In brief

Alopecia, or hair loss, affects both genders, and is of multiple etiologies. A multicenter retrospective study conducted at public and private specialist hair clinics in 15 different countries showed that a total of 57 types of alopecia were diagnosed with androgenetic alopecia, alopecia areata, telogen effluvium and frontal fibrosing alopecia being the most observed frequent types of alopecia.

Introduction

Alopecia, or hair loss, affects both genders, is of multiple etiologies, each with a different frequency, clinical presentation, depending on age, ethnicity and geographical location. Patients seek care at specialist hair clinics (SHC), which are the ideal spots to provide useful insights into disease epidemiology.

Frequency in Alopecia by Type, Gender and Age

A multicenter retrospective study was conducted at public and private SHC in 15 different countries: Australia, Brazil, Chile, Colombia, Germany, Italy, Mexico, Norway, Poland, Portugal, South Africa, Spain, Switzerland, USA and UK. Data on age, gender and the types of alopecia were collected.

Androgenetic alopecia was the most frequent type of alopecia, in both genders (37.7%). Men consulting for androgenetic alopecia were younger than women (33 vs. 45 years, respectively).

Alopecia areata was the second most frequent type of alopecia (18.2%), with female predominance (64% females vs. 36% males).

Telogen effluvium was the third most frequent cause of consultation (11.3%), with a clear female predominance.

Patients consulting with acne keloidalis nuchae, folliculitis decalvans and dissecting cellulitis were most frequently men, while patients consulting with traction alopecia, centrifugal cicatricial alopecia, frontal fibrosing alopecia, fibrosing alopecia in a pattern distribution and lichen planopilaris were most frequently women.

The youngest patients consulted for acne keloidalis nuchae, alopecia areata, dissecting cellulitis and folliculitis decalvans, and the oldest patients in frontal fibrosing alopecia, fibrosing alopecia in a pattern distribution, discoid lupus and lichen planopilaris.

The group of cicatricial alopecias represented 27% of patients consulting at SHC

Localization variations

Androgenetic alopecia, Alopecia aerate, telogen effluvium and frontal fibrosing alopecia were the most frequent cause of consultation in Specialist Hair Clinic centers.

Traction alopecia, acne keloidalis nuchae, centrifugal cicatricial alopecia and folliculitis decalvans more frequent in Africa whereas alopecia areata was more frequent in European patients compared to the rest of continents.

Conclusion

A total of 57 different diagnoses of alopecia were described, showing the complexity of the diagnosis of hair disorders. The most frequent types of alopecia evaluated at SHC were androgenetic alopecia, alopecia areata, telogen effluvium and frontal fibrosing alopecia.

Reference

Vañó-Galván S. Frequency of the Types of Alopecia at Twenty-Two Specialist Hair Clinics: A Multicenter Study. Skin Appendage Disord. 2019 Aug;5(5):309-315.