Alopecia areata is a form of non-scarring hair loss. In this condition, the hair follicles are present and visible, but they are empty as the hair is lost.Alopecia areata is thought to be an autoimmune condition, in which the body attacks healthy body tissue (in this case a protein in the hair follicles), disrupting the hair’s natural life cycle. (90 to 95% of hair on the scalp is growing, or in the anagen phase, while the rest of the hair is preparing to shed, called the catagen phase and eventually falls out in the telogen phase). Initial hair loss typically appears as coin-sized, round, well-defined patches on the scalp or face in men.If the condition worsens, it can affect other parts of the body and result in universal hair loss. Alopecia areata is a relatively common condition in North America, affecting approximately 1 or 2 persons in 1000.In general, hair loss should not be treated as a purely medical problem. It can negatively affect a person’s self-esteem, and be a cause of social anxiety. Fortunately, advancements in topical and oral medications have helped individuals reduce hair loss, and in some cases, have helped regrow hair.
Common features of alopecia areata include:
Sudden thinning and loss of hair usually in round, well defined patches
Some individuals have reported a tingling or stinging sensation in areas of hair loss
Hair loss may be very extensive, but most have only small areas of hair loss
Alopecia is considered to be an autoimmune disease: the immune cells attack a protein in the bulb region of the hair follicle, causing the hair to fall out while leaving the hair follicle itself intact. Since there is no permanent damage to the hair follicle, hair may regrow over time.
Use gentle shampoos and conditioners to cleanse the hair. After washing your hair, let it naturally air dry. Hot air dryers can often damage hair and cause it to break.Activities such as over-brushing or over-styling the hair can often lead to more hair loss. Use a large-toothed comb to minimize the risk of breaking or pulling out hair. Avoid hairstyles that pull on the hair such as ponytails.Cut back on hair styling products that contain alcohol, which may irritate the scalp.
The best strategy is to consult a dermatologist when you first notice any signs of excessive shedding to make certain that an underlying medical condition is not the actual cause. Only a qualified physician can dispense proper advice and medical treatment to minimize or reverse hair loss.
A doctor may prescribe topical or intralesional corticosteroids, anthralin, and topical minoxidil, which can be used to treat localized patches of alopecia areata. Corticosteroid injections are usually given every 4 to 6 weeks. This treatment comes with the risk of thinning skin, but this side effect often resolves over time. This side effect is uncommon. With this treatment, most patients will see hair growth after 6 months.Treating extensive alopecia areata will often involve the use of topical immunotherapies, and psoralen. Immunotherapy using squaric acid or DPCP works on the basis of producing an inflammatory response that diverts the attacking lymphocytes away from the hair follicle, allowing regrowth.The use of systemic steroids is discouraged as there is always rebound hair loss.
Procedures such as psoralen plus ultraviolet A light therapy (PUVA) has been used in the past for severe cases of alopecia areata.