Alopecia areata, commonly known as alopecia, is an autoimmune disease that results in hair loss. Alopecia is caused when the body’s immune system attacks the cells in hair follicles, because it mistakenly perceives them as invaders. In most cases, hair falls out in only a few small, round patches but, in some cases, alopecia causes a total loss of hair on the scalp (alopecia areata totalis) or a complete loss of hair everywhere on the body (alopecia areata universalis).
Causes of Alopecia Areata
The precise causes of alopecia remain unknown. What is known is that the body’s white blood cells attack the growing cells in hair follicles. The new cells in the follicles, however, retain their potential to grow hair. It is suspected that a combination of genetic factors reacts to an environmental trigger, perhaps a virus, to bring on alopecia.
Risk Factors for Alopecia Areata
Almost two percent of the population, regardless of gender or ethnic background, is affected by alopecia, which often has its onset during childhood. Anyone with a family member suffering from alopecia has a slightly increased risk of its developing. Twenty percent of people who develop alopecia have family members with the disease. If a family member has had hair loss before the age of 30, the risk is greater.
Another risk factor for alopecia is having a family member with another type of autoimmune disorder, such as rheumatoid arthritis. But, although there is a genetic element, the vast majority of parents with alopecia do not pass it on to their children. Even in identical twins, there is only a 55 percent chance that, if one twin develops alopecia, the other twin will, too.
Symptoms of Alopecia Areata
Apart from hair loss, alopecia has no effect on physical health. With alopecia areata universalis, however, the loss of eyelashes, eyebrows, and hair in the nose and ears increases susceptibility to dust, pathogens and other airborne particles. For the majority of patients, however, the emotional toll it takes is the worst part of alopecia, which can have a negative effect on self-image and self-esteem.
For most patients, the condition is temporary. In some cases, however, patients have a greater risk of permanent hair loss. That risk increases when the following occurs:
- Alopecia develops at a young age
- Hair loss is extensive and has lasted more than a year
- Patient has serious allergies
- Patient has an autoimmune disorder
- Patient has abnormal nails
Alopecia is an extremely unpredictable disease. Some people lose small patches of hair for a short time; others lose and regrow hair in spurts over a course of years. In some patients, regrown hair comes in white, and then regains its original color.
Diagnosis of Alopecia Areata
For the most part, the visible symptoms of alopecia provide for its diagnosis, although various tests may be performed to rule out other reasons for hair loss. Those tests include microscopic examination of hair or a scraping of scalp tissue, and blood tests to rule out thyroid abnormalities.
Treatment of Alopecia Areata
Although there is no cure for alopecia, many patients are helped by various treatments.
For Hair Growth
- Corticosteroid injections, pills or topical creams
- Topical sensitizers
- Hair-growth preparations (such as Rogaine)
- Anthralin (medication used for psoriasis)
- Psoralen with ultraviolet light therapy (PUVA)
Many patients also try alternative treatments, including acupuncture, aromatherapy, and nutritional supplements, to promote hair growth.
For Emotional Support
Psychotherapy and support groups can help patients with alopecia to feel confident, in control, and socially comfortable. Many patients are helped by wearing caps, wigs or scarves.
For Sun Protection and Warmth
Areas without hair are more susceptible to ultraviolet rays, so sunscreen should be applied every day to those areas. Sunglasses should be worn, not only to protect the eyes from the sun, but from airborne particles. Moisturizing ointments should be applied to the inside of the nose to help protect the body from pathogens when protective hair is missing.
Although atypical hair loss can be traumatic, with appropriate treatment, patients with alopecia areata can cope well with its effects.