A female with alopecia areata. Image credit: Flickr
A female with alopecia areata. Image credit: Flickr

Alopecia areata is a type of hair loss wherein the hair falls out in patches, usually on the scalp. The patches are usually few and far between. The hair loss could be sudden and a bald patch may appear within a few days. Body hair could also be lost due to alopecia areata. The condition doesn’t thin out hair but creates bald spots in the affected areas, and is therefore also called spot baldness. In some rare cases, the condition may spread to the entire scalp or whole body. However, the majority of people don’t lose hair completely.

Alopecia areata isn’t contagious, or cannot be spread to other people. Moreover, there’s no physical pain or suffering involved. The only major negative effect is the emotional trauma. The sun and other elements can have a negative effect on exposed scalp and skin. Besides hair, alopecia areata may even hurt nails.

Vulnerable People

Alopecia areata has no age or gender bias. It could strike an individual during early childhood or adulthood, or late teens. Kids who develop alopecia areata prior to puberty are quite likely to suffer from more persistent and extensive hair loss.

People with alopecia areata are healthy with no particular skin issues. The problem isn’t contagious, but is hereditary. Often, the hair fall starts right from childhood. People who have a family member or close relative suffering from the condition are likely to be affected the most. Moreover, a family with alopecia areata history is also likely to have a family or personal past of other autoimmune diseases.

Causes

Alopecia areata is an autoimmune health condition wherein the immune system inadvertently attacks the good body parts, misinterpreting them as undesirable, foreign objects, like viruses or bacteria. The good body part, within this context, is hair. It’s not clear as to why the immune system resorts to such an attack.

At times, alopecia areata is linked to other autoimmune disorders such as vitiligo, thyroid disease, rheumatoid arthritis, ulcerative colitis and lupus. However, curing or diagnosing these conditions is not likely to cure or lend positivity to alopecia areata treatment.

Extreme stress could help trigger an existing condition, but there’s little to no scientific evidence proving the stress-alopecia areata connection. Similarly, hormones, viruses, allergies, and also toxins are suspected to contribute. Vitamin deficiency or diet is not related to the problem.

Symptoms

Generally, soft and small bald patches are early indicators. These patches could be in different shapes, but are typically oval or round. Scalp and facial hair are likely to be affected most – including eyebrows, eyelashes, nasal hair, etc. The affected areas may feel marginally itchy or tingling during early alopecia areata development stages.

There’s inflammation involved but since it’s deeply entrenched into the skin, the skin surface experiences no pain and there’s no redness too.

Recovery

Chances of hair growing back cannot be ruled out, but it’s hard to determine when. In some cases, the lost hair just won’t grow back, or resurfaced hair may fall out again. The pattern of hair growth and hair fall may vary across individuals.

Diagnosis

Generally, a diagnosis is not needed for alopecia areata as it’s obvious. However, specific tests can be performed to confirm the condition’s presence. For instance, a scalp biopsy is carried out.

Treatment

Currently, there isn’t any proven cure (drugs, topical medication, etc.) for alopecia areata. Topical medicines such as corticosteroids may activate hair follicles and promote hair growth, but they can’t prevent fresh bald patches from surfacing in the future. Moreover, corticosteroid works only if the alopecia areata is mild.

Corticosteroid injections could work for some people; however, side effects such as thinning of skin at injection site is likely. Also, systemic corticosteroids in pill forms could be used. However, continuous usage can cause major issues such as bone thinning (osteoporosis). Unfortunately, all of these treatments work only for a few people. People with long-term, extensive alopecia areata may not be benefited.

At times, doctors could use drugs or medications primarily derived for other diseases, which may have a positive secondary effect on hair growth. These include steroid tablets, contact sensitization treatment, ultraviolet light treatment, and dithranol cream. For instance, dithranol cream is primarily used to treat psoriasis. However, it causes skin irritation and this at times could end up stimulating hair regrowth when applied to bald sites. However, such treatments still don’t prevent hair loss or attack the problem at the roots.

There are rare instances when people only develop a few bald patches and later recover completely without any treatment. Such occurrences are few and far between and cannot be predicted.

Taking Care

As aforementioned, treating the disease from its roots is extremely difficult. However, there are certain measures that could be taken to reduce specific discomforts or physical dangers relating to the condition. Those include:

  • Using sunscreens for the face, scalp, and other exposed skin.
  • Wearing sunglasses (due to the lack of eyelashes and eyebrows) to protect the eyes from debris and dust, and sun.  
  • Wearing scarves, caps, or wigs for protecting the scalp from sun exposure.
  • Applying antibiotic ointment within the nostrils – thanks to missing nostril hair – to help keep germs at bay.

Besides sporting headgear, using eyebrow pencils for masking missing eyebrows, and using hair-colored cream, powder, crayon, etc. to camouflage the bald patches also add positively to physical appearance.