What is Alopecia Areata? Causes, symptoms, and treatments

person suffering with Alopecia Areata

An autoimmune condition called alopecia areata causes hair loss, and millions of people around the world are impacted by the skin condition.

Alopecia areata affects persons of all ages, genders, and races, though it frequently manifests in childhood. This article offers useful knowledge on Alopecia Areata.

What Is Alopecia Areata?

woman with Alopecia Areata

Alopecia areata is a chronic skin disorder that occurs when the immune system attacks your hair follicles. This chronic disease results in hair falling, mainly in the head and sometimes in the eyebrows, eyelashes, and other parts of the body.

The condition varies from person to person, and many factors can vary between different individuals. Some people have small patches of hair loss, others larger patches that are like a band of involvement around the head, others have a complete loss of scalp hair but maintain other areas, and some lose scalp as well as facial and body hair. Some cases go away on their own, others worsen slowly, and others can worsen quite suddenly. Some people will achieve regrowth on their own or with various treatments and in others, it can be difficult to achieve regrowth.

Alopecia areata has no cure. However, there are many treatments that can help your hair grow back. The good news is that hair follicles are not destroyed by the inflammation in alopecia areata, so it may be possible to regrow hair even in those with a large degree of hair loss or in those who have had a loss of hair for a long time.

Who Gets Alopecia Areata?

Alopecia areata can affect anyone. It affects all racial and ethnic groups equally and both men and women equally. Although it can start at any age, most people develop it in their twenties, thirties, or as teenagers. It tends to be more severe and progressive when it starts in children under the age of ten.

Types Of Alopecia Areata

The following are the main types of Alopecia Areata

Patchy Alopecia Areata

Patchy Alopecia Areata

Patchy alopecia areata is characterized by bald patches on the scalp and occasionally in other parts of the body. This is the most prevalent form of alopecia areata, and it frequently results in hair loss that resembles coins or larger ovals.

Alopecia Totalis

Alopecia Totalis on male

When compared to patchy forms of alopecia, alopecia totalis results in entire or nearly complete scalp hair loss. This may start out as patchy alopecia areata but then the patches may expand until they eventually join together and involve the entire scalp.

Alopecia Universalis

man suffering from Alopecia Universalis

Alopecia universalis, like alopecia totalis, can result in almost total or entire loss of scalp hair. Alopecia universalis differs from other forms of hair loss in that it also affects the hair on the face and the rest of the body completely or extensively.

Diffuse Alopecia Areata

Diffuse Alopecia Areata

A less common type of the condition, diffuse alopecia areata, causes abrupt and widespread scalp hair thinning. This can mimic other forms of hair loss such as the shedding form of hair loss called telogen effluvium.

Ophiasis Alopecia

Ophiasis Alopecia

In the ophiasis form of alopecia areata, the hair loss takes on a distinctive band-like pattern along the scalp’s occipital and temporal region, including the sides and lower back areas into the shape of a broad strip or wave.

Alopecia Areata Symptoms

It is important to know the warning signs of alopecia areata, so that you can get evaluated by a dermatologist as soon as possible. The most common signs are small patches that turn into completely bald spots. Nails can also show signs of alopecia areata.

Here are the most common signs:

  • Bald patches of skin
  • Patches with itching and burning sensation
  • Hair loss in a short period of time
  • Nail changes

Causes Of Alopecia Areata

Alopecia areata is caused by the immune system attacking hair follicles at the lower portion (bulb) of the hair follicle. This may be due to a loss of the immune privilege of the hair follicle. Why certain individuals develop this is not entirely understood.

There are known risk factors including a family history of the condition as there is known to be a genetic component. However, there are multiple genes associated rather than a single gene that causes alopecia areata, and alopecia areata is thought to be multifactorial with environmental and lifestyle factors also playing a role. Environmental and lifestyle factors can include things like stress among others.

Alopecia areata has been reported to occur more frequently in those with a history of asthma, allergies, vitiligo, pernicious anemia, thyroid disease, and Vitamin D deficiency.

Alopecia Areata Prognosis

About half of those with mild alopecia areata recover within a year. However, alopecia areata frequently becomes active again. In fact, the majority of those with alopecia areata will have many episodes throughout their lifespan.

Alopecia Areata Diagnosis

hair loss expert checking patient

Alopecia areata can typically be diagnosed based on physical examination with a dermatologist including dermoscopy. If the physical examination findings are unclear, then a biopsy may be required to confirm the diagnosis in some cases.

Alopecia Areata Home Remedies and Alternative Medicine

There are many home remedies suggested and recommended by various individuals for alopecia areata, but most have no evidence in the medical literature showing them to be effective. A recent systematic review on complementary and alternative medicine for alopecia areata showed treatments such as essential oil aromatherapy, topical garlic, and oral glucosides of peony with the compound glycyrrhizin to have some evidence showing them to be effective for alopecia although more studies are still needed. Always consult with your doctor regarding your hair loss prior to starting home remedies as hair loss.

Medical Treatment For Alopecia Areata

There is no cure for this chronic illness. However, there are a number of medications and treatments available that may help regrow the hair.

  • Corticosteroids: Anti-inflammatory drugs injected into and/or applied topically to the scalp or other areas that are affected.
  • Topical immunotherapy: Chemicals are applied to the scalp to trigger an allergic reaction to change the immune profile of the cells away from those that cause alopecia areata and help regrow hair.
  • Minoxidil: A treatment that is applied topically to the affected areas or taken by mouth.
  • JAK Kinase Inhibitors: This is a group of medications that can be taken by mouth or used topically to help regrow hair. This includes the FDA-approved treatment oral Olumiant (baricitinib).

Always consult with a doctor prior to starting any treatment for hair loss so that an appropriate diagnosis can be made and appropriate treatment options for your case can be discussed.

At Root Hair Institute, our team of experts works together to provide the best hair loss solutions for patients with all forms of hair loss including alopecia areata. Our mission is to provide transparent and inclusive care with the proper support and education.

Book a consultation with Root Hair Institute, and let’s talk about your hair condition so we can make the proper diagnosis. Together with our team, we’ll work on a tailored treatment plan just for you.

REFERENCES:

  1. Miteva, M., Villasante, A. Epidemiology and burden of alopecia areata: a systematic review. Clinical, Cosmetic, and Investigational Dermatology. 2015;8:397-403.
  2. Rajabi, F., Drake, L.A., Senna, M.M., et al. Alopecia areata: a review of disease pathogenesis. British Journal of Dermatology. 2018;179(5):1033-1048.
  3. Darwin, E., Hirt, P., Fertig, R., et al. Alopecia areata: Review of epidemiology, clinical features, pathogenesis, and new treatment options. International Journal of Trichology. 2018;10(2):51-60.
  4. Tkachenko, E., Okhovat, J.P., Manjaly, P., et al. Complementary & Alternative Medicine for Alopecia Areata: A Systematic Review. 2019; S0190-9622(19)33304-3.
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