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My Hair is Thinning at the Sides and I’m Not Sure Why!

Losing your hair is never a pleasant experience. That experience is made worse if the hair loss does not follow the usual patterns and if the experts struggle to explain why it’s happening. That is often the situation those losing hair from the sides of their head find themselves in. We can all grasp that there are many causes of hair loss, but why does it thin on the sides and not on the crown?

The answer to that question lies somewhere in the middle between traction alopecia and cicatricial alopecia. Read on to discover more about these two types of hair loss and how they might be responsible for your thinning temples.

The Usual Suspects

The science around hair loss has advanced in quantum leaps in the past two decades or so. We now understand so much more about the different types of hair loss and their various causes. These types also have many sub-categories, but the main ones – the usual suspects in most cases of hair loss and thinning – are listed below.

Androgenetic alopecia is the technical term for the hair loss we know as male and female pattern baldness. It’s a genetic condition that can nevertheless be treated effectively with medications and hair transplant surgery.

Telogen effluvium, strictly speaking, isn’t a type of hair loss at all, but rather a form of hair shedding. The difference between hair shedding and hair loss is that shedding is usually temporary. Telogen effluvium occurs when a greater proportion of hair than normal is moved into the resting and shedding phases of the hair growth cycle, often following a traumatic or stressful event or illness.

Anagen effluvium is the dramatic hair loss that results from medical treatment for illnesses like cancer.

Alopecia areata is an autoimmune disorder in which the body’s immune system attacks healthy cells in the body, including the cells that make up hair follicles.

These types of hair loss can cause thinning on any part of the scalp, but mostly it occurs in the frontal areas and the crown. Frontal traction alopecia, on the other hand, is associated with hair loss from the sides of the head.

Traction Alopecia

Traction alopecia is when the hair falls because of constant physical stress and strain from tight hairstyles or rough combing and brushing. Braids and ponytails are the worst offenders. If you constantly wear your hair in these styles for a long time, you are quite likely to experience some hair loss as a result. If you spot the problem early and adopt a looser style, your hair will grow back. Leave it too late, however, and the loss could be permanent. That’s because the small bumps and inflammation that are symptoms of traction alopecia evolve to become permanent scars that destroy the hair follicles and prevent them from producing new hair.

With traction alopecia, the frontal hairline is affected along with the temples and the area around the ears. That’s why hair loss in and around the temples is often put down to this type of hair loss. That may not be the case, however. There are occasions when people show all the signs of traction alopecia without ever having worn their hair in one of the tight styles that cause it. It is at these times that the finger of blame for the hair loss points towards cicatricial alopecia.

Researchers have not yet been able to explain what causes cicatricial alopecia, other than to say that it is an inflammatory condition in which the same sort of scarring of the hair follicles seen in traction alopecia is again evident. Cicatricial alopecia can occur anywhere on the scalp. When it appears on the front or sides of the head, it is often referred to as cicatricial marginal alopecia.

As with traction alopecia, early diagnosis of cicatricial alopecia is key. Caught at this stage, it can be treated effectively. Treatment usually takes the form of topical or oral minoxidil, sometimes in conjunction with a course of intralesional steroids.


Some types of hair loss are more common and, therefore, better understood than others. Male and female pattern baldness, for example, fall into this category. Hair loss from the sides of the head may be more unusual, but it is likely that traction alopecia or cicatricial marginal alopecia are causing your hair loss.

If you have concerns, the sooner you speak to someone about your hair loss the better. It could be that you’re worrying about nothing; some level of daily hair loss is normal, after all. If there is a problem, however, early diagnosis and treatment give you a better chance of dealing with the problem effectively. Vinci Hair Clinic is offering a free, no-obligation consultation to all our new clients. Get in touch and book your appointment today!