is quite common to also suffer loss of eyebrows, eyelashes and facial hair (if any ie beard). Basically, total loss of hair above the neck.

This is a difficult condition to cure and can take along time for improvements to show, if any.


This condition speaks for itself – being the total loss of all scalp and body hair. Again, occurring for the same reasons as before, totalis and universalis require more medical attention than a trichologist can offer (steroids). Results with these two complaints are minimal, if any, due to follicular degeneration.


This section deals with hair loss caused by natural or traumatic scarring. This can be due to either the atrophy, or demise of the hair follicles resulting from a degeneration of the skin tissue in affected areas or severe mechanical and/or chemical abuse.


There are two main types of cicatricial, or natural scarring alopecia. They are known as PSEUDOPELADE and FOLLICULITIS DECALVANS. These conditions usually affect women over the age of 40. They occur, it would appear, for similar reasons – a natural scarring which slowly progresses causing baldness in affected areas, destroying skin tissue and hair follicles alike.

The cause, to our continual frustration, is still unknown although the conditions have been linked to skin complaints such as LICHEN PLANUS and LUPUS ERYTHEMATOSUS. Cicatricial conditions, once begun, can continue slowly for years, although rarely lead to total baldness. They are uncompromising and difficult to stabilize with treatment, much to a trichologists dismay. If a condition does decide arrest itself, it is usually spontaneous.


This type is often visually explained as “footprints in the snow”. Small, bald, discoloured patches occur, quite often, throughout the scalp. Most conditions we have examined, the patient usually has enough hair to hide or camouflage the problem. The patches appear very small, smooth, soft, round and slightly depressed actually looking like scars.


This type lends a “moth eaten” appearance and seems to slowly spread out from the middle of the top of the head. It forms larger areas of baldness and affected areas look unnatural – a mottled shiny effect. Patches can spread out to form a larger patch when they meet.


These complaints are much more frequently seen, the reasons being purely due to external causes, whether known or unbeknown to the patient. There are three main types:


This is caused by continual pulling or stress on the hair. Certain hairstyles, ponytails, plaits, tightly wound rollers, over-vigorous brushing or combing etc, over a period of time, can continually, and sub-consciously, pull hair out. As hair is continuously pulled out of the same follicles, they go into a degenerative state and, eventually, give up hair production. This can cause areas to look thinner.

Black women tend to suffer the most due to tightly plaited styles and aggressive hairdressing techniques. Also, people who wear their hair back too tightly (air stewardesses) or wear rollers in bed!! Watch out ladies – you’ll have his eye out with a pin!!


More uncommon these days due to the advancement of hair products. Chemical over-processing can cause scalp burn as well as hair breakage. If the burn is severe, it can scar the scalp and hair will not grow in this area. (See also Afro-Caribbean hair section).


This is a form of tractional alopecia. It represents itself as a patchy, balding area caused by an irresistible desire to pull, pluck, tug or twist ones own hair out. It more often relates to adolescent maturing females who usually concentrate on one main patch. This condition is described as an impulse-control disorder.

Older hairs are easily pulled but newer hairs tend to break near the scalp when tugged so the patches are never usually completely bald.

Although the area can become quite sore and sensitive, this may not deter the person as they can often begin to enjoy the painful sensation.

Treatment does help to regrow hairs from follicles that are still alive, but degenerative scarring will take place if the person persists for long periods. If the patient understands this, they will often stop the habit. Although more unusual, eyebrows, eyelashes and some pubic regions can also be affected.

If you feel you may be suffering with any of the above complaints and wish to find out more about how The Spencer Clinic can help you, simply call us today on 020 7584 4255 or get a Free Online Diagnosis.