Alopecia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Ogechukwu Hannah Nnabude, MD

Overview

Scarring alopecia is caused by numerous dermatologic factors, including glabrous skin (non-hairy), and is very difficult to diagnose and manage. Non-scarring alopecia is characterized by the absence of visible inflammation of the skin involved. Endocrine abnormalities such as hypothyroidism and Cushing's syndrome, medications such as allopurinol, warfarin and steroids, autoimmune diseases such as systemic lupus erythematosus, and infectious diseases such as syphilis and tinea capitis can also cause alopecia.

Causes

Common Causes

Severe emotional or physical stress may cause one-half to three-quarters of the hair on the scalp to shed in a type of alopecia called Telogen effluvium. Shampooing, combing, or just stroking thee hair can lead to massive amounts of hair being detached from the scalp. This may occur to a noticeable degree weeks or even months after the stressful episode. The rate of hair loss often slows down after about 6 - 8 months.

Triggering factors may include:

• High fever or severe infection
• Childbirth
• Major surgery, major illness, sudden blood loss
• Severe emotional stress
• Crash diets, especially those that do not contain enough protein
• A number of medications, including retinoids, birth control pills, beta-blockers, certain antidepressants, NSAIDs (including ibuprofen) and calcium channel blockers

Other possible causes of hair loss, especially if it is in an unusual pattern, include:

• Alopecia areata -- bald patches that develop on the scalp, beard, and, possibly, eyebrows. Eyelashes may fall out as well.
• Anemia
• Autoimmune conditions such as lupus
• Burns
• Certain infectious diseases such as syphilis
• Excessive shampooing and blow-drying
• Hormone changes
• Thyroid diseases
• Nervous habits such as continual hair pulling or scalp rubbing
• Radiation therapy
• Tinea capitis (ringworm of the scalp)
• Tumor of the ovary or adrenal glands

Causes by Organ System

Cardiovascular	Vasculitis
Chemical / poisoning	Selenium, thallium
Dermatologic	Acrokeratosis paraneoplastica of Bazex, alopecia cicatrisata, alopecia mucinosa, discoid lupus erythematosus, erythroderma, folliculitis, folliculitis decalvans, keratosis follicularis spinulosa decalvans cum op, perifolliculitis capitis abscedens et suffodiens, pseudopelade of Brocq, tufted folliculitis, Parry-Romberg syndrome
Drug Side Effect	Aclarubicin, actinomycin D, albendazole, amiodarone, antidepressants, Aprepitant, beta blockers, Bicalutamide, birth control pills, calcium channel blockers, cidofovir, clomifene, colchicine, combined oral contraceptive pill, Cyclophosphamide, Cytarabine, cytosine arabinoside, cytotoxic therapeutic agents, dabrafenib mesylate, Dacarbazine, Dactinomycin, danazol, daunorubicin, docetaxel, Doxorubicin Hydrochloride, eflornithine, Epirubicin hydrochloride, Epirubicin , Eribulin, etoposide, Febuxostat, Fluorouracil, Floxuridine, fluoxymesterone, gestrinone, heparin, hydroxychloroquine, idarubicin, ifosfamide, interferon alpha, Interferon alfa-2b , irinotecan hydrochloride, Ixabepilone, lamivudine, leflunomide, Leuprolide, Levoleucovorin, Levobunolol hydrochloride, lomustine, Megestrol, melphalan, mesalamine, methotrexate, methylphenidate, minocycline hydrochloride, Mitomycin, mitoxantrone, nabumetone, naltrexone, NSAIDs, Olsalazine, Oxandrolone, oxaliplatin, Oxaprozin, oxcarbazepine, paclitaxel, Palbociclib, pazopanib, Penicillamine, Pertuzumab, pixantrone, pramipexole, proguanil, repaglinide, retinoids, Sargramostim, Sodium aurothiomalate, sorafenib, stanozolol, Sulfasalazine, sulindac, Spironolactone, Temozolomide, teniposide, teriflunomide, testosterone, thiotepa, Tiagabine, topotecan, trabectedin, Tretinoin, tribavirin, valproic acid, vemurafenib, vincristine, Vinblastine, vismodegib
Ear Nose Throat	No underlying causes
Endocrine	Adrenal cortex insufficiency, hormone changes, hyperthyroidism, hypopituitarism, hypothyroidism, thyroid diseases
Environmental	No underlying causes
Gastroenterologic	Canada-Cronkhite syndrome
Genetic	Ablepharon macrostomia syndrome, Bazex-Dupre-Christol syndrome, biotinidase deficiency, BRESHECK syndrome, CARASIL, chondrodysplasia punctata 2, X-linked dominant, dermatopathia pigmentosa reticularis, Dubowitz syndrome, dwarfism-cerebral atrophy-keratosis follicularis syndrome, dystrophia myotonica type 2, epidermolysis bullosa with pyloric atresia, haemochromatosis, Hallermann-Streiff syndrome (HSS), Hay-Wells syndrome, hidrotic ectodermal dysplasia, holocarboxylase synthase deficiency, Hutchinson-Gilford progeria syndrome, hypohidrotic ectodermal dysplasia, autosomal dominant, hypohidrotic ectodermal dysplasia, autosomal recessive type, hypohidrotic ectodermal dysplasia, X-linked, hypotrichosis simplex, incontinentia pigmenti, junctional epidermolysis bullosa, non-Herlitz type, keratitis-ichthyosis-deafness syndrome, autosomal recessive, keratosis follicularis spinulosa decalvans cum ophiasi, lamellar ichthyosis type 2, Marie Unna hereditary hypotrichosis, monilethrix, myositis ossificans progressiva, orofaciodigital syndrome type 1, papular atrichia, proteus syndrome, pseudoprogeria syndrome, Rosselli-Gulienetti syndrome, Schopf-Schulz-Passarge syndrome, total congenital alopecia, vitamin D dependent rickets type 2a, Werner syndrome, Woodhouse-Sakati syndrome
Hematologic	Anemia, sudden blood loss
Iatrogenic	Major surgery, radiotherapy
Infectious Disease	Chagas disease, dissecting cellulitis, lepromatous leprosy, secondary syphilis, severe infection, shingles, tinea capitis, tinea favosa capitis, tuberculoid leprosy
Musculoskeletal / Ortho	Myotonic dystrophy
Neurologic	Parry-Romberg syndrome
Nutritional / Metabolic	Hypervitaminosis A, iron deficiency, vitamin H deficiency, zinc deficiency
Obstetric/Gynecologic	Child birth, pregnancy
Oncologic	Adrenal gland tumor, Cutaneous T-cell lymphoma, Ovarian tumor
Ophthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	Severe emotional stress, trichotillomania
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	Alopecia areata, atopic dermatitis, autoimmune adrenalitis, lichen planopilaris, lichen planus, psoriasis, systemic lupus erythematosus, Vogt-Koyanagi-Harada syndrome
Sexual	No underlying causes
Trauma	Burns, traction alopecia
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Aging, crash diet, excessive blow-drying, excessive shampooing, high fever, major illness

List of Causes in Alphabetical Order

Ablepharon macrostomia syndrome Aclarubicin Acrokeratosis paraneoplastica of Bazex Actinomycin D Adenal gland tumor Adrenal cortex insufficiency Aging Albendazole Alopecia areata Alopecia cicatrisata Alopecia mucinosa Amiodarone Anemia Antidepressants Aprepitant Atopic dermatitis Autoimmune adrenalitis Bazex-Dupre-Christol syndrome Beta blockers Biotinidase deficiency Birth control pills BRESHECK syndrome Burns Calcium channel blockers Canada-Cronkhite syndrome CARASIL Chagas disease Child birth Chondrodysplasia punctata 2, X-linked dominant Cidofovir Clomifene Colchicine Combined oral contraceptive pill Crash diet Cyclophosphamide Cutaneous T-cell lymphoma Cytarabine Cytosine arabinoside Cytotoxic therapeutic agents Danazol Daunorubicin Dermatopathia pigmentosa reticularis Discoid lupus erythematosus Dissecting cellulitis Docetaxel Doxorubicin Hydrochloride Dubowitz syndrome Dwarfism-cerebral atrophy-keratosis follicularis syndrome dystrophia myotonica type 2 Eflornithine Epidermolysis bullosa with pyloric atresia Epirubicin hydrochloride Eribulin Erythroderma Etoposide Excessive blow-drying Excessive shampooing Fluoxymesterone Folliculitis Folliculitis decalvans Gestrinone Haemochromatosis Hallermann-Streiff syndrome (HSS) Hay-Wells syndrome Heparin Hidrotic ectodermal dysplasia High fever Holocarboxylase synthase deficiency Hormone changes Hutchinson-Gilford progeria syndrome Hyperthyroidism Hypervitaminosis A Hypohidrotic ectodermal dysplasia, autosomal dominant Hypohidrotic ectodermal dysplasia, autosomal recessive type Hypohidrotic ectodermal dysplasia, X-linked Hypopituitarism Hypothyroidism Hypotrichosis simplex Idarubicin Ifosfamide Incontinentia pigmenti Interferon alpha

Irinotecan hydrochloride Iron deficiency Ixabepilone Junctional epidermolysis bullosa, non-Herlitz type Keratitis-ichthyosis-deafness syndrome, autosomal recessive Keratosis follicularis spinulosa decalvans cum op Keratosis follicularis spinulosa decalvans cum ophiasi Lamellar ichthyosis type 2 Leflunomide Lepromatous leprosy Lichen planopilaris Lichen planus Major illness Major surgery Marie Unna hereditary hypotrichosis Melphalan Methotrexate Methylphenidate Mitoxantrone Monilethrix Myositis ossificans progressiva Myotonic dystrophy NSAIDs Orofaciodigital syndrome type 1 Ovarian tumor Oxaliplatin Oxaprozin Paclitaxel Palbociclib Papular atrichia Parry-Romberg syndrome Pazopanib Perifolliculitis capitis abscedens et suffodiens Pixantrone Pregnancy Proguanil Proteus syndrome Pseudopelade of Brocq Pseudoprogeria syndrome Psoriasis Radiotherapy Retinoids Rosselli-Gulienetti syndrome Sargramostim Schopf-Schulz-Passarge syndrome Secondary syphilis Selenium Severe emotional stress Severe infection Shingles Sorafenib Stanozolol Sudden blood loss Systemic lupus erythematosus Temozolomide Teniposide Teriflunomide Testosterone Thallium Thiotepa Thyroid diseases Tiagabine Tinea capitis Tinea favosa capitis Topotecan Total congenital alopecia Trabectedin Traction alopecia Tretinoin Tribavirin Trichotillomania Tuberculoid leprosy Tufted folliculitis Valproic acid Vasculitis Vemurafenib Vincristine Vismodegib Vitamin D dependent rickets type 2a Vitamin H deficiency Vogt-Koyanagi-Harada syndrome Werner syndrome Woodhouse-Sakati syndrome Zinc deficiency