Clinicians caring for individuals with alopecia understand its psychological toll on patients and families and recognize the significant negative impact on their quality of life. This is particularly true for rare, monogenic forms of alopecia, such as hypotrichosis and monilethrix, which result from pathogenic variants in single genes and typically present early in life. Although several genes underlying monogenic alopecias are already known, at the time of writing of this article, no viable therapeutic options for these conditions were available. The psychosocial and emotional burden is also high for patients with more common forms of hair loss. These include male and female pattern hair loss, alopecia areata, and frontal fibrosing alopecia (FFA). Common alopecias have a more complex genetic basis, involving multiple variants and genes, and the risk of disease is shaped by the cumulative effects of these and varying degrees of environmental influence.