Alopecia areata is a common hair loss issue faced by many individuals.
This is characterized by patches of hair loss in a particular area of the scalp or facial hairs. Of course, in rare cases, this disease can affect the entire body resulting in total hair loss (Alopecia Universalis).[1,2]
Alopesia/Alopecia is a hair loss issue in which the immune system of the body suppresses the hair follicles in a particular area of the body leading to patches of hair loss. Mostly this happens on the scalp, but it can also happen to hairs in any part of the body.
However, the suppression of the hair follicles is not permanent, and it can be reversed with alopecia treatments over a period in most cases. Even without the medication, the hair will re-grow after a couple of months.[3,4]
This hair disorder can occur to people of any age group…alopecia in children also seen in good numbers.
Different Types Of Alopecia
This disease has several variations. Here are the most common varieties of this hair loss illness:-
Alopecia Areata:- It is an autoimmune condition which causes patchy hair loss. It can be one small/large patch or several patches of hair loss. This is the most common alopecia type.
Alopecia Totalis :- This is characterized by the total disappearance of hairs on the scalp. The occurrence of alopecia totalis is rare, and the complete cure of it also is quite difficult.
Alopecia Universalis:- It is the most severe form of alopecia that results in complete loss of hair not only on the scalp but the entire body. Even the eyelashes and eyebrow hairs will fall off. This is rather difficult to achieve complete cure from this one.
Alopecia Barbae:- The type of alopecia mostly occurs in men, and it affects the beard area. It can either be a small patch of hair loss or extensive patches of facial hair loss.
Androgenetic Alopecia:- This is another common form of alopecia… it is the male/female pattern baldness. It is the gradual thinning of hair which finally make the scalp appear through the hair…finally leads to partial or complete baldness. This is mostly a genetically acquired hair loss disorder. In this case, the re-growth of hair is not easy…..almost impossible.[12,13]
Here is a Video on Cicatricial Alopecia:(Courtesy: The Cicatricial Alopecia Research Foundation (CARF) @YouTube)
Traction Alopecia:- This is not a disease…but this occurs due to poor hair care. Mostly it happens with excessive pulling and pressure exerted on the hair because of certain hair styles (particularly tight ponytail, pigtails, or braids) or habituated pulling of hair with hands.[16,17]
Anagen Effluvium:- This type of hair loss usually occurs due the side effects of certain medications (e.g. cancer treatment) or due to pollution, use of poor quality shampoo, oil, bathing bars, etc. This is easily curable by not using those things causing Anagen Effluvium.[18,19]
Telogen Effluvium:- It is the most common hair loss issue. It is actually the progressive hair loss that occurs as people grow older in age. This can also happen to young people as well. Thinning of the hair can be treated and stopped with proper hair care.[20,21]
Alopecia Areata Nails:- In some cases, the effects of alopecia disorder could also affect the nails on fingers and toes. The nails could develop tiny pinpoint dents, white spots, white lines, cracks or splits due to this disorder. This is curable and mostly disappears with alopecia treatments.[22,23]
The most common symptom of alopecia is hair loss in patches. It may begin with a coin-sized patch on the scalp, beard or any part of the body and eventually many bigger and larger patches of hair loss could occur.[24,25]
If you notice suddenly clumps of hair falling out from a particular area of the scalp or beard…it could most probably be an alopecia issue. Mostly it appears at the back or sides of the scalp first.
Of course, all patchy hair loss need not be alopecia as some fungal infections like ringworms can also cause such type of hair fall.
In some cases, the nails also develop white spots, dents, and cracks with the onset of this disease.
Alopecia Areata CausesAlopecia is an autoimmune disease….the immune system (especially the white blood cells) of the body mistakenly suppresses the functions of the hair follicles. The medical science has not been able to find the exact reason for such a health phenomenon.
‘The condition occurs when white blood cells attack the cells of hair follicles, causing them to shrink and dramatically slow down hair production.’
Medical studies only suggest that autoimmune disease like alopecia occur when the genetic makeup of the person in combination with other particular biological conditions of the individual hinders the normal functioning of the hair follicles.
Besides alopecia, the autoimmune issue can also give rise to other diseases like allergies, asthma, hay fever, pernicious anemia, vitiligo, lupus, etc. It is not necessary all these diseases will occur in a person with the autoimmune condition.[30,31,32]
The autoimmune condition in the body creates a particular situation in which the cytokines (chemical messenger) released by lymphocytes around the hair follicles rejects the hair growth for some reasons. This mostly happens to a cluster of hair follicles in the particular area of the body….a reason for the hair loss in patches.
The autoimmune issues usually have a genetic conception. The children born to a parent with an autoimmune health condition is more likely to have the same problem as well.
Normally the autoimmune situation may not result in alopecia….but sometimes a stressful event in life can stimulate the occurrence of this hair loss disease.
This hair disorder can happen to people at any age in both men, and women.
Alopecia Areata Treatment
There is no fast cure for alopecia areata. Normally the lost hair will gradually begin to re-grow within few weeks…that is to say in six months or before the hair could usually grow in the affected areas.
Unfortunately, there is not yet any reliable alopecia areata treatment till now and also for other forms of autoimmune hair loss. Some of the currently available medicines work well in some cases but not for all the patients.
There are also no preventive medicines to resist the reoccurrence of this hair loss disease. So even while treatment is going on for alopecia in one area, a new patch of hair loss could occur in some other area.
The hairs in the alopecia affected areas will begin to re-grow when the cytokines (chemical signals) send by the hair follicles are rightly received by the immune system for the hair re-growth to be restored.
Mostly the immune system overcomes or rectifies the ‘autoimmune disorder’ by itself and then the hair will begin to grow again naturally.
Even with the treatments, it is not necessary that immune disorders will be rectified immediately….it may take months to get back to normalcy.
There are a couple of popular treatments available for promoting fast hair growth in the affected areas.
Minoxidil:- It is a very popular medicine usually used for alopecia treatment and also for other hair loss issues. This ointment needs to be applied to the affected areas twice a day till the satisfactory results are achieved.
Corticosteroids:- This is a palliative medicine that works on an autoimmune system that causes this hair loss disease. It is usually injected into the area of the skin where alopecia is active. After a few shots of corticosteroids injections in 3 to 6 weeks time, the hairs usually begins to grow faster.[37,38]
This medicine is also available in ointment form for external application. This medicine in pills form is not encouraged as for the possible side effects associated with it.
Anthralin:- This is mostly used as a remedy for the autoimmune system that causes alopecia. It is a tar-like substance usually applied to the affected area, and it should be washed off after 30 minutes to one hour.[38,39]
Diphencyprone:- This is immunotherapy…an ointment solution that is applied to the alopecia affected areas of the skin. This is the most successful immunotherapy treatment till date.
It is effective for alopecia cure…but it is mostly used to cause mild skin allergies and irritation in the affected areas.
The allergic reaction induced by the Diphencyprone tricks the immune system to rush the supply of white blood cells to fight the allergen. This eventually activates and stimulates the hair follicles and helps in the re-growth of hair.[41,42]
It is important to note that the occurrence of alopecia can be recurring. Most patients experience that recurring occurrence of this disease a couple of times before it could be cured with medication.
There also natural hair loss remedies that may restrict the severity of alopecia.
In the case of Alopecia Universalis and Alopecia Totalis, the hair may never re-grow again to its original status as before the hair loss. Even the hair that re-grows will not have the dark color or gray hair and will be thinner as well.
The duration of the re-growth of hair varies from people to people. Some patients quickly recover from the disease and get back the normal hairs in a few weeks or months. Some may have to wait several months to see the hairs growing again in spite of the best treatments they could be undergoing.
Managing Alopecia And Living With It
Emotionally it is difficult for the patient to accept the hair loss…especially alopecia that makes a person look ugly with round patches on the scalp.
The first step of the patient is to accept the reality and realize that it is the only problem that can be overcome soon.
Another option is to shave off the hair completely and wear a cap or scarf on your head…. Shaven heads looks better than one with patches of hair loss.
Some conveniently make use of the occasion to get them painted with their favorite tattoos…of course to disguise the patchy hair loss.
You can also get hairpieces made from natural human hair fixed onto nylon netting. You can fix it like a wig, and it has a natural look as well.
If you are emotionally stressed, it will worsen the alopecia disease and, even more patches of hair loss would appear soon. The patient must engage in de-stressing activities and seek the help of a counselor to cope with the issue psychologically.
If you have lost the eyebrows; painting them with the assistance of a tattooing artist is good.
Finally, alopecia is not life-threatening disease…mostly it will last only for a few months as new hairs will grow soon in the place of the lost ones.