There are different types of this condition. Alopecia areata is most common in its main form, but there are other, more rare types:
- Alopecia areata totalis means you’ve lost all the hair on your head.
- Alopecia areata universalis is the loss of hair over your entire body.
- Diffuse alopecia areata is a sudden thinning of your hair rather than lost patches.
- Ophiasis alopecia areata causes hair loss in a band shape around the sides and back of your head.
Symptoms
The most prominent symptom of alopecia areata is patchy hair loss. Coin-sized patches of hair begin to fall out, mainly from the scalp. Any site of hair growth may be affected, though, including the beard and eyelashes.
The loss of hair can be sudden, developing in just a few days or over a period of a few weeks. There may be itching or burning in the area before hair loss. The hair follicles are not destroyed and so hair can re-grow if the inflammation of the follicles subsides. People who experience just a few patches of hair loss often have a spontaneous, full recovery without any form of treatment.
About 30 percent of individuals who develop alopecia areata find that their condition either becomes more extensive or becomes a continuous cycle of hair loss and regrowth.
About half of patients recover from alopecia areata within 1 year, but many will experience more than one episode. Around 10 percent of people will go on to develop alopecia totalis or alopecia universalis.
Alopecia areata can also affect the fingernails and toenails, and sometimes these changes are the first sign that the condition is developing. There are a number of small changes that can occur to nails:
- pinpoint dents appear
- white spots and lines appear
- nails become rough
- nails lose their shine
- nails become thin and split
Additional clinical signs include:
Exclamation mark hairs: This occurs when few short hairs that get narrower at their bottom and grow in or around the edges of bald spots.
Cadaver hairs: This is where hairs break before reaching the skin surface.
White hair: This may grow in areas affected by hair loss.
Types of Alopecia Areata
There are three main types of alopecia areata:
- Patchy alopecia areata. In this type, which is the most common, hair loss happens in one or more coin-sized patches on the scalp or other parts of the body.
- Alopecia totalis. People with this type lose all or nearly all of the hair on their scalp.
- Alopecia universalis. In this type, which is rare, there is a complete or nearly complete loss of hair on the scalp, face, and rest of the body.
Causes
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
MANAGEMENT AND TREATMENT
Alopecia areata cannot be cured; however, it can be treated and the hair can grow back.
In many cases, alopecia is treated with drugs that are used for other conditions. Treatment options for alopecia areata include:
Corticosteroids: anti-inflammatory drugs that are prescribed for autoimmune diseases. Corticosteroids can be given as an injection into the scalp or other areas, orally (as a pill), or applied topically (rubbed into the skin) as an ointment, cream, or foam. Response to therapy may be gradual.
Rogaine ® (minoxidil): this topical drug is already used as a treatment for pattern baldness. It usually takes about 12 weeks of treatment with Rogaine before hair begins to grow.
Other drugs that are used for alopecia with varying degrees of effectiveness include medications used to treat psoriasis and topical sensitizers (drugs that are applied to the skin and cause an allergic reaction that can cause hair growth).
LIVING WITH
Apart from drug treatments, there are various cosmetic and protective techniques that people with alopecia can try. These include:
Use makeup to hide or minimize hair loss.
Wear sunglasses to protect the eyes from the sun and the environment (if there is loss of eyelashes).
Wear coverings (wigs, hats, or scarves) to protect the head from the elements.
Eat a well-balanced diet. Hair growth is a vitamin- and mineral-dependent process. People on fad diets often have problems with hair loss (although not specifically related to alopecia areata.)
Reduce stress. Although never proven through large trials and investigations, many people with new onset alopecia areata have had recent stresses in life, such as work, family, deaths, surgeries, accidents, etc.
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