Author: Dr. Jangid | Date Published: March 10, 2023
Alopecia areata is an autoimmune disorder causing unpredictable hair loss, often manifesting in small, quarter-sized patches. While these patches are typically discreet, some individuals may experience more severe cases, leading to complete hair loss on the scalp or even across the entire body. This condition tends to affect individuals before the age of 30.
What Are The Causes Of Alopecia Areata?
Alopecia areata can manifest in various forms, each characterized by distinct hair loss patterns in different body areas. The various types of alopecia areata include:
Alopecia Areata (Patchy Alopecia):
This is the most prevalent form, marked by the sudden onset of one or more round or oval patches of hair loss on the scalp, beard, eyebrows, or other hairy regions of the body. The affected skin typically appears smooth, and short, broken hairs may be visible.
Alopecia Totalis:
This form involves extensive hair loss on the scalp, leading to complete baldness. It may also affect eyebrows, eyelashes, and facial hair, with the skin remaining smooth without scarring.
Alopecia Universalis:
This severe variant results in the complete loss of hair on the scalp and body, including eyebrows, eyelashes, and all body hair. Similar to other forms of alopecia areata, the affected skin remains smooth.
Alopecia Barbae:
Specifically affecting the beard area in men, this variant results in patchy hair loss in the facial hair region. It can occur in isolated patches or spread to encompass a larger area of the beard.
Alopecia Ophiasis:
Characterized by hair loss along the sides and lower back of the scalp in a wave-like pattern, which resembles a band. Ophiasis is a less common but more severe form of alopecia areata.
Diffuse Alopecia Areata:
Unlike the patchy presentation, diffuse alopecia areata involves more widespread thinning of the hair without well-defined patches. This form may pose a diagnostic challenge as it can resemble other types of hair loss.
It's essential to recognize that the progression and severity of alopecia areata can vary among individuals. Some may experience a single episode of hair loss, while others may have recurrent episodes or progress to more extensive forms of the condition. It is advisable to seek consultation with a healthcare professional for a proper diagnosis and appropriate management.
Also, Read This: Tractional Alopecia Its Causes, Symptoms And Treatments
Symptoms & Causes Of Alopecia Areata
What Are The Causes Of Alopecia Areata?
Alopecia areata is an autoimmune disorder triggered by the immune system, when it mistakenly attacks the hair follicles, it results in hair loss. While the precise cause of this condition remains elusive, several factors may contribute to its development:
Genetic Predisposition:
Alopecia areata often exhibit a strong genetic component. Individuals with a family history of autoimmune diseases or alopecia areata may have an increased susceptibility to the condition.
Autoimmune Response:
The immune system, which typically defends the body against external threats, inexplicably targets hair follicles in alopecia areata. This particular activity disrupts the normal hair growth cycle.
Environmental Factors:
Certain environmental triggers could potentially initiate or worsen alopecia areata in individuals genetically predisposed to the condition. These triggers may include viral or bacterial infections, exposure to specific chemicals, or high levels of stress. It's important to note that these factors might act as triggers, but they do not directly cause alopecia areata.
Immunological Factors:
Individuals with alopecia areata often exhibit changes in their immune system, involving shifts in the balance of immune cells and the production of inflammatory molecules. These alterations contribute to the immune system's attack on hair follicles.
Other Autoimmune Diseases:
There is an increased likelihood of individuals with alopecia areata developing other autoimmune conditions, such as thyroid disorders, rheumatoid arthritis, or vitiligo.
What Are The Common Symptoms?
Hair Loss In Patches:
The most noticeable symptom is the development of round or oval patches of hair loss on the scalp, beard, eyebrows, or other areas of the body. These patches are usually smooth and may be of various sizes.
Rapid Onset:
Hair loss in alopecia areata often occurs suddenly and may progress rapidly. Individuals may notice the appearance of bald patches over a relatively short period.
Regrowth Of White Or Fine Hair:
In some cases, affected areas may show signs of regrowth, but the new hair is often fine and white or gray. This regrowth may be more noticeable on the edges of the bald patches.
Nail Changes:
In some individuals with alopecia areata, there may be changes to the nails, such as dented nails, ridges, or white spots on the nails.
Itching On Affected Area:
Some people with alopecia areata may experience mild tingling or itching in the affected areas before hair loss becomes apparent.
Progression To Total Hair Loss:
In more severe cases, alopecia areata can progress to total hair loss on the scalp (alopecia totalis) or complete loss of body hair (alopecia universalis).
Recurrent Episodes:
Alopecia areata can be a recurring condition, with periods of hair loss followed by periods of regrowth. The pattern of hair loss and regrowth can vary with each recurrence.
How Does Alopecia Areata Get Diagnosed?
Physical Examination
A thorough examination of the affected areas is crucial. The characteristic pattern of hair loss in small, round patches is a key indicator. The specialist may also check for other signs, such as changes in the nails, which can sometimes accompany alopecia areata.
Pull Test
A gentle pull test may be performed, where the dermatologist lightly tugs on a few hairs in the affected area to assess if they come out easily. This helps in evaluating the stage of hair loss.
Trichoscopy
Trichoscopy is a non-invasive technique where a dermatoscope (a handheld device with magnification and light) is used to examine the scalp and hair follicles. It can provide detailed images of the affected areas and aid in diagnosis.
Biopsy
In some cases, a skin biopsy may be recommended. A small sample of the affected skin is examined under a microscope. This can help rule out other potential causes of hair loss and confirm the presence of characteristic immune cells around the hair follicles.
Blood Tests
Blood tests may be conducted to check for underlying conditions or imbalances that could contribute to hair loss. Common tests include a complete blood count (CBC), tests for thyroid function, and tests for autoimmune markers. It is important to note that the diagnosis of alopecia areata is primarily clinical, based on the characteristic appearance of hair loss and the absence of scarring alopecia. The additional tests are often used to rule out other potential causes and to gather more information about the individual's overall health.
Visit A Specialist If You Are In Doubt
The healthcare provider will ask about your medical history, including any family history of autoimmune diseases or alopecia areata. They may inquire about recent illnesses, stressors, or significant life events that could be associated with the onset of hair loss.
What Are The Treatment Options For Alopecia Areata?
Corticosteroids:
These are anti-inflammatory medications applied directly to the affected areas. They can help suppress the immune response and reduce inflammation.
Intralesional Corticosteroid Injections:
Corticosteroids are injected directly into the affected skin areas. This is often used for localized and stubborn cases.
Topical Immunotherapy:
Medications like anthralin or topical immunotherapy using chemicals like diphencyprone (DPCP) can be applied to the scalp to induce an allergic reaction. This reaction may stimulate the immune system and promote hair regrowth.
Systemic Corticosteroids:
In severe cases, oral corticosteroids may be prescribed to suppress the immune response. However, long-term use carries potential side effects, and this treatment approach is often reserved for specific situations.
Minoxidil:
This over-the-counter medication is commonly used for pattern baldness, but it may also promote hair regrowth in some cases of alopecia areata.
Light Therapy (Photochemotherapy):
This involves exposing the affected skin to ultraviolet A (UVA) or UVB light after the application of a light-sensitizing medication.
Platelet-Rich Plasma (PRP) Therapy:
This involves injecting the patient's concentrated platelets into the scalp to stimulate hair follicles.
It's important to note that the effectiveness of treatments can vary from patient to patient. Response to treatment and regrowth may be temporary. Hence, staying in touch with your dermatologist and following his instructions is the key to successful treatment and management of Alopecia.