14/05/2020
What is alopecia areata?
Alopecia areata is a condition that causes hair to fall out in small patches, which can be unnoticeable. These patches may connect, however, and then become noticeable. The condition develops when the immune system attacks the hair follicles, resulting in hair loss.
Sudden hair loss may occur on the scalp, and in some cases the eyebrows, eyelashes, and face, as well as other parts of the body. It can also develop slowly and recur after years between instances.
The condition can result in total hair loss, called alopecia universalis, and it can prevent hair from growing back. When hair does grow back, it’s possible for the hair to fall out again. The extent of hair loss and regrowth varies from person to person.
There’s currently no cure for alopecia areata. However, there are treatments that may help hair grow back more quickly and that can prevent future hair loss, as well as unique ways to cover up the hair loss. Resources are also available to help people cope with stress related to hair loss.
Treatment
There’s no known cure for alopecia areata, but there are treatments that you can try that might be able to slow down future hair loss or help hair grow back more quickly.
The condition is difficult to predict, which means it may require a large amount of trial and error until you find something that works for you. For some people, hair loss may still get worse, even with treatment.
Medical treatments
Topical agents
You can rub medications into your scalp to help stimulate hair growth. A number of medications are available, both over-the-counter (OTC) and by prescription:
Minoxidil (Rogaine) is available OTC and applied twice daily to the scalp, eyebrows, and beard. It’s relatively safe, but it can take a year to see results. There is only evidence that it’s useful for people with limited alopecia areata.
Anthralin (Dritho-Scalp) is a drug that irritates the skin in order to spur hair regrowth.
Corticosteroid creams such as clobetasol (Impoyz), foams, lotions, and ointments are thought to work by decreasing inflammation in the hair follicle.
Topical immunotherapy is a technique in which a chemical like diphencyprone is applied to the skin to spark an allergic rash. The rash, which resembles poison oak, may induce new hair growth within six months, but you’ll have to continue the treatment to maintain the regrowth.
Injections
Steroid injections are a common option for mild, patchy alopecia to help hair grow back on bald spots. Tiny needles inject the steroid into the bare skin of the affected areas.
The treatment has to be repeated every one to two months to regrow hair. It doesn’t prevent new hair loss from occurring.
Oral treatments
Cortisone tablets are sometimes used for extensive alopecia, but due to the possibility of side effects, you should discuss this option with a doctor.
Oral immunosuppressants, like methotrexate and cyclosporine, are another option you can try. They work by blocking the immune system’s response, but they can’t be used for a long period of time due to the risk of side effects, such as high blood pressure, liver and kidney damage, and an increased risk of serious infections and a type of cancer called lymphoma.
Light therapy
Light therapy is also called photochemotherapy or phototherapy. It’s a type of radiation treatment that uses a combination of an oral medication called psoralens and UV light.
Natural treatment
Some people with alopecia areata choose alternative therapies to treat the condition. These may include:
aromatherapy
acupuncture
microneedling
probiotics
low-level laser therapy (LLLT)
vitamins, like zinc and biotin
aloe vera drinks and topical gels
onion juice rubbed onto the scalp
essential oils like tea tree, rosemary, lavender, and peppermint
other oils, like coconut, castor, olive, and jojoba
an “anti-inflammatory” diet, also known as the “autoimmune protocol,” which is a restrictive diet that mainly includes meats and vegetables
scalp massage
herbal supplements, such as ginseng, green tea, Chinese hibiscus, and saw palmetto
Most alternative therapies haven’t been tested in clinical trials, so their effectiveness in treating hair loss isn’t known.
Additionally, the Food and Drug Administration (FDA) doesn’t require supplement makers to prove their products are safe. Sometimes the claims on the supplement labels are inaccurate or misleading. Always talk to a doctor before trying any herbal or vitamin supplement.
The effectiveness of each treatment will vary from person to person. Some people won’t need treatment because their hair grows back on its own. In other cases, however, people won’t see improvement despite trying every treatment option.
You might need to try more than one treatment to see a difference. Keep in mind that hair regrowth may only be temporary. It’s possible for the hair to grow back and then fall out again.
Causes of alopecia areata
Alopecia areata is an autoimmune condition. An autoimmune condition develops when the immune system mistakes healthy cells for foreign substances. Normally, the immune system defends your body against foreign invaders, such as viruses and bacteria.
If you have alopecia areata, however, your immune system mistakenly attacks your hair follicles. Hair follicles are the structures from which hairs grow. The follicles become smaller and stop producing hair, leading to hair loss.
Researchers don’t know the exact cause of this condition.
However, it most often occurs in people who have a family history of other autoimmune conditions, such as type 1 diabetes or rheumatoid arthritis. This is why some scientists suspect that genetics may contribute to the development of alopecia areata.
They also believe that certain factors in the environment are needed to trigger alopecia areata in people who are genetically predisposed to it.
Symptoms of alopecia areata
The main symptom of alopecia areata is hair loss. Hair usually falls out in small patches on the scalp. These patches are often several centimeters or less.
Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places. Others lose it in a lot of spots.
You may first notice clumps of hair on your pillow or in the shower. If the spots are on the back of your head, someone may bring it to your attention. However, other health conditions can also cause hair to fall out in a similar pattern. Hair loss alone isn’t used to diagnose alopecia areata.
In rare cases, some people may experience more extensive hair loss. This is usually an indication of another type of alopecia, such as:
alopecia totalis, which is the loss of all hair on the scalp
alopecia universalis, which is the loss of all hair on the entire body
Doctors might avoid using the terms “totalis” and “universalis” because some people may experience something between the two. It’s possible to lose all hair on the arms, legs and scalp, but not on the chest, for example.
The hair loss associated with alopecia areata is unpredictable and, as far as doctors and researchers can tell, appears to be spontaneousTrusted Source. The hair may grow back at any time and then may fall out again. The extent of hair loss and regrowth varies greatly from person to person.
