Alopecia Areata- Information, Treatment & Prevention

By: Juliet Cohen

Alopecia areata is the name for a condition in which round patches of hair loss seem suddenly. Because it causes bald spots on the scalp, especially in the first stages, it is sometimes called spot baldness. Alopecia areata is not contagious. It occurs more frequently in people who have affected family members, suggesting that heredity may be a factor. The condition is thought to be an autoimmune disorder in which the body attacks its own hair follicles and suppresses or stops hair growth. There is evidence that T cell lymphocytes cluster around these follicles, causing inflammation and subsequent hair loss. Alopecia areata affects both males and females. This type of hair loss is different than male-pattern baldness, an inherited condition. The exact role of stressful events remains unclear, but they most likely trigger a condition already present in susceptible individuals, rather than acting as the true primary cause.

Alopecia areata is more likely to become in people who have relatives with autoimmune disorders. An unknown ecology trigger such as emotional stress or a pathogen is thought to combine with hereditary factors to cause the condition. Alopecia areata occurs in people who are apparently healthy and have no skin disorder. Certain chemicals that are a part of the immune system called cytokines may play a role in alopecia areata by inhibiting hair follicle growth. As with most autoimmune diseases, alopecia areata is associated with increased risk of developing other autoimmune diseases, specifically systemic lupus erythematosus. Initial presentation most commonly occurs in the late teenage years, early childhood, or young adulthood, but can happen with people of all ages.

Alopecia can certainly be the cause of psychological stress. Alopecia areata does not result in physical disability, but it can be emotionally very distressing. In most cases that begin with a small number of patches of hair loss, hair grows back after a few months to a year. Effects of alopecia areata are mainly psychological. However, patients also tend to have a slightly higher incidence of asthma, allergies, atopic dermal ailments, and even hypothyroidism. Loss of hair also means that the scalp burns more easily in the sun. Patients may also have aberrant nail formation because keratin forms both hair and nails. Because hair loss can lead to significant appearance changes, individuals may experience social phobia, anxiety, and depression.

There is currently little provision for psychological treatment for people afflicted with alopecia. Wearing a head covering does not interfere with hair regrowth. This may be a good choice for people with extensive scalp hair loss who do not have enough hair to cover it. In cases where there is severe hair loss, there has been limited success treating alopecia areata with clobetasol or fluocinonide, steroid cream. Steroid injections are commonly used in sites where there are small areas of hair loss on the head or especially where eyebrow hair has been lost. Oral corticosteroids decrease the hair loss, but only for the period during which they are taken, and these drugs have adverse side effects. Some other medications used are minoxidil, irritants, and topical immunotherapy cyclosporine, each of which are sometimes used in different combinations.

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