Hair-loss Q&A: Alopecia Areata

Hair-loss Q&A: Alopecia Areata

What is Alopecia Areata?

Alopecia areata is a type of hair-loss condition that is marked by a sudden loss of hair. On the scalp, patches are seen that are typically totally absent of hair. This can also happen on other parts of the body as well, and may not always be noticed by the affected person because of it. 

This type of hair-loss is considered to be non-scarring, which means that there isn’t permanent damage to the hair follicle. Most people affected by this condition will have their hair eventually grow back in, as it tends to be a temporary condition. However, this process can take months and the hair does not always grow back. Around 50 percent of patients affected with mild alopecia areata will regrow all of their hair in about a year. Unfortunately, most of these people will have multiple bouts of alopecia areata in their lifetime and the cumulative psycho-social effects can be very difficult for the person affected.

Alopecia areata occurs in both men and women and people of all races. It can affect patients of any age, but often occurs for the first time before the age of 30.

Although alopecia areata is not a life-threatening condition and does not cause physical pain, the psychosocial effects can be life-altering and psychologically damaging.

What causes Alopecia Areata?

Our body’s immune system is a powerful tool that protects us from the outside world, however, at times it can cause damage to us directly. In alopecia areata, the body’s immune system attacks our hair follicles. It isn’t clear why this happens, but histopathology confirms the process. And this is why most treatments for this condition work to suppress the immune system. As mentioned before, luckily the hairs are not typically permanently damaged and if successfully treated can regain their full growth. 

Are their symptoms of Alopecia Areata?

The major feature noticed by patients with alopecia areata are smooth, oval shaped patches of complete hair-loss that seems sudden. The hair-loss typically happens fairly quickly, over the matter of a couple of weeks. The hair regrowth typically occurs months later, however, in some of the worse cases the hair-loss can persist for years. The patches can also group together to form large, very irregular shaped patches of hair-loss.  

Most patients will not have more than a few small patches of hair-loss, however, an unfortunate small group of patients will lose all of the scalp hair (which is referred to as alopecia totalis) or all of the hair on their entire body (which is referred to as alopecia universalis).

Is there a test to diagnose Alopecia Areata?

Alopecia areata can almost always can be diagnosed clinically, meaning by your doctor can make the diagnosis by examining your skin and reviewing the history of your condition. In cases where the diagnosis is not clear or some features appear unusual, a punch skin biopsy can be done to clear things up. Blood serum tests for thyroid disease may or may not be considered.

Does Alopecia Areata run in families or have a genetic component?

Though not entirely clear, it is known that 1 in 5 patients with alopecia areata have a family member who is also affected by the same condition. This supports a genetic predisposition, but much work needs to be done to isolate the genes involved.

Is there a pschyosocial effect of having Alopecia Areata? 

Hair-loss can be absolutely devastating and particular in scenarios when the hair-loss is sudden and/or difficult to hide. Some patients would benefit from aggressive treatment for their hair-loss as well as speaking to a license mental health professional about their condition. Your doctor can work with you to find ways to camouflage your condition along the way of your treatment journey. 

For additional information and support please make an appointment to be seen by our professionals on our main page at www.edermgroup.com or give us a call at 817-736-2912. You may also benefit from the support of larger foundations as well: National Alopecia Areata Foundation (www.naaf.org).

 

The injections in the bald head of a girl. Treatment of alopecia. Real alopecia areata
The injections in the bald patches of a girl for the treatment of alopecia areata.

What treatments are available for Alopecia Areata?

As mentioned before, not all patients require treatment and many patients may improve without it. For patients who do require treatment, your doctor can formulate a plan to best suit your condition.

Topical steroids — These medications are used for their anti-inflammatory effects, as we described above, this condition is marked by inflammation.

Injected steroids — Injected corticosteroids is often used in adults and children with few patches of hair-loss. Injected directly into the affected areas can aid in improvement.

Oral steroids — Oral corticosteroids are not the go to treatment for this condition but can be used effectively for more severe cases. Your doctor will discuss the risks and benefits of such treatments. This is best used to control rapid, extensive hair-loss cases but of note it is not a suitable long-term treatment option and is best used as a bridge to recovery. Hair-loss could return once oral steroids are stopped. 

Minoxidil — An over counter product can be helpful in hair growth in general, however, it does not target the root cause of hair-loss in the case of alopecia areata. Minoxidil is approved to treat androgenetic alopecia in both men and women but can be used off-label for other types of hair-loss as well.

Topical immunotherapy — Topical immunotherapy, can be an effective treatment and is particularly useful in extensive cases of alopecia areata. It does so by creating a controlled allergic reaction in the treatment area that can effectively modulate the inflammatory process.

Investigational treatments — Exciting new therapies are on the horizon for alopecia areata including Janus kinase inhibitors. The two medications in this category showing promise are tofacitinib and ruxolitinib, which can be used both in the topical and oral forms. These medications are immunosuppressing and come with an important safety profile that should be reviewed by you and your doctor.

PRP – Platelet-rich plasma has also been used to treat alopecia areata with success, however, data on its efficacy is limited and it’s benefits should be discussed with your doctor.

 

If you suffer from alopecia areata or other types of hair-loss, please give us a call today at 817-736-2912 to get yourself scheduled for an appointment.

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