General: Symptoms of alopecia vary among patients. Patients may experience subtle hair thinning, extensive hair loss, or baldness. Males, females, and children can experience alopecia.

Alopecia areata: Patients with alopecia areata usually lose small round patches of hair on the scalp, face, and chest. Other parts of the body, including the eyelashes, eyebrows, and genitals, may also be affected.

Androgenetica alopecia: Males with androgenetica alopecia may experience hair loss during adolescence. This type of hair loss usually starts at the temples and crown of the head. Eventually, the patient may be partially or completely bald.

Females with androgenetic alopecia usually experience hair loss at the front, sides, or top of the head. Unlike males, females rarely develop complete baldness. Females usually only experience hair thinning.

Other: Alopecia that is caused by poor nutrition, infancy, hair treatments, infections, or illnesses may cause hair thinning, balding, or patches of hair to fall out. Unlike alopecia areata and androgenetica alopecia, these symptoms are temporary.

General: In most cases, alopecia does not require a diagnosis. The healthcare provider can usually determine the cause of hair loss after a physical examination and medical history. If there is a family history of alopecia, androgenetica alopecia is suspected. The healthcare provider will also ask questions about recent infections, new medications, diet, and hair treatments to determine if such factors are causing hair loss. If alopecia areata is suspected, a fluorescent antinuclear antibody (FANA) test may used to confirm a diagnosis.

Fluorescent antinuclear antibody (FANA) test: The fluorescent antinuclear antibody (FANA) test is a blood test used to detect abnormal antibodies, called autoantibodies. The autoantibodies bind to components of and individual's own cells and cause the immune system to attack the body. If autoantibodies are present, the patient has an autoimmune disorder.

During the procedure, a small sample of blood is taken from the patient and sent to a laboratory. The scientist tests the blood to determine whether or not it contains autoantibodies.

If a patient has a positive FANA result and has symptoms characteristic of alopecia areata, the patient is diagnosed with the disorder.

In rare occasions, the FANA test results can be positive in people who do not have autoimmune disease. This is called a false positive test result. The frequency of false-positive test results increases with age. A false negative result is also possible, but it is uncommon. Patients can be re-tested if a false negative test result is suspected.

Dandruff: If patients develop alopecia as a result of poor nutrition, they may also have dandruff. Dandruff causes dry, itchy, and excessive flaking of skin on the scalp. Improving nutrition will help reduce symptoms of dandruff.

Dandruff and alopecia may also be unrelated. However, dandruff may become more noticeable when the individual loses hair. White flakes of skin may be visible on clothing. Patients can purchase medicated shampoos to treat dandruff. For instance, zinc pyrithione shampoos (Selsun Salon® or Head & Shoulders®), tar-based shampoos (Neutrogena® or T/Gel®), salicylic acid shampoos (Ionil T®), selenium sulfide shampoos (Selsun Blue®), and ketoconazole shampoos (Nizoral®) have been used to treat dandruff.

Quality of life: Some patients with hair loss may have a difficult time coping with their appearance. Some patients may experience a decrease in their quality of life or suffer from low self-esteem. These patients may benefit from medical or non-medical hair replacements. Treatment may include hair pieces, surgery, or medications.

Sunburn: Patients who experience hair loss have an increased risk of developing sunburn, especially if they have light or fare skin. Patients who are bald or have bald patches of skin on the scalp should put sunblock on the scalp to prevent sunburn and skin cancer. Patients should choose a sunblock with a sun protection factor (SPF) of 15 or higher. The sunblock should offer protection against both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Patients with hair loss should wear hats in the sun and try to minimize sun exposure, if possible. An umbrella or parasol may also be beneficial.

Aging: Hair loss is a common sign of aging. The body slowly loses its ability to replace hairs that are shed. Males and females may experience hair thinning or baldness as a result of aging. This type of hair loss is permanent.

Genetics: Researchers believe that several genes play a role in the development of androgenetica alopecia. Hair loss that is inherited is permanent. An estimated 60% of patients with androgentica alopecia are male. This is because one of the genes associated with the condition is located on the X chromosome. Males have only one X chromosome. Therefore, if a male inherits the defective X chromosome he will develop alopecia. A male can look to his mother's father to determine whether or not he is likely to develop alopecia. If a male's maternal grandfather has alopecia, he has an increased risk of developing alopecia.

Females are less likely to develop alopecia because they have two X chromosomes. If the female inherits only one defective X chromosome, the other X chromosome will prevent alopecia from developing. Females need to inherit two defective X chromosomes in order to develop alopecia. In other words, a female may experience hair loss if her father has hair loss and her mother either has hair loss or carries the mutated chromosome, but does not have hair loss.

Hair treatments: Chemicals used for dying, tinting, bleaching, straightening, or perming the hair may damage the hair or cause breakage, especially if they are used excessively or incorrectly. Also, too much hairstyling that involves pulling on the hair may lead to some hair loss. This type of hair loss is temporary.

Infancy: Newborns often lose hair during the first several months of life. This baby hair, also called vellus, is replaced with more permanent hair. Also, many babies lose patches of hair on the back of their heads. This condition is often caused by rubbing against playpens, car seats, or mattresses. However, once the baby learns how to sit up, the hair will begin to grow back.

Immune system: Alopecia areata is an autoimmune disorder in which the body's immune system attacks hair follicles resulting in unpredictable patches of hair loss on the scalp, face, and other parts of the body. In healthy individuals, the immune system helps fight against disease and infection. However, for unknown reasons, the immune system in patients with alopecia areata mistakes the hair follicles for harmful invaders. The immune system then attacks the hair follicles as if they were disease-causing substances, such as bacteria. This type of hair loss can be managed with treatment.

Illness or surgery: Some patients may experience hair loss three to four months after an illness or surgery. These conditions do not cause the body to lose more hair than normal. Instead, they reduce the amount of new hair that is produced. Over time, the hair will begin to grow normally. Also, infections, such as ringworm, may infect the hair and skin on the scalp. As a result, the patient typically experiences hair loss. Once infections are treated, the hair will begin to grow back.

Medications and medical treatments: Temporary alopecia is a side effect of many medications, including some drugs that are used to treat arthritis, gout, depression, heart problems, cancer, and high blood pressure. In some female patients, birth control pills may cause hair loss. The hair will grow back once the medication is stopped.

Medical treatments may also lead to hair loss. For instance, patients who undergo chemotherapy or radiation therapy to treat cancer may develop temporary alopecia.

Poor nutrition: Poor nutrition may lead to alopecia. Patients who do not consume enough protein or iron in the diet may experience hair loss. Once the diet is corrected, the hair will grow back.