Alopecea Areata

“Alopecia” is a general term doctors use when they talk about hair loss. “Alopecia areata” means patchy hair loss.

Symptom Overview

Most people develop patches of hair loss over a few weeks. The patches are usually round or oval and about the size of a coin. The scalp without hair is smooth and looks completely normal. It is neither red nor inflamed.

Some people report tingling or very mild irritation in the affected area. Around the edges of the hairless patches, you may find short hairs (about three millimeters long). These are called exclamation mark hairs.

Alopecia areata can also cause hair loss in the eyebrows, eyelashes, beard, armpits, and around the genital area. Some people also develop pitting in their nails.

Causes

The cause of the hair loss is uncertain, but much evidence suggests that it may be caused by an autoimmune disease. This means that the cells in the body that normally fight infections (white blood cells) attack some of your own cells. In alopecia areata, the white blood cells gather around the hair follicles and cause inflammation, which makes the hair stop growing and fall out.

Fortunately, the hair follicles are not permanently damaged, so the hair can grow back. Some people lose all the hair on their head (alopecia totalis) or all the hair on their body (alopecia universalis). Alopecia areata affects about 2 out of 100 people, and it can occur at any age. It is common to have more than one episode of hair loss, and many experience it for the first time as a child or young adult.

Risk Factors

About 2 out of 10 people with alopecia areata have a family member with the same condition. You are also more likely to get it if you or someone in your family has another type of autoimmune disease, such as type 1 diabetes, thyroid diseases, or vitiligo (white patches on the skin).

Treatment

The treatment often depends on the severity, and many people regain their hair without treatment.

Hair transplantation and PRP treatments have documented effects on this type of condition. We can determine if you fall into the category that may benefit from these treatments.

Mild to Moderate Hair Loss

If you have only a couple of small patches of hair loss, there is a good chance that the hair will regrow on its own. Many with mild hair loss therefore choose not to undergo treatment.

If you have more than a couple of patches of hair loss, cortisone injections or topical treatments may be effective. Cortisone injections are the best treatment for areas with patchy hair loss, and regrowth usually begins within one to six months.

Cortisone reduces inflammation and can be injected directly into the area of hair loss. You will likely be referred to a specialist for this treatment. Depending on the size of the area being treated, you may need multiple injections. Before the treatment, the skin can be numbed with an anesthetic cream.

Many people need more than one treatment. Treatments are given with a minimum of six weeks between each session. Injections can sometimes cause the skin to thin, but this is usually temporary. Acne and redness at the injection site can be possible side effects.

Cortisone preparations also come as gels, liniments, and creams that you apply directly to the areas of hair loss. This is called topical cortisone treatment and can be used in the treatment of children. The type you use will depend on where the hair loss is. Liniments and gels are often easier to apply to the scalp.

Unfortunately, cortisone injections do not work for everyone, and they are rarely used for children.

If hair loss occurs very quickly, the doctor may prescribe cortisone tablets. The treatment can help stop or slow hair loss, but often the improvements are temporary. This is because cortisone tablets are used only for short periods due to side effects. Examples of side effects can be high blood pressure, increased appetite, stomach irritation (gastritis), changes in mood and sleep patterns, and increased blood sugar in people with diabetes.

Minoxidil is a treatment that many men use for age-related hair loss. Some also use it for alopecia areata, but it is uncertain whether it helps. Some skin irritation may occur. Minoxidil can be combined with topical steroids and is available over the counter at the pharmacy.

Extensive Hair Loss

If the hair loss is extensive, there is less chance that cortisone injections and topical treatments will work. But there are other treatments you can try.

Topical immunotherapy (also called contact allergy treatment) involves making you allergic to a substance and then regularly applying a weak solution of this to keep the skin mildly irritated (inflamed). This stimulates hair growth for up to 6 out of 10 people, but researchers do not know exactly why. This treatment can have side effects, including blisters, itching, and swollen glands in the neck. If you have dark skin, the skin can become lighter in the affected areas.

Self-Help and Advice

Many find it difficult to cope with hair loss, especially children and young people. You can talk to your doctor about this. The doctor can provide support and possibly refer you to a psychologist. Meeting other people with alopecia areata can be very helpful for some.

People often use wigs, hats, and other head coverings to hide hair loss. Many men (and some women) choose to shave their heads until the hair starts to grow back. However, if the scalp is shaved, you must use sunscreen to avoid sun damage. Makeup and temporary tattoos can hide the loss of eyebrows.

Will the hair grow back?

If the hair loss is mild, there is a good chance that the hair will grow back. The hair may be thin or white when it first grows back before returning to its normal thickness and color. If the hair loss is more extensive, you can still achieve full regrowth, but this is less likely. Most people with alopecia areata have more than one episode of hair loss in their lifetime.

Up to 1 in 10 people develop chronic alopecia areata. But no matter how long-lasting your hair loss is, there is still a chance that the hair will grow back.

(Source: www.helsenorge.no)