Alopecia causes

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


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.


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:

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

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 [5], 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


  1. Grover C, Khurana A (2013). "Telogen effluvium". Indian J Dermatol Venereol Leprol. 79 (5): 591–603. doi:10.4103/0378-6323.116731. PMID 23974577.
  2. 2.0 2.1 2.2 Asghar F, Shamim N, Farooque U, Sheikh H, Aqeel R (2020). "Telogen Effluvium: A Review of the Literature". Cureus. 12 (5): e8320. doi:10.7759/cureus.8320. PMC 7320655 Check |pmc= value (help). PMID 32607303 Check |pmid= value (help).
  3. Guo EL, Katta R (2017). "Diet and hair loss: effects of nutrient deficiency and supplement use". Dermatol Pract Concept. 7 (1): 1–10. doi:10.5826/dpc.0701a01. PMC 5315033. PMID 28243487.
  4. Watras MM, Patel JP, Arya R (2016). "Traditional Anticoagulants and Hair Loss: A Role for Direct Oral Anticoagulants? A Review of the Literature". Drugs Real World Outcomes. 3 (1): 1–6. doi:10.1007/s40801-015-0056-z. PMC 4819463. PMID 27747798.
  5. 5.0 5.1 5.2 Shelley ED, Shelley WB (1985). "Alopecia and drug eruption of the scalp associated with a new beta-blocker, nadolol". Cutis. 35 (2): 148–9. PMID 3979099.
  6. Etminan M, Sodhi M, Procyshyn RM, Guo M, Carleton BC (2018). "Risk of hair loss with different antidepressants: a comparative retrospective cohort study". Int Clin Psychopharmacol. 33 (1): 44–48. doi:10.1097/YIC.0000000000000191. PMID 28763345.
  7. Thomson SR, Mamulpet V, Adiga S (2017). "Sodium Valproate Induced Alopecia: A Case Series". J Clin Diagn Res. 11 (9): FR01–FR02. doi:10.7860/JCDR/2017/28564.10658. PMC 5713753. PMID 29207731.
  8. HOLOWACH J, SANDEN HV (1960). "Alopecia as a side effect of treatment of epilepsy with trimethadione. Report of two cases". N Engl J Med. 263: 1187. doi:10.1056/NEJM196012082632308. PMID 13715510.
  9. 9.0 9.1 Forouzan P, Cohen PR (2020). "Systemic Lupus Erythematosus Presenting as Alopecia Areata". Cureus. 12 (6): e8724. doi:10.7759/cureus.8724. PMC 7372242 Check |pmc= value (help). PMID 32699719 Check |pmid= value (help).
  10. Vincent M, Yogiraj K (2013). "A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction". Int J Trichology. 5 (1): 57–60. doi:10.4103/0974-7753.114701. PMC 3746235. PMID 23960405.
  11. Callen JP (2000). "Dermatomyositis". Lancet. 355 (9197): 53–7. doi:10.1016/S0140-6736(99)05157-0. PMID 10615903.