Alopecia Areata

May 17th, 2017          Written by a Staff Member of Hair Loss in Women

What is Alopecia Areata?

The word alopecia comes from Ancient Greek and translates as “fox disease,” because foxes change their fur twice per year. Areata means “patches or circumscribed areas.”

According to Dermatology Online Journal at University of California Davis, alopecia areata is the second most common cause of hair loss, after androgenetic alopecia.

Alopecia areata is an immune condition that causes patches of hair loss on the scalp, eyebrows, and/or beard, as well as other parts of the body, and in some cases, a total loss of hair everywhere on the scalp or body. In many cases, the patches are the size of a quarter, and often occur in only a few places. Another characteristic that individual strands may be wider at one end, and narrow at the other, due to the time in the growth cycle of the hair fiber when the hair ceased to grow (referred to “exclamation point hairs”).

Alopecia areata can also affect the fingernails and toenails, and sometimes these are the first signs of the condition. Fingernails and toenails may develop dents, white spots, may become rough, and may become thin and split.

Alopecia Areata VS Alopecia Totalis and Alopecia Universalis

When hair is lost on the entire scalp, the condition is alopecia totalis. It can also cause hair loss of the eyebrows and eye lashes.

Alopecia universalis is when the entire body loses its hair including the scalp, armpits and limbs.

Alopecia areata’s lifetime risk is around 2% of the population, affecting both men and women, all ethnic groups, and is more common in children and young adults.

Usually people with this condition are healthy, but some have thyroid disease, some vitiligo (a loss of skin color in blotches), and atopy (the genetic tendency to develop allergic diseases such as hay fever, asthma, and eczema, which are associated with heightened immune responses to common allergens, especially inhaled allergens and food allergens.)

How do you get Alopecia Areata?

According to the National Alopecia Areata foundation, Alopecia areata is known as a “polygenic disease.” For someone to develop alopecia areata, both of their parents must contribute specific genes in order for their child to develop it. For this reason, most parents will not pass along the disease to their children. Therefore scientists believe that it takes more than genetics to develop this disease and that environment plays a role.

Your chances of having this condition are greater if you have a relative with the disease, as well as other autoimmune disorders such as diabetes, Down syndrome, lupus, or thyroid disease. 1 in 5 people with this condition have a family member who has dealt with it.

Alopecia areata isn’t contagious, it’s an autoimmune disease, which means that a person’s immune system attacks healthy parts of the body, including the hair follicles. The causes are genetic, along with unknown factors. Extreme stress may be one of the unknown factors, but there’s little evidence at this point to support that theory.

How to Diagnose Alopecia Areata

Dermatologists and doctors will usually diagnose alopecia areata just by plain sight. They may also use a microscope to look at the degree of hair loss and examine affected hairs. If they’re still unsure, they’ll perform a skin biopsy. And if they need to rule out other autoimmune diseases, they may perform a blood test.

Depending on the degree and location of hair loss, people dealing with alopecia areata (or alopecia totalis or alopecia universalis) may want to take other precautions, such as wearing sunscreen on areas of the body normally protected by hair, glasses to protect their eyes from the sun (if they are missing eyebrows and eyelashes), as well as ointments inside of the nose (nostril hair helps protect from organisms from penetrating the skin).

How To Treat Alopecia Areata

There isn’t a cure for this condition. Alopecia areata may appear and disappear spontaneously. Sometimes the hair may be gone for many years. However, people with only a few patches often regrow their hair without ever needing treatment. Around 30% of people with alopecia areata find that their condition either becomes worse or go through continuous cycles of hair loss and regrowth.

A common treatment for  alopecia areata is corticosteroids. According to Dr. Chantal Bolduc, MD, in an article about alopecia areata on Medscape, corticosteroid therapies can include intralesional injections or topical application. For intralesional steroids, few studies are available regarding it’s effectiveness. However, they are in wide use. Triamcinolone acetonide (Kenalog) is the most common treatment.

For adults, these shots are often the first treatment used by dermatologists, with patients receiving shots every 3 to 6 weeks. These are often given through local injections, or less often through topical ointments or pill form. Hair growth usually begins about 4 weeks after the last shot.

Health care professionals will also administer 5% minoxidil, and anthralin cream (Psoriatec), which can grow hair.

According to the American Academy of Dermatology (AAD), Diphencyprone (DPCP) is another option. It’s a medicine that’s applied to bald skin that causes a small allergic reaction which dermatologists believe that this allergic reaction tricks the immune system, sending white blood cells to the scalp in order to fight the inflammation. It also prevents the hair follicles from going dormant, and causing the hair loss. With DPCP it can take 3 months for hair to start regrowing.

Dermatologists and doctors have also had some success using drugs that are more commonly in use to treat psoriasis as well as other autoimmune disorders. These will help regrow hair, but don’t prevent further hair loss.

Natural Treatments for Alopecia Areata

There is a study that was conducted in the United Kingdom there in 1998 by researchers at the Department of Dermatology that concluded that essential oils can treat alopecia areata. The oils used in the study were thyme, rosemary, lavendar, and cedarwood. These are a blend in a base of jojoba oil and grapeseed oil. A second group had just the oils massaged directly into their scalps.

The results: the first group had a 44% improvement in hair regrowth, and the second had a 15% improvement. In photos the degree of improvement was highly significant. Essential oils regrow hair because they stimulate blood vessels in the scalp where the hair follicles are. This results in more blood flow, which brings nutrients to the hair follicle.

The AAD also notes that researchers are looking into laser therapy as a possible treatment option.

In the mean time, wigs and hats can cover bald spots. And some are using mores artistic options such as henna crowns, and or head scarves.

Support For Alopecia Areata

Bald Girls Do Lunch is a great resource for any woman dealing with alopecia areata.

National Alopecia Areata Foundation is a comprehensive site for people dealing with this condition that includes events (see below), latest news, connections to support groups, products, and lots of great information.

Annual Alopecia Areata Conference – The NAAF’s annual conference brings together researchers, exhibitors and people of all ages living with Alopecia Areata.

Alopecia World is a great place for connecting online with others suffering from alopecia areata.