Hair loss patterns can provide clues about potential causes. While it typically begins slowly, paying attention to which areas of the scalp are first affected can help discern underlying triggers.
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What side does hair loss come from?
Most forms of hair thinning begin symmetrically on the top of the scalp, either from the frontal hairline backward or evenly all over the top.
Male/female pattern hair loss
The most common cause of diffuse thinning, androgenetic alopecia impacts either sex and causes loss from the frontal hairline receding in men or diffuse thinning over the top and sides in women. This type emerges symmetrically on both sides of the scalp.
Telogen effluvium
Temporary shedding triggered by shocks to the body like childbirth, surgery, crash dieting or illness leads to simultaneous hair fallout uniformly over the entire scalp within 3 months of the inciting event.
Alopecia areata
An autoimmune disorder resulting in smooth, coin-sized bald patches can start on any area of the head, including behind the ears or back, and may spread to involve both or just one side over time.
Traction alopecia
Scarring hair loss along the hairline edges and sides of the scalp stems from tight hairstyles like braids, extensions or ponytails that excessively pull single hairs out symmetrically over the long term.
Other location-specific patterns
Rarer causes may initially affect only one side, such as central centrifugal cicatricial alopecia, which predominantly impacts Black women on the crown, or trichotillomania, which leads to irregular clusters of hair loss along the sides or back.
Managing trichotillomania often involves cognitive behavioral therapy (CBT) and habit-reversal techniques to address the underlying compulsive behavior.
When hair loss begins asymmetrically on a single side, it often suggests a localized issue, such as a benign scalp cyst, which may require removal by a dermatologist.
Seeking evaluation and treatment
If concerned about non-symmetric thinning or rapid onset of small patches, having a physician examine the scalp helps identify if further diagnostics or prescription interventions may be warranted.
In general, hair loss emerging symmetrically along the hairline scalp edges or uniformly over the top is more likely following patterned genetic thinning trends.
Understanding where shedding originates from provides clues to discovering its root cause and addressing it appropriately for regrowth success.
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