78 Alopecia Alopecia, or hair loss where there was formerly hair growth, is a common problem that affects more than half of the male population, and up to 40% of females over the age of 70. Scalp alopecia is of particular concern because the length and fullness of hair on the scalp are associated with youthfulness and physical attractiveness, and this hair frames the face to draw attention to the eyes. Gray, thinning hair is associated with increasing age and maturity and areas of balding draw attention away from the eyes to the forehead and scalp. Although alopecia can be the result of many different processes, the most common cause is androgenetic alopecia (AGA). When evaluating a patient with alopecia, a detailed history and physical are necessary to properly diagnose and treat the underlying condition. Alopecia can be distinguished as diffuse or focal, and nonscarring or scarring (also known as cicatricial). Diffuse nonscarring alopecia can be caused by the following:
Androgenetic (or androgenic) alopecia (AGA): AGA is the most common cause of alopecia in men and women. AGA may begin in puberty for men and typically increases in incidence per decade, with 30% of men noticing some baldness in their thirties, 40% in their forties, and so forth, until ultimately 60 to 80% of all men eventually experience AGA. The onset is typically later for women and ultimately less common. The incidence varies by ethnic group, with Chinese, Japanese, and black men less frequently affected than whites, but for all groups the incidence increases with age.
Alopecia areata
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