Alopecia areata: the bald truth

Alopecia areata is an autoimmune disease that causes patches of hair loss. It can happen anywhere on the body, but is most noticeable and common on the scalp and beard area, where the body’s hair grows the longest and densest. A leading dermatologist tells us all about alopecia areata in this article.

Anyone can get alopecia areata, but children, those with a family history of it, and those with autoimmune disorders like diabetes, lupus, or thyroid disease are more at risk.

It is not a dangerous condition, and will not affect your physical health or bodily functions. However, the mental impact can be quite significant. People with alopecia areata may have their self-confidence deteriorate, and they might also be treated differently by their peers, especially children. This can lead to anxiety, social withdrawal, and depression.

Alopecia areata has several classifications:

• Alopecia areata totalis, where all the hair on the scalp has been lost
• Alopecia areata universalis, where the hair has been entirely lost all over the body
• Diffuse alopecia areata, where the hair doesn’t fall out, but thins out
• Ophiasis alopecia areata, where only a band of hair falls out at the back and sides of the scalp

Even hair like the eyebrows and eyelashes fall out with alopecia. Alopecia areata can also change the texture of your nails with dents or divots. There may also be sensations of itching in places where there has been hair loss.

How is alopecia areata treated?

The hair may never grow back, or it will grow back and fall out again. Sometimes, the hair will grow back in a different texture. There is no way to predict how the disease will affect the follicles, as the reasons why are not understood yet.

The immune system begins to attack the hair follicles because it believes they are like fungi, parasites, and viruses, and need to be expelled from the body.  It is a chronic condition with no cure, but it can be managed, by slowing, pausing, or reversing the hair loss. Medications used in the treatment of alopecia areata are:

• Corticosteroids, anti-inflammatory drugs that are used to treat autoimmune diseases, can be injected into the scalp directly, taken as a pill, or applied topically. The side effects may be an increased appetite, weight gain, and blurred vision.
• Minoxdil is a topical medication for pattern baldness, and results can be seen after around 12 weeks when the hair begins to regrow. It can cause headaches and scalp irritation.
• Phototherapy uses ultraviolet light lamps to stimulate hair growth and strengthen the follicles.
• Platelet-rich plasma transfer, where blood is taken from the body, infused with platelets, and reinjected into the scalp to increase blood flow in the scalp and encourage hair growth. There are can be some scalp pain and irritation, as well as nausea from the loss of blood during this treatment.
• Topical immunotherapy, where an allergen is rubbed into the skin to agitate the skin (contact dermatitis) and encourage hair growth. However, this can cause swollen lymph nodes, eczema, and other mild allergic reactions.

Some patients may decide to opt for wigs, hats, and scarves if treatment is not fruitful, or to better express themselves and find style with the condition.

If you are experiencing alopecia areata, or unexplained hair loss, you can book a consultation with a specialist via Top Doctors