There might be several people who might not even be aware of what alopecia areata is, but those in the know will know that this is a condition that leads to hair loss, mainly on the head. This is actually a condition, within the human body, that leads to the loss of hair, in patches and while it happens mostly on the head, in rare cases, it can affect other parts of the body.

What is Alopecia Areata?

  • Alopecia areata is an autoimmune condition, which leads to hair falling out
  • The condition causes the body to attack the hair follicles, which leads to the hair to fall out
  • The loss of hair can be in a pattern or in small patches that are random
  • The loss of hair is most commonly seen on the head, but in rare cases, it can affect other parts of the body as well
  • There is till date, no exact cause that has been identified for alopecia areata
  • The condition has been attributed to other autoimmune conditions such as Type 1 diabetes or rheumatoid arthritis
  • In most cases, there is only partial hair loss, but in the most severe cases, there can be complete hair loss or alopecia universalis
  • In many cases, the hair does grow back, but there is always the chance for it to fall out again

There is no proven cure for alopecia areata, but several routes of treatment have proven effective and while hair does grow back, what is more important to remember is the fact that the further hair loss can be prevented.

What are the causes of Alopecia Areata?

 Studies looking into the causes of alopecia areata have been going on for a long time and are still continuing, but one thing that doctors and researchers have been able to confirm is that this is an autoimmune condition. An autoimmune condition is one wherein the immune system of the body is unable to differentiate between the good cells and the bad cells. In alopecia areata, the immune system of the body attacks the follicles of the hair, leading to them falling out. The condition leads to the hair follicles becoming smaller, which eventually stops the production of hair altogether.

Perhaps the main issue behind alopecia areata is the fact that despite in-depth research, there is still no clear reason for why the immune system attacks the hair follicles. However, it has been noticed that people who have a family history of type 1 diabetes or other autoimmune conditions such as rheumatoid arthritis are more prone to developing this hair condition.

What are the symptoms of Alopecia Areata?

The fact that alopecia areata is a condition that leads to loss of hair, that itself is the first symptom.

  • Hair tends to fall out in small round patches, normally a few centimetres, mainly on the scalp
  • Loss of hair could occur on other parts of the body as well
  • If the hair loss is really extensive and there is no hair on the entire head, it is referred to as alopecia totalis
  • If the hair loss is extremely extensive and there is no hair on the entire body, the condition is known as alopecia universalis
  • Even in this condition of hair loss, hair could grow back and then it could fall out again

How is alopecia areata diagnosed?

Proper diagnosis of alopecia areata can be done only by an experienced doctor and most of them will be able to detect the same, only by looking at the scalp and gauging the extent of hair loss.

  • Some doctors might take a few hair samples and examine them in greater detail under a microscope to determine that it is alopecia areata.
  • In certain cases, the doctors might request for a scalp biopsy, simply because they would want to rule out other conditions that could lead to hair loss, such as scalp infections. A small piece of skin will be removed from the scalp and the same will be used for the biopsy.
  • In case, the doctor suspects any other kind of autoimmune conditions, he could also suggest that the patient undergoes a few blood tests. The blood tests will be specific to the kind of condition that is being suspected or will be with the intention of locating certain antibodies.
  • Some of the other commonly prescribed blood tests include those to check iron, testosterone and thyroid levels, erythrocyte sedimentation rate, follicle stimulating and luteinizing hormone levels and antinuclear antibody test.

Who is most likely to get alopecia areata?

 There is no fixed rule or guide book that can tell you who is most likely to get alopecia areata, however, it has been noticed that genetics have a large role to play in it. If someone in the family has alopecia areata, chances are that it might travel down the family tree and affect others as well.

It is important to remember that alopecia areata is an autoimmune condition, which means that it can affect anyone. It is just as important to remember that alopecia areata, if detected in time, can be treated and the results can be permanent.

How is alopecia areata treated?

 While there is no cure for alopecia areata, the condition can be treated, provided the same is detected well in time. As a matter of fact, treatment can not only help stop further hair loss, it can also assist with hair growing back faster.

Here is how medical treatment for alopecia areata works:

 There are certain medications such as Minoxidil, which can be rubbed into the scalp and that in help with the stimulation of hair growth. There are also other creams and ointments which can be applied to the scalp for better hair growth. Certain doctors would also be willing to prescribe steroid injections, which are normally injected into the scalp. Photochemotherapy is also known to be an effective solution, where radiation with ultraviolet light, combined with oral medication can help improve hair growth.

There is also a range of alternative therapies:

 Some of the most commonly used alternative therapies to treat alopecia areata include intake of vitamins, aromatherapy, herbal supplements and acupuncture. However, none of these therapies have been proven, which is why their effectiveness is not guaranteed for everyone.

What can be done to help with alopecia areata?

 There are some steps that can be taken to help reduce the discomfort that is often associated with alopecia areata:

  • Whenever you are stepping out, make sure that you apply sunscreen to the areas that have been affected by the condition.
  • The scalp should also be protected with a scarf or hat
  • If eyelashes have fallen out, it would be wise to wear sunglasses

Alopecia areata manifests in each person, in a different manner, which is why it is important to remember that the hair growth and efficacy of any and all treatments will vary. While some people might see results after the very first treatment, there would be those who will need more than five or six sessions, before they start to see the very first hair. It is also crucial to remember that in many cases, the hair growth might be temporary and the hair can fall off. In many cases, different treatments might be required and for some only a combination might work.

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Most hair follicles on the scalp do not produce hair continuously. The follicles may be in either of the three stages of the hair cycle : Anagen (growing), Catagen ( falling) and Telogen (resting) phase. There may be a temporary or permanent loss depending on various multiple conditions & diagnoses. They are listed under different names like scarring alopecia, alopecia areata, anagen effluvium, telogen effluvium, etc. The various types of hair loss are being listed below to know the real root cause.

Hair Loss types in Men and Women

Hair Loss types in Men and Women

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. It affects both men and women equally and may be experienced first in childhood. Many people affected with Alopecia Areata will only have one experience of loss with re growth occurring afterwards. There are three types of Alopecia Areata which are named according to their severity. • Alopecia Areata is mild patchy hair loss on the scalp • Alopecia Totalis is the loss of all scalp hair • Alopecia Universalis is the loss of scalp and all body hair Researchers believe that Alopecia Areata is an auto-immune disease; this means that the body’s immune system acts as if the hair follicles are foreign and attacks them. White blood cells called T-lymphocytes attack the hair follicle which causes the hair to stop growing and enter into the telogen (resting) phase, then about 3 months later, when the resting phase is over the hair will then fall out. Only when T-lymphocytes stop attacking the hair follicle, will new hair grow.

Androgenetic Alopecia:
Male and female pattern baldness (androgenetic alopecia) is the most common forms of hair loss. It can affect both men and women although men experience a much greater degree of loss. In women, Androgenetic Alopecia appears as diffuse hair loss occurring over most of the scalp. In men, the pattern of loss usually starts with a receding hairline which then advances to thin the top of the head. After a lot of research, it is now known that it is more specifically the male hormone dihydrotestosterone (DHT) – ( produced by the action of enzyme 5 alpha reductase on testosterone) 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. This is because the body is unable to convert testosterone into dihydrotestosterone. When Androgenetic Alopecia occurs large active hair follicles in specific areas begin to change to smaller less active ones that shrink slightly with each new growth cycle. If an individual has androgenetic alopecia the overall levels of testosterone may be normal however the activity of 5 alpha reductase is greater than normal which results in increased amounts of dihydrotestosterone in the hair follicle.

Telogen Effluvium:
Telogen Effluvium occurs when sudden or severe stress causes an increase in the shedding of the hair. Doctors seem to agree that telogen effluvium is probably the second most form of hair loss seen by dermatologists. In Telogen effluvium, a sudden or stressful event can cause the hair follicles to prematurely stop growing and enter into a resting phase. This occurs when there is a change in the number of hair follicles growing hair. If the number of hair follicles producing hair drops drastically for any reason during the resting, or telogen phase, there is a significant corresponding increase in dormant, telogen stage hair follicles. Accordingly the result is shedding, or effluvium hair loss. This will then appear as diffuse thinning of hair on the scalp, which may not be even all over. This can be more severe in certain areas of the scalp more than others. Interestingly, most hair on top of the scalp thins a lot more than it does at the back and sides of the scalp. There is generally no hair line recession, except in a few chronic cases that are rare.

Scarring Alopecia:
When inflammation of the hair follicles occurs due to infection it can lead to Scarring Alopecia. While many forms of scarring alopecia exist, a common theme is a potentially permanent and irreversible destruction of hair follicles and their replacement with scar tissue. Most forms of scarring alopecia occur first as small patches of hair loss that may expand with time. In some cases hair loss is gradual, without noticeable symptoms, and can go unnoticed for a long time. In other instances, hair loss is associated with severe itching, burning, and pain, and progresses at a rapid pace. The early stages of scarring alopecia can have inflammatory cells around the hair follicles, which may induce destruction of the hair follicles and development of scar tissue. Visual indicators may help with diagnosis, but to diagnose a scarring alopecia, a skin biopsy is confirmatory. It will not only help to diagnose scarring alopecia but also any other cause as well. A small piece of 2 to 4 mm diameter is taken and examined carefully under a microscope.

Congenital Hypotrichosis:
Dermatologists describe this as a condition of no hair growth. This condition is wholly unlike alopecia which describes hair loss where formerly there was hair growth; hypotrichosis describes a situation where there wasn’t any hair growth in the first place. Hypotrichoses are conditions affecting individual’s right from birth and usually stay with them throughout their lives. They mostly occur as a result of genetic aberrations or defects of embryonic development. There are usually hundreds of types of genetic hypotrichoses. Often, individuals affected have other physical or mental problems that are way beyond just a lack of hair.

Congenital Aplasia:
Congenita is a rare disorder that often results as a small blistered atrophied area usually in the midline of the scalp and present from birth. In most cases, the problem heals itself. However, in larger areas it may be associated with underlying developmental disorders. Babies may be born with a patch of skin like an open wound or an ulcer. This defect often occurs at the back of the scalp, at the center of hair growth. If the defect is small, the skin will scab over and the baby is left with a scar. This sometimes happens in the womb and all seen at birth is scalp patch where there are no hair follicles. This is often done with some urgency, since the open wound is a site of potential hemorrhage and infection. The quicker the defect heals, the better.

Triangular Alopecia:
Triangular alopecia is similar to congenital aplasia. It is apparent from birth and tends to affect a triangular patch of skin and hair above temples. For largely unknown reasons, the skin essentially does not grow hair follicles in this area in a few people. Affected areas can be surgically removed or implanted with hair follicles taken from elsewhere on the scalp.

Congenital Atrichia:
Congenital atrichia is another condition in hair loss patterns. This was the first human hair loss disease researchers determined that was caused by a single gene defect. Generally regarded as a hypotrichosis, this is not strictly so. Congenital Atrichia occurs when a baby is born without hair follicles in certain areas. This can be quite common and usually only occurs in a few spots. In early childhood they lose all their hair, and it never re-grows.

For the hair, ringworm scalp usually begins as a small pimple to progressively expand in size, leaving scaly patches of temporary baldness. The fungus gets into hair shafts. This is the typical way that ringworm operates. In the affected area, hair become brittle and break off easily leaving only a bald patch of skin. Affected areas are often itchy, red and inflamed, scaly patches may blister and ooze. The patches are usually redder around the outside with a more normal skin tone in the center. This may eventually create the appearance of a ring, hence the name, ringworm. Ringworm is believed to be contagious. It can be passed from one person to the next by direct skin-to-skin contact. You can also catch ringworm through contact with contaminated items such as combs, unwashed clothing, and shower or pool surfaces.

Folliculitis refers to focal inflammation of hair follicles. It generally looks like acne with little rings of inflammation to surround opening of a hair follicle. The whole thing works in stages. In the early stages, the hair shaft may still be present in the middle of folliculitis, but as it progresses hair falls out often. When it is severe, the inflammation is generally intense enough to permanently destroy hair follicles, leaving small bald patches. Variations of folliculitis exist which are non-infectious like those caused by oils and greases applied to the skin that clog up hair follicles, but is usually due to a bacterial infection.

Anagen Effluvium – Cancer Treatment Hair Loss:
Anagen Effluvium is the sudden hair loss which occurs as a result of Chemotherapy or Radiation Treatment given for Cancer treatment. In Anagen Effluvium the hair does not enter a resting stage as is does with Telogen Effluvium. The hair loss is usually sudden occurring 1 to 3 weeks after exposure to the chemicals or radiation has occurred. Cancer treatments in the form of Chemotherapy and Radiation Treatments are the most common causes of Anagen Effluvium. However, exposure to toxic chemicals such as Thallium and Arsenic may also produce a sudden loss of hair. One of the side effects of this cancer chemotherapy is that it can also stop the growth of the hair and may cause the shedding of hair. In some cases up to 90% of the hair may be affected and often the remaining 10% may also go into the resting phase. Some hair follicles do not shed the hair but produce a narrower weaker hair which breaks off easily. Sometimes when the hair grows back the texture can be different. Some people who have had curly hair have claimed that their hair has grown back straight and sometimes even the color can become different. The important thing to remember is that this hair loss is not permanent and once treatment is stopped the hair follicles will recover and the hair will grow back.

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