What Type Of Alopecia Do I Have? How To Tell 8 Types Apart

You can usually work out what type of alopecia you have from 4 clues: where the hair is missing, whether it’s coming out in patches or thinning all over, how fast it started, and what your scalp skin looks like. Those 4 answers narrow 8 types down to 1 or 2. A short exam confirms which one, most often with a gentle pull test and a magnified look at the scalp.

The type that shouldn’t wait for a routine visit is scarring alopecia. In a 2026 study of 1,034 people with scarring hair loss, those with CCCA, the scarring type most common in Black women, waited 5.67 years on average for a diagnosis. A scarred follicle doesn’t grow hair again.

Alopecia is the medical name for hair loss, and it covers at least 8 conditions with different causes and outcomes. Clinicians tell them apart by 4 things: the pattern of loss, the speed of onset, the condition of the scalp skin, and what the hairs look like under magnification. Blood tests look for triggers, not the type.

Pattern hair loss is the answer far more often than anything else. In a 2025 International Journal of Trichology study, a Swiss hair referral center that counted 15,211 patients from 2011 to 2021 found pattern hair loss in 67%, alopecia areata in 11%, a scarring alopecia in 11% and telogen effluvium in 7%.

Having 2 types at once is common too. In a 2022 US chart review of 138 people with non-scarring hair loss and abnormal lab results, 39% carried more than 1 diagnosis, most often pattern loss plus shedding.

How do I tell what type of alopecia I have?

Answer 4 questions, then find your answers in the table. They usually point to 1 or 2 rows.

1. Where is the hair missing? Temples and crown, the part line, the front hairline, separate patches, or everywhere.
2. Patches or all over? Smooth, round patches point one way. Even thinning points another.
3. How fast did it start? Over years, over weeks, or all at once after a rough month.
4. What does the scalp skin look like? Normal, scaly, red around the hairs, or smooth and shiny with no visible pores.

The 4th question matters most. It separates hair that can come back from hair that can’t.

Type	Where and how it looks	How fast	Scalp skin	Confirmed by	Grows back?
Pattern hair loss (androgenetic alopecia)	Men: temples and crown. Women: a wider part, front hairline usually holds	Years	Normal	Magnified exam showing hairs of mixed thickness	Treatment can hold it and regrow some. Untreated, it progresses
Telogen effluvium	Thinning all over, more hair in the drain	Sudden, about 3 months after a trigger	Normal	History plus a pull test	Yes, usually within 6 to 9 months
Alopecia areata	Smooth round or oval patches, sometimes brows, lashes or beard	Days to weeks	Smooth, normal color	Exam, with short “exclamation mark” hairs at the patch edge	Often, though relapses are common
Traction alopecia	Hairline and temples, where styles pull	Months to years	Normal, sometimes small red bumps	Exam and styling history	Yes if tension stops early. Late loss is permanent
Scarring alopecia (CCCA, FFA, lichen planopilaris, discoid lupus)	CCCA: crown. FFA: front hairline and brows. Others: patches	Months to years	Shiny and smooth with no pores. May itch, burn or feel tender	Biopsy, though FFA is often diagnosed on exam	No. Treatment aims to stop the spread
Tinea capitis (scalp ringworm)	Scaly patches with broken hairs, mostly in children	Weeks	Scaly, sometimes swollen and sore	Fungal scraping or culture	Yes, with antifungal pills
Trichotillomania (hair pulling)	Irregular patches where the hand reaches	Varies	Normal	Exam, with hairs snapped at different lengths	Usually, if the pulling stops early
Anagen effluvium	Fast loss all over	Within about 2 weeks of chemotherapy	Normal	Treatment history	Yes, after treatment ends

Pattern hair loss (androgenetic alopecia)

Pattern hair loss is slow, inherited thinning driven by hormones, and it’s the most common type by a wide margin. MedlinePlus Genetics estimates it affects 50 million men and 30 million women across the US.

In men, it usually starts above both temples and at the crown. In women, the middle part widens while the front hairline mostly holds. For men, the age data sits in our male hair loss timeline. Women have a longer list of possible causes to rule out, and we cover them in 14 causes of thinning.

The clue is in the hairs. Follicles shrink a little with each growth cycle, so the hairs they make get shorter and finer. Under magnification, a clinician sees thick and thin hairs side by side. At our Weston evaluation, that’s the first sort we make: follicles that are shrinking, which can respond to treatment, and follicles that are gone, which can’t.

Only 2 treatments carry FDA approval for pattern loss: topical minoxidil, for men and women, and oral finasteride, for men only.

Telogen effluvium: sudden, all-over shedding

Telogen effluvium is sudden, all-over shedding that starts about 3 months after a shock to the body. It usually settles on its own once the trigger is gone.

Common triggers include childbirth, a high fever, surgery, a new medication, a crash diet, fast weight loss and an untreated thyroid problem. Beta blockers are among the most common drug triggers, according to StatPearls. Weight loss shots count too, and shedding after weight loss follows the same delay.

StatPearls puts the gap between trigger and shedding at about 3 months, with a range of 1 to 6. Acute cases last under 6 months. The shed hairs are full length, often with a small white bulb at the root. A gentle pull on about 60 hairs that brings out 4 or more points to an active shed.

Counting hairs in the drain won’t separate this from pattern loss, since medical sources disagree on normal daily shedding. The 3-day wash test does better, because it checks what share of shed hairs are short and fine. The 2 conditions often show up together. In a Vancouver hair clinic, 38.6% of women with pattern hair loss also had telogen effluvium.

Alopecia areata, the autoimmune type

Alopecia areata is the autoimmune type. The immune system attacks growing hair follicles, and hair falls out in smooth, round patches, sometimes within days.

A Minnesota population study put the lifetime risk at 2.1%. Patches can show up on the scalp, eyebrows, eyelashes or beard. Check the edge of a new patch: short hairs that narrow toward the scalp, called exclamation mark hairs, are a hallmark. About 10% to 15% of people with it also get small pits in their nails.

Patches often regrow without treatment. Among people with patchy alopecia areata, 34% to 50% recover within 1 year, according to StatPearls. Most relapse later, fewer than 10% recover completely, and about 10% go on to lose all scalp or body hair.

For small, limited patches in adults, steroid injections into the patch are a first-line treatment, per the British Association of Dermatologists. Severe cases now have 3 FDA-approved pills, covered below. None of the 3 is available at our clinic, so we send round, smooth patches to a dermatologist first.

Traction alopecia

Traction alopecia is hair loss from steady pulling. It’s reversible if the pulling stops early and permanent once it scars.

Tight ponytails, braids, extensions and weaves pull hardest at the hairline and temples, so that’s where it shows. In a Cape Town study of 874 adults, 31.7% of women had traction alopecia, against 2.2% of men.

A single clue sets it apart from other hairline loss: a thin fringe of short hairs left along the front edge of the hairline. In a study of 41 women with traction alopecia, 85% had that fringe. Frontal fibrosing alopecia, a scarring type, tends to erase it.

Heat tools and relaxers don’t cause traction alopecia on their own, according to StatPearls. They raise the risk when combined with tight styles. The first fix is looser styles, and medicines are add-ons.

How do I know if my alopecia is scarring?

Look at the skin. Scarring alopecia leaves smooth, shiny skin with no visible pores where hair used to grow, and it often itches, burns or feels tender before you see much loss.

The main types:

• CCCA (central centrifugal cicatricial alopecia): starts at the crown and spreads outward. StatPearls puts it at 2% to 7% of women of African descent, and it’s the most common scarring type in middle-aged Black women.
• Frontal fibrosing alopecia (FFA): a band of hairline that moves back, often with eyebrow loss. StatPearls reports it’s rising in Europe, the US and Japan.
• Lichen planopilaris: redness and scale around single hairs, with itching or burning.
• Discoid lupus: red, scaly patches that can leave scars and color changes.

CCCA and female pattern hair loss both start at the crown, which is why they get mixed up. The scalp tells them apart. With pattern loss, the skin looks normal and the hairs get thinner. With CCCA, the scalp can feel tender, tight or itchy, and under magnification the follicle openings are gone.

The wait is the real danger. In a 2026 JAAD International study, people with CCCA waited 5.67 years on average for a diagnosis, and people with FFA or lichen planopilaris waited 2.88 years. The 1,034 people in it came through a patient advocacy group and reported their own history. A follicle destroyed by scarring alopecia never regrows hair, so a longer wait can mean more permanent loss.

If your crown thinning comes with a tender, tight, itchy or burning scalp, we refer you to a dermatologist, and a biopsy may be needed. Our women’s hair regrowth page spells out the same referral rules.

What is mistaken for alopecia?

A fungal scalp infection, hair pulling and breakage from heat or chemicals can all pass for alopecia at first glance. Each needs a different fix.

Tinea capitis (scalp ringworm). This fungal infection causes scaly patches with broken hairs, mostly in children aged 3 to 14. It needs prescription antifungal pills, usually for 1 to 3 months, according to the CDC, because creams don’t clear it. Under magnification, the broken hairs can look like commas or corkscrews.

Trichotillomania (hair pulling). People with this condition pull out their own hair over and over, often without noticing. In a US survey of 10,169 adults, 1.7% had it at the time. The patches are irregular, and the hairs in them are snapped at different lengths. In a study of 44 patients, every one showed those broken hairs under magnification. The usual first treatment is a form of behavioral therapy called habit reversal training.

Breakage. Heat styling, bleach and relaxers damage the hair shaft, and damaged hair snaps partway down. The follicles are fine. Broken hairs have no bulb at the end, and the fix is gentler styling rather than a hair loss treatment.

Anagen effluvium

Anagen effluvium is fast, all-over hair loss from chemotherapy or radiation. It usually starts within about 2 weeks of a chemotherapy dose, and the hair grows back after treatment ends. Heavy metal exposure and severe protein malnutrition can cause it too. It’s the only type where the cause is almost never a mystery.

What happens at a hair loss evaluation

A good evaluation names the type and the stage first. Treatment comes after.

At our Weston clinic, the first visit is an evaluation only, with no treatment. We examine the scalp under magnification and take baseline photos in fixed lighting. That shows whether follicles are shrinking or gone, what the pattern is and how far along it is.

If you started a weight loss shot or lost weight fast in the past year, we want to hear it in the first 5 minutes. Then we decide whether you need labs, and we wait for the lab results before we set a timeline. You leave with a diagnosis and a written plan in the order to start, or with a referral.

Step	What happens	What it tells you
Pull test	The clinician grasps 40 to 60 hairs and pulls gently	More than 10%, or 4 to 6 hairs, points to active shedding. A normal pull brings out 2 or fewer
Magnified scalp exam (trichoscopy)	A handheld scope or camera views the scalp up close	Mixed hair thickness: pattern loss. Exclamation mark hairs and black or yellow dots: alopecia areata. No follicle openings: scarring. Comma or corkscrew hairs: fungus. Hairs broken at different lengths: pulling
Scalp biopsy	A small punch of skin, often 4 mm, goes to a lab	Needed for most scarring alopecia and for unclear cases
Blood work	Common panels include TSH, ferritin, a CBC and vitamin D	Finds triggers such as thyroid disease or low iron. It doesn’t name the type
Fungal scraping or culture	Scale or hairs go to a lab	Confirms scalp ringworm

Is there a blood test for alopecia?

No blood test tells you which type of alopecia you have. The type comes from the pattern of loss and the scalp exam.

According to a 2017 American Family Physician review, “there are no routine tests to evaluate hair loss.” The authors save lab work for when your history or exam suggests a cause.

Labs still earn their place. A trigger like low iron or an underactive thyroid can sit on top of pattern loss and blunt any treatment. StatPearls lists a CBC, iron studies including ferritin, TSH and vitamin D as common checks, plus testosterone for women with signs of excess androgens. Low protein intake works the same way, and protein deficiency hair loss shows up as extra shedding about 3 months later. Labs tell you why you’re shedding. The exam tells you what you have.

What’s FDA approved for alopecia areata in 2026?

The FDA has approved 3 oral JAK inhibitors for severe alopecia areata: baricitinib (Olumiant), ritlecitinib (Litfulo) and deuruxolitinib (Leqselvi). They calm the immune attack on the follicle.

Drug	FDA approval	Approved for	Trial result
Baricitinib (Olumiant)	June 13, 2022	Adults. Lilly announced approval for ages 12 and up on Sept. 25, 2026	35% and 32% on 4 mg reached at least 80% scalp coverage by week 36 in 2 trials, against 5% and 3% on placebo
Ritlecitinib (Litfulo)	June 23, 2023	Ages 12 and up	23.0% reached at least 80% coverage by week 24, against 1.6% on placebo
Deuruxolitinib (Leqselvi)	July 25, 2024	Adults	29% and 32% reached at least 80% coverage by week 24 in 2 trials, against 1% on placebo

These results come from the FDA’s drug trial snapshots and approval records. Each label carries a boxed warning for serious infections, death, cancer, major heart events and blood clots. A 4th drug, upadacitinib (Rinvoq), was submitted to the FDA for alopecia areata in April 2026 and isn’t approved for it yet.

None of these pills is available at our clinic. A dermatologist prescribes and monitors them, which is why round, smooth patches go to a dermatologist first.

How long people wait for a diagnosis

People wait months to years for the right diagnosis, and what that wait does depends on the type. A telogen effluvium shed usually settles by itself, while pattern loss keeps going and scarring loss is permanent.

Type	Average wait	What was measured	Source
Alopecia areata	9.6 months	Time to diagnosis, US survey of 500 people	Skin Appendage Disorders, 2026
FFA or lichen planopilaris	2.88 years	Time to diagnosis	JAAD International, 2026
Female pattern hair loss	4.1 years	Onset to seeing a hair specialist, 210 women in Vancouver	International Journal of Trichology, 2016
CCCA	5.67 years	Time to diagnosis	JAAD International, 2026

The alopecia areata survey drew mostly white women with above-average incomes, so its authors caution that the average may not hold for everyone. If shedding runs past 6 months, it has outlasted a typical acute shed, and it’s time for an exam.

What we treat in Weston, and what we refer

We treat pattern hair loss, and for telogen effluvium we look for the trigger. We refer alopecia areata, scarring alopecia and anything we can’t diagnose with confidence to a dermatologist.

For pattern loss, plans follow our three-layer framework for every hair loss patient. The FDA-approved baseline comes first: minoxidil, plus finasteride for men. PRF therapy, microneedling and peptides come second, and they only help follicles that are shrinking but still alive. A transplant is the 3rd layer, for scalp where the follicles are gone, and we refer that to a surgeon because we don’t perform transplants.

Our Weston hair restoration page lists the options we offer.

We won’t start treatment while a thyroid or iron problem is still unsorted, and we won’t treat active scarring alopecia. We’d rather lose an appointment than treat the wrong condition. Our 2 providers are board-certified physician assistants with more than 30 years of combined clinical experience, and you can read about our providers before you book.

If the 4 clues still leave you asking what type of alopecia you have, book an evaluation. The first visit at our Weston clinic is an evaluation only, and you leave with a diagnosis and a written plan, or a referral to the right specialist. Patients come from Davie, Cooper City, Pembroke Pines, Miramar, Southwest Ranches and Weston itself, and consults run in person or by telehealth. Call (954) 373-8483 or book a consult.

FAQs

What type of alopecia do I have if my hair is thinning all over?

Even thinning across the whole scalp usually means telogen effluvium, pattern hair loss, or both. Telogen effluvium starts suddenly, about 3 months after a trigger like illness, childbirth or fast weight loss, while pattern loss builds over years and shows most on top. In a Vancouver hair clinic study, 38.6% of women with pattern hair loss also had telogen effluvium.

Which type of alopecia is autoimmune?

Alopecia areata is the autoimmune type. The immune system attacks growing follicles, which causes smooth, round patches on the scalp, eyebrows or beard. A Minnesota population study put the lifetime risk at 2.1%. Some scarring types, such as lichen planopilaris and discoid lupus, also involve immune inflammation around the follicle.

Which type of alopecia is reversible?

Telogen effluvium, early traction alopecia, scalp ringworm and chemotherapy hair loss usually reverse once the cause is treated or removed. Alopecia areata often regrows as well: 34% to 50% of patchy cases recover within a year without treatment, though relapses are common. Scarring alopecia doesn’t reverse, and pattern hair loss keeps progressing unless it’s treated.

Does alopecia areata come back after the hair regrows?

It often does. StatPearls reports that most people with patchy alopecia areata relapse at some point, and fewer than 10% recover completely. A relapse within a year of regrowth is common, and most relapses happen within 5 years, according to the American Academy of Dermatology.

Can a blood test tell me what type of alopecia I have?

No. A 2017 American Family Physician review says there are no routine lab tests for hair loss and reserves labs for when the history or exam points to a cause such as thyroid disease or low iron. The type comes from the pattern of loss and a magnified scalp exam.

When should I see a dermatologist about hair loss?

See a dermatologist first for smooth, round patches, lost eyebrows or eyelashes, or a scalp that itches, burns, feels tender or looks shiny and smooth. Those signs point to alopecia areata or a scarring alopecia, and scarring loss can’t be undone. In a 2026 study, people with CCCA waited 5.67 years on average for a diagnosis.