Hair Loss & Alopecia Areata – Causes, symptoms and treatment

Hair loss is a common concern of many people. All of us find few or more hair fall every day. However, 50-100 hairs are normal to lose as per studies.

It becomes notable when we experience more than usual hair loss. Alopecia areata is the one of the type of hair fall that affects the hair of some or all area of the body.

What is Alopecia Areata?

Alopecia, also called spot baldness, is a type of hair fall in which hair starts falling in clumps and leaves small bald patches. Initially, these small patches remain unnoticeable.

Alopecia areata is defined as the autoimmune disease in which body’s own immune system attacks healthy hair follicles (roots on scalp from where hair starts growing). This causes some or all hair to come out, normally from head, face or sometimes other areas of the body.

bald spot coin sized

Sometimes you can see hair fall in few spots or lose a lot of them from all over the body. The alopecia hair loss can affect both males and females of all ages.

Hair often grows back to normal but they may fall out again. In some cases, hair loss can be permanent.

The amount of hair loss in anyone is depend on what type of alopecia he/she has.

There are 3 type of alopecia areata:

  • Alopecia areata – most common form of hair loss. Small, coin-sized one or more hairless patches in the scalp or on other areas of body.
  • Alopecia totalis – the person loses all the hair on the scalp.
  • Alopecia universalis – loss of all hair on entire body.

What causes Alopecia Areata?

There are many reasons for this complex hair loss type. Recent studies show that Alopecia areata is an autoimmune disease. That means, when the body’s immune system mistakenly assumes the healthy cells as foreign invaders, such as viruses and bacteria.

And, so a misguided immune system attacks these cells. In this type of disease, immune system tends to attack the healthy hair follicles and disrupts the healthy hair growth.

The exact cause of it is still unknown. Researchers are not exactly sure what cause immune system to attack hair follicles.

However, this type of hair loss often occurs in people with the history of alopecia areata. Plus, people with the family history of other autoimmune diseases such as thyroid disease, type 1 diabetes, vitiligo or rheumatoid arthritis are also at the risk of this hair fall.

That’s why scientists think that genetic can be the culprit for alopecia areata.

There is a little evidence to support the cause of alopecia areata by chronic stress.

Signs and symptoms of Alopecia

The signs and symptoms of Alopecia areata are different for everyone who has it – pattern of hair loss, how severe it is or chances of regrowth.

The effect of it may vary person to person. But here are some common signs and symptoms of alopecia areata that may help you to recognize it:

  • You may notice clumps of hair on pillow, comb or in shower drain.
  • Small, smooth and round or oval bald patches mainly on scalp. But may affect face, beard, eyebrows or other areas of body.
  • Hair loss and regrowth at the same time in different area of the skin.
  • Itching or burning in the area of hair loss.
  • Sudden hair loss in a small period of time, with hair loss generally on one side.
  • Exclamation mark hairs”, few short hairs which are narrower at the bottom grows in or at the edges of bald spots, forming exclamation mark.
  • Hair around damaged hair follicles tend to easily pull out.
  • Pinpoint dents or white spots on fingernails or toenails.
  • Nails become rough, thin and lose their shine.

In some cases, people with this type hair loss are likely to see the hair loss and hair growth cycle itself repeating its process. However, there is no guarantee that the hair will grow back.

Rarely the disease grows into the worst form of alopecia, totalis or universalis. Still it is good that even you have the disease, your hair follicles are not destroyed so hair can re-grow. The process for hair re-grow may different for each patient.

How is alopecia areata diagnosed?

alopecia areata diagnosis

You need to visit a doctor if the hair loss is significant. Your doctor will diagnose alopecia areata by seeing the pattern of your hair loss.

They’ll simply look at the degree of your hair loss or pull out few hairs from the scalp to examine under a microscope.

If the clinical diagnosis doesn’t find out the reason of hair fall, a doctor can also perform a scalp biopsy to rule out other conditions that triggers hair loss. During this, they’ll take a small piece of skin from your scalp for analysis.

If the other autoimmune diseases are at suspect, you’ll have several blood test done.

How to treat Alopecia Areata?

Currently, there is no cure for alopecia areata. Although, there are many treatments that may help to grow hair back more quickly and slow down the future hair loss.

For the few, small patches, the doctor may not suggest the treatment, as they will grow back within few months. For more severe hair loss, treatment is required.

The hair loss condition is not easy to predict. So, you may need to undergo number of trial and error process of various treatment until you find the best for you.

Alopecia Areata treatments

Here are some treatments you can try:

  • Corticosteroid – anti-inflammatory drugs that suppress the immune system. They can be given in form of injections, orally as pills or creams, foam and ointment to rub on the skin.
  • Anthralin – a topical drug applied to skin as creams or pastes to promote hair regrowth.
  • Minoxidil (Rogaine) – an over-the counter (OTC) product, used on scalp, beard and other hair-bearing areas. Thought it’s comparatively safe, it may take a year to see the result.
  • Topical immunotherapy – go for this if you have a lot of hair loss and patches. The process applies chemicals like diphencyprone to the skin to purposely spark an allergic reaction. The reaction will actually stimulate the new hair growth, but also makes itchy rashes. However, you’ll need to continue the treatment to maintain the hair growth.
  • Steroid injections – steroid injected into the bald spots of the skin and have to repeat once every 1-2 months. It still does not stop new bald patches formation.
  • Oral supplements – cortisone and other oral immunosuppressants like methotrexate and cyclosporine are the options. As there is a possibility of side effects, they can’t be used without doctor’s permission. Long term usage can damage the liver and kidney as well as puts you at the risk of high blood pressure or lymphoma cancer.
  • Photochemothereapy – in this treatment combination of oral medication (psoralens) and UV light is used as radiation.

Though there are many medications and therapies, the effect of each treatment can be different from person to person. Some even don’t need any treatment as their hair starts growing itself after few times.

On the other hand, people don’t see improvement despite of trying every treatment. Chances are also there where you see the new hair growth and they fall out again later.

Few Tips

Living with hair loss is not an easy. It affects one’s emotional aspect and attack on the self-confidence and social image.

No one wants to be noticed due to excessive hair loss. At the same time, it’s frustrating to not even know whether the hair will be back or hair loss continues.

People with alopecia areata can opt some healthy tips to protect the skin and scalp from many outside elements too:

  • Always wear sunscreen if out.
  • Carry a heat to protect hairs on the head.
  • Wear sunglasses to protect eyebrows and eyelashes.
  • Style your hair such that it covers the bald patches.
  • Wear a wig, cap or scarf.
  • Don’t take stress, although the science hasn’t proved it yet. It can be one of the many reasons.
  • Join the support group, where you’ll find the people just like you. It makes you realize you’re not alone. National Alopecia Areata Foundation (NAAF) offers support groups to give practical tips to handle the emotional stress due to the condition.

The condition does not have any loss of overall health. But, anyhow it can bring psychological stress of losing self-image in society. It becomes embarrassing when people notices your hair loss.

It is difficult to stand-out with bare head in public when you are still struggling with your hair loss.

Don’t worry as you are not alone in this battle. Ask your doctor what can be done if you’ve start noticing excess hair loss. Consult them about various medications and therapies.

And don’t miss out the tips to regain your self-confidence and self-worth. Remember, everyone has equal right to show their own capability, no matter with hair or without hair!