Alopecia
Areata Causes, Diagnosis and Treatments at a Glance
Alopecia
areata is not a life-threatening disease; however, it triggers an alarm for
affected patients, causing tremendous emotional and psychosocial distress. With
its recurrent episodes of erratic, unpredictable, patchy hair loss, alopecia areata
is an insidious hair disease that disrupts the life of the young and old.
What is alopecia areata?
Alopecia
areata (AA) is defined as an autoimmune disease that attacks the rapidly
growing cells in the hair follicles, which causes them to shrink and
drastically slow down hair production. It causes hair loss in patches mostly on
the scalp; however, it can occur on any other hair-growing part of the body.
The condition tends to be rapid and often involves one side of the head more
than the other. The distinctive bald patch seen in alopecia areata is a round
and smooth patch. In odd occasions, complete loss of scalp and body hair
occurs.
What causes alopecia areata?
Studies have
shown that alopecia areata is an abnormality in the immune system wherein for
unknown reasons the body’s own immune system attacks the hair follicles and
disrupts normal hair cycle. Alopecia areata is sometimes associated with other
autoimmune conditions such as allergic disorders, lupus, rheumatoid arthritis, thyroid
diseases and ulcerative colitis.
Even until
today, the cause of alopecia areata is still unknown. However, scientists
believe that a person’s genes can certainly play a role. For people whose genes
put them at risk for the disease, some type of trigger (maybe a virus or
something in the person’s environment) starts the attack on the hair follicles.
According to
studies, about 10 percent of patients with this condition may never regrow hair
and a greater possibility of having permanent hair loss if you:
- have
a family history of the problematic condition;
- have
the condition at a younger age (before puberty);
- have
another autoimmune disease;
- are
prone to allergies (atopy);
- have
extensive hair loss; and
- have
abnormal color, texture, shape, or thickness of the fingernails or
toenails.
How is alopecia areata diagnosed?
Alopecia
areata is diagnosed through physical examination and a review of one’s medical
history. A dermatologist can diagnose alopecia areata by looking at the hair
loss condition. If the bald spot is expanding, the dermatologist will perform a
skin biopsy to confirm that the disease is indeed alopecia areata. During a
skin biopsy, the dermatologist removes a small piece of skin so that it can be
studied under a microscope. Sometimes, a
blood test may be necessary if the dermatologist thinks the patient might have
another autoimmune disease.
What are some treatments of alopecia areata?
Alopecia areata
cannot be “cured” but it can be treated. There are some medications that can
stimulate hair regrowth. While these treatments may promote hair growth, none
of them can prevent new bald patches or actually cure the underlying diseases.
A
dermatologist may recommend one or more of the following treatments:
Corticosteroids — are
powerful anti-inflammatory drugs similar to a hormone called cortisone which is
produced naturally in the body to regulate inflammation and control auto-immune
disorders and many other types of diseases. Corticosteroids may be administered
for alopecia areata in three ways:
- Local
injections
— Injections of corticosteroids directly into hairless patches on the
scalp, brow, and beard areas increase hair regrowth in most cases. Typically
results are not visible until roughly 1 to 2 months after the treatment.
Possible side effects of using this injection might include pain, mild
swelling and skin discoloration. Because injections can be painful, they
may not be preferred for children.
- Oral
corticosteroids
— These corticosteroids are taken by mouth such as prednisone. The side
effects of using this treatment may include hypertensions and cataracts
that is why it’s only used occasionally and within a shorter period of
time.
- Topical
corticosteroids
— Topically administered corticosteroids like creams and ointments are far
less traumatic than injections, hence these are more preferred for
children. However, they are less effective than injections; therefore, to
improve results, these need to be combined with other topical hair loss
treatments (e.g., anthralin or minoxidil).
Anthralin — is a synthetic tar-like substance
available as cream or ointment which is applied daily to the scalp and washed
off. It is a common treatment for psoriasis and it can also be used to treat
alopecia areata. New hair growth is usually evident in 8 to 12 weeks after
using this treatment.
Sulfasalazine — is a drug used to treat
various autoimmune disorders such as psoriasis; however, it has been used by
patients with severe alopecia areata.
Topical sensitizers — are
medications that provoke allergic reactions that lead to itching, scaling, but
eventually hair regrowth. New hair growth is usually established within 3 to 12
months of this treatment. Squaric acid dibutylester (SADBE) and
diphenylcyclopropenone (DPCP) are two topical sensitizers used to treat
alopecia areata; however, their safety and consistency of formula are currently
still under review.
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