Alopecia: Information on Causes, Diagnosis & Treatments

Alopecia Areata Overview

Hair Loss Alopecia Areata is a disease affecting hair follicles, especially on the scalp where the body’s immune system misguidedly attacks hair follicles to stop the growth of hair. This condition occurs most commonly in individuals who are thirty years and younger, however, men and women of any age can be affected equally. The disease usually occurs suddenly within days.

Typical cases involve asymmetric pattern baldness on the patient’s scalp along with eyebrows and facial bearded areas. Usually, hair loss is minimal in mild cases. In severe cases, complete baldness (alopecia totalis) can occur on the scalp and in extreme cases, complete hair loss occurs over the entire body (alopecia universalis).

The disease is classified as an autoimmune problem because the body believes it is being harmed by foreign invaders. The result of the attack causes inflammation to hair follicles, which leads to the hair falling out.

The condition is not contagious nor does it make anyone sick. However, it is often emotionally challenging to the point where patients will receive counseling or participate in support groups to manage psychological reactions to the disease’s many symptoms.

What Causes Alopecia?

Alopecia areata is the result of white blood cells attacking hair follicle cells which make them shrink and diminish the production of hair. The exact cause has yet been determined. However, scientists believe that the immune system mistakenly targets hair follicles thinking and it is being invaded by foreign objects.

While scientists do not yet know why the changes happen, genetics appears to be connected to the problem. This is because alopecia areata tends to happen in individuals who are genetically predisposed to the condition because another family member suffered from the disease. Research studies have shown that one out of every five cases of alopecia areata involves patients who had family members that at some point and develop the condition before.

Having a family history (genetic predisposition) of other known autoimmune disorders might also play a role in the development of alopecia areata. Test results show that individuals who are hyper allergic (atopy) or suffered vitiligo or thyroiditis should be at higher risk for developing alopecia areata.

For decades, doctors and patients believed that stress caused the condition. Even though extremely stressful life events made play a part in triggering alopecia areata, research studies indicate that it is more likely caused by genetics.

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Common Symptoms

Early detection of the disease usually comes from the patient who notices patchy hair loss on the scalp or other areas of the body. In many cases, patches the size of large coins begin falling out of the scalp or other body areas. The condition can also affect the growth of hair on eyelashes and beards.

Typically, alopecia areata will develop suddenly within a few days or weeks. Some individuals experience a burning or itching sensation in the area where they hair will eventually fall out in the days ahead. Alopecia is not a permanent condition, meaning the hair follicles can be restored after the inflammation of hair follicles diminishes. Nearly all patients experiencing the condition will have a full, spontaneous recovery without the need of treatment.

However, approximately one out of every three individuals suffering from alopecia areata experience intense and extensive symptoms associated with the cycles of hair loss. Nearly one out of every two patients recovered completely from the condition within the first year after experiencing at least one episode. One out of every ten individuals will suffer extreme cases of alopecia totalis (hair loss on the entire scalp) or alopecia universalis (total hair loss all over the body).

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Diagnosing Alopecia

Usually, a diagnosis of alopecia areata can be confirmed in a doctor’s office after examining common symptoms associated with the condition. The dermatologist might measure the degree of lost hair on the scalp or other areas, examine affected follicles, and evaluate the condition of the hair at the affected site by looking at it under a microscope. If the results are inconclusive, the doctor will look for other noticeable changes that often occur concomitantly with alopecia areata. These include:

  • Fingernails and toenails that have become rough and lost their shine

  • Pinpoint dents that appear in fingernails and toenails

  • Thinning nails that split

  • White lines and spots that appear on nail beds

  • Cadaver hairs that break off before appearing on the surface of the skin

  • Tiny white hair regrowth at the affected hair loss area

  • Characteristic hair growth where shorter hairs are narrow at the base than at the ends.

Even if these noticeable symptoms are not identified during a clinical examination, the doctor may recommend performing a skin biopsy to rule out known autoimmune diseases. A blood test can also confirm that conditions other than alopecia areata are occurring. However, many of the signs and symptoms of alopecia areata are very distinctive and unique, which makes a confirming a diagnosis of the disease straightforward and quick.

The doctor may recommend blood tests to rule out other diseases and conditions with similar symptoms. These tests could include:

  • Antibody test

  • C-reactive protein test

  • Thyroid hormone evaluation tests

  • Follicles stimulation test

  • Luteinizing hormone tests

  • Total and free testosterone tests

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Treating the Condition

Medical science has yet to find a cure for alopecia areata. However, there are many treatments that are available to help lost hair regrow quickly. Doctors can prescribe anti-inflammatory medications including corticosteroids that are known to suppress the body’s immune system to stop attacking hair follicles mistakenly. Usually, these drugs are administered through an injection, taken orally, or applied using a topical ointment.

Doctors can also prescribe other drugs that promote health growth or manage the immune system. Some of these include minoxidil, anthralin, DPCP (diphenylcyclopropenone), and topical immunomodulators therapy SADBE (squaric acid dibutyl ester) drugs. In some cases, photochemotherapy treatments have been proven to be highly effective where a radiation treatment is used concomitantly with oral drugs and ultraviolet light.

Some individuals with alopecia areata have seen great success with alternative therapies to treat the body and mind even though no clinical trials have been performed to determine their efficacy. Some of these include:

  • Herbal supplements

  • Aromatherapy

  • Acupuncture

  • Vitamins

How the hair grows back varies between individuals. Some patients forgo treatment and allow the hair to grow back naturally without assistance. Others have never seen any significant improvement in their condition despite attempting to find a successful recovery using all treatment options. The most successful outcome of hair regrowth when experiencing typical alopecia areata symptoms usually requires more than just a single treatment to detect any difference.

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Coping with Alopecia Areata

Coping with this condition can be emotionally challenging, especially in individuals who have lost hair all over the entire scalp. A typical response to the condition is to feel depressed and isolated or overwhelmed when coping with the many symptoms associated with the disease.

Some individuals have found emotional relief and diminish levels of anxiety and stress by participating in sports groups across the United States. These groups allow a place to openly discuss the emotions associated with losing hair on part or all the scalp by others who also suffer from the condition.

Sources:

https://www.niams.nih.gov/health_info/Alopecia_Areata/

http://www.mayoclinic.org/diseases-conditions/hair-loss/multimedia/patchy-hair-loss-alopecia-areata/img-20006441

https://my.clevelandclinic.org/health/articles/hair-implants

https://www.niams.nih.gov/Health_Info/alopecia_areata/default.asp

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