What Causes Hair Loss at the Nape of Neck: Common Triggers Unveiled

WrittenbyLuat Duong
Last updated

Many of us take our hair for granted until one day, we notice it's not as thick or full as it used to be. While hair loss is typically associated with the top of the scalp, it can occur anywhere – including the nape of the neck. This article delves into the potential causes of hair loss at the nape of the neck, helping you understand why it might be happening and what you can do about it.

What Causes Hair Loss at the Nape of the Neck?

The main causes of hair loss at the nape of the neck include traction alopecia, alopecia areata, androgenetic alopecia, frontal fibrosing alopecia, heat and chemical damage, acne keloidalis nuchae, and certain hair shaft disorders. Each of these conditions is associated with specific risk factors and triggers, and the appropriate treatment will depend on the precise cause of the hair loss.

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Traction Alopecia: Hair Under Stress

Traction alopecia is hair loss resulting from the tight pulling of hair. Hair styling practices such as tight ponytails, braids, and weaves can cause this type of hair loss. If caught early, hair regrowth can occur even without treatment. However, if the traction is prolonged, the hair loss can become permanent. Moreover, some individuals with a condition that mimics traction alopecia actually have a scarring alopecia known as cicatricial marginal alopecia.

Alopecia Areata: An Autoimmune Response

Alopecia areata is an autoimmune disease affecting about 2% of the population globally. This condition can cause hair loss anywhere on the body, including the nape of the neck. The specific form of alopecia areata that results in hair loss at the back of the scalp is known as the 'ophiasis' form. While this form is often resistant to standard treatments, topical steroids, steroid injections, and diphencyprone are typically the first-line treatment options.

Androgenetic Alopecia: Genetic Thinning

Androgenetic alopecia, also known as male or female pattern baldness, typically results in hair loss at the top of the scalp. However, in advancing stages, it can also lead to thinning along the nape of the neck.

Frontal Fibrosing Alopecia: A Scarring Phenomenon

Frontal fibrosing alopecia (FFA) is a type of scarring alopecia that primarily affects women between 45 and 70 years of age. While it typically causes hair loss along the frontal hairline and eyebrows, it can also affect the nape of the neck. Treatments for FFA include topical steroids, steroid injections, and oral medications like finasteride, doxycycline, and hydroxychloroquine.

Heat and Chemical Damage: External Causes

Overuse of heat and chemical treatments can lead to hair shaft damage and subsequent hair loss at the nape. Over time, these factors can contribute to an increased risk of developing traction alopecia.

Acne Keloidalis Nuchae: An Inflammatory Cause

Acne keloidalis nuchae (AKN) is a condition characterized by small, raised bumps along the back of the scalp, often resulting in hair loss in the region. The hair loss associated with AKN is often permanent and can lead to thick and disfiguring scars.

Hair Shaft Disorders: Structural Problems

Finally, certain hair shaft disorders can lead to hair loss at the nape of the neck. Individuals with these disorders have abnormalities in their hair shaft production, which can often lead to hair breakage. Monilethrix is one such disorder that frequently results in hair loss along the nape.


Hair loss at the nape of the neck can be unsettling and frustrating, but understanding the potential causes can help guide treatment decisions. It's important to consult with a healthcare professional or a dermatologist who specializes in hair loss if you're experiencing this issue. They can diagnose the underlying cause of your hair loss and help develop an appropriate treatment plan to manage your condition and support hair regrowth.

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Luat Duong

Luat Duong is a Copenhagen-based writer and content strategist specializing in hair loss and health. His work has been featured in MyHealthGuide, The Right Hairstyles, and Woman's Era. He is a graduate of Vaasa University. You can connect with him on LinkedIn.