Alopecia areata is a hair loss condition also known as auto-immune disease that causes the quick start of round patches of baldness or spot baldness. It causes sudden flat or circular patches of hair loss which varies in sizes from an inch to the whole scalp or sometimes even the whole body. During the early stages, a single patch is observed and consequently more patches develop in other areas which are usually round or oval.
The patch looks so smooth that as though hair follicles had been entirely damaged. Hairs may be seen at the margin of this patch. These are broken, short hair that diminish at the base. Pulling slightly on these hairs causes them to fall out. Some people may experience a slight burning or tingling in the area of hair loss. Mainly young people in their early age start losing hair. Very few people may have this problem genetically. It affects both genders. Alopecia areata is infrequently related with any other external or internal medical problems. The state of hair may improve or can get worse on its own. Most often these bald areas regrow their hair spontaneously. Causes of Alopecia Areata The growth of alopecia areata is erratic. A number of people loose hair in only a small patch. Some may have more extensive involvement. A total loss of scalp hair is known as “Alopecia totalis”. The loss of body hair is known as “Alopecia universalis”.
These two conditions are rare. Alopecia areata is occasionally associated with other autoimmune conditions such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. The diagnosis or treatment of these diseases is not likely to affect the course of alopecia areata. Sometimes, alopecia areata occurs within family members, suggesting a role of genes. There is a higher rate of a family history of alopecia areata in people who are affected. Genetic factors seem to play an important role in this. Alopecia areata appears to also have an autoimmune factor causing the patient to develop antibodies to different hair follicle structures. Certain chemicals that are a part of the immune system called cytokines may play a role in alopecia areata by inhibiting hair follicle growth. Some studies show that emotional stress may also cause alopecia areata. From the prudent area, the hair follicles enter into the telogen or late catagen stage of hair growth due to which hair loss occurs. In the catagen stage the hair follicle discontinue growing and in the telogen stage it falls out. Hair pass through these stages casually and the growing hair on the rest of the head outnumber the hair that fall out. In alopecia areata, something causes all the hairs in a certain area to enter the telogen or catagen stage at the same time. Recently some studies have suggested that alopecia areata can be caused by an oddity in the immune system. This particular abnormality leads to autoimmunity, a mistaken immune system that tends to attack its own body. As an effect, the immune system attacks specific tissues of the body. For unidentified reasons, the body’s own immune system disturbs the hair follicles and disrupts normal hair formation.
What is the treatment for alopecia areata?
Spontaneous remissions and reoccurrences are common in Alopecia Areata. However, there are very less chances of hair re-growth when the time period of hair loss and the area is larger as in alopecia totalis and alopecia universalis. Mild cases of Alopecia Areata can be treated with intralesional steroid injections. Treatment can also include topical corticosteroids, minoxidil or contact immunotherapy. For more severe cases, oral steroids can also be considered. On rare occasions, if Alopecia Areata is stable and unresponsive to medical treatment, hair transplantation may be considered. Therefore, a cosmetic concealment or an exact treatment of alopecia areata is certainly very part of patient management, otherwise the damaging emotional effect of significant hair loss for both women and men can be considerable.
Hair brings confidence and happiness to an individual and improves the attitude of the person. But the problem of hair fall shatters the personality of one and all. It is now no longer limited to elderly people but also affecting the younger generation. No one from us wants to encounter this scary feeling of hair loss. Usually every day there is a hair fall which is very normal. But, some people may experience excessive loss in a day or month.
This type can affect men, women and children. The DHT (Dihydrotestosterone) – the male sex hormone – is the primary trigger for male and female pattern baldness. In addition, more and more follicles go into the resting phase with growing age leading to gradual thinning of hair. Most commonly, hair loss is related with determined genetic factors, family history, and the overall aging process. Many men and women may notice a mild and often normal physiologic thinning of hair starting in their thirties and forties. Further some time, normal life variations including temporary severe stress, nutritional changes, and hormonal changes like those in pregnancy, puberty, and menopause may cause a reversible hair loss. There are many other causes of scalp loss and they do differ individually.
Androgenetic Alopecia.
Among adults, the most common cause of loss is Androgenetic Alopecia, sometimes called male or female pattern baldness. It can affect both men and women although men experience a much visible degree of loss. In women, Androgenetic Alopecia appears as diffuse hair loss occurring over most of the scalp. In men however the pattern of loss usually starts with a receding hairline which then advances to thin the top of the head. However, it is now known that it is more specifically the male hormone dihydrotestosterone – DHT (which is converted from testosterone by the enzymes 5 alpha reductase) which contributes to Androgenetic Alopecia in those who are genetically predisposed. It is interesting to note that individuals with a deficiency in 5 alpha reductase do not develop Androgenetic Alopecia. It also can occur in people who take steroids like testosterone to build their bodies.
Alopecia Areata.
Alopecia Areata is thought to be an auto-immune disease of the hair, initially appearing as a rounded bare patch about an inch across. These can get bigger, and in a small number of cases, can progress to total hair loss. It affects both men and women equally and is often experienced first in childhood. The hair usually grows back within a year, but not always. Sometimes people with alopecia areata lose their hair again. There are three types of Alopecia Areata which are named according to their severity. Alopecia Areata is mild patchy loss on the scalp Alopecia Totalis is the loss of all scalp Alopecia Universalis is the loss of scalp and all body hair.
Trichotillomania
: It is a psychosomatic disorder in which people over and over again pull their hair out, often leaving bald patches. As an outcome, it causes baldness by damaging hair of different lengths. People with trichotillomania usually need professional help from a specialist or other mental health professional before they are able to stop pulling their hair out.
Excessive Hair Treatments and Styling:
Getting hair treatments frequently like applying chemicals such as coloring, bleaching, straightening, and applying heat to hair (like using a hot iron or hot blow drying) can cause damage that may make the hair break off or fall out temporarily. Hair fall due to hair styling can be permanent. So avoid wearing hair pulled so tightly that it places tension on the scalp can result in a condition called traction alopecia. Traction alopecia can be permanent if the style is worn for a long enough time that it damages the follicles.
Poor Nutrition:
This is one of the commonest reasons for loss, especially in India. Iron deficiency (anemia) tops the list and is followed by protein deficiency. Improper absorption of the nutrients can also lead to poor nutrition. This is why some people with eating disorders like anorexia and bulimia lose their hair. The body isn’t getting enough protein, vitamins, and minerals to sustain growth. Some teens who are vegetarians also lose their hair if they don’t get enough protein from non-meat sources. Disorder in the hair growth cycle: Several major factors can change the growth cycle temporarily. For example, delivering a baby, having surgery, going through a traumatic event, or having a serious illness or high fever can temporarily cause shedding of large amounts of hair. Because the hair we see on our heads has actually taken months to grow, a person might not notice any disruption of the growth cycle until months after the event that caused it. This type of hair loss corrects itself.
Hormonal Changes
: Hormonal problems may cause loss. Pregnancy, childbirth, menopause, hypothyroidism, hyperthyroidism, etc. can lead to significant hair loss. If your thyroid gland is overactive or underactive, your hair may fall out. This loss usually can be helped by treatment thyroid disease. Hair loss may occur if male or female hormones, known as androgens and estrogens, are out of balance. Correcting the hormone imbalance may stop your loss.
Medications and Infections:
Some medicines can cause hair loss. Medicines that can cause hair loss include blood thinners (also called anticoagulants), medicines used for gout, medicines used in chemotherapy to treat cancer, vitamin A (if too much is taken), birth control pills and antidepressants. Diet pills that contain amphetamines also can cause loss. This type of loss improves when you stop taking the medicine. Certain infections can cause loss. Fungal infections of the scalp can cause hair loss in children. The infection is easily treated with antifungal medicines. Hair loss may occur due to poor blood circulation, mental stress, or while recovering from a serious illness such as high fever, sudden or excessive weight loss, after a surgery or from metabolic disturbances. Since loss may be an early sign of a disease, it is important to find the cause so that it can be treated.
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