About Alopecia Areata Treatment Other Types
What is Alopecia?
Alopecia can occur among men, women and children.
While we all lose hair everyday (losing 50-100 hairs per day is considered normal), some people will develop disorders of hair loss, such as alopecia areata, or female and male pattern hair loss. The term "alopecia' refers to hair loss, but is not a specific condition or diagnosis.
Anyone experiencing sudden or significant hair loss or hair thinning should see a dermatologist for a specialist medical diagnosis.
Alopecia areata is an autoimmune disorder and occurs when the immune system attacks the hair follicle causing inflammation around the hair root. The hair root then becomes inactive and the hair falls out.
Despite the loss of hair, in cases of alopecia areata the hair follicle remains alive. It is simply waiting for the signal to be transmitted to restart the hair growth cycle.
It is thought that there is a genetic disposition to develop alopecia areata, which is consistent with its autoimmune basis. There may be a family history. Sometimes there is also a stressful event, but only in a minority of cases.
Alopecia areata is not contagious and cannot be "caught' through body contact, sharing a comb or any other means of contact.
There are usually no warning symptoms for alopecia areata, the hair simply stops growing and falls out.
Alopecia areata affects males and females equally and can develop in people of all ages, although it is most common in teenagers and young adults.
This condition most commonly occurs in people who are otherwise healthy and is not related to their general health.
In alopecia areata, the scalp is the most common area affected, but eyelashes, eyebrows, and facial hair and indeed the whole of the body may also be involved. Localised forms of alopecia areata are most common but ,rarely, hair loss can be very widespread over the body.
As the hair follicle remains active in cases of alopecia, it is not uncommon for the hair to start growing again on its own.
Treatments focus on stimulating hair regrowth and include:
- Topical lotions and creams
- Cortisone injections
- Irritants to activate the immune system
- Oral corticosteroids tablets
- In serious cases, tablets to dampen the immune system (immune suppressants)
It may also be possible to camouflage the hair loss until treatment takes effect.
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Androgenetic alopecia or common balding is the most common form of alopecia. In men it is known as male pattern hair loss. The hair loss of androgenetic alopecia tends to occur in a predictable “pattern”, with thinning at the temples and vertex (top) of scalp being most prominent.
Androgenetic alopecia occurs due to the action of male hormones (androgens) on the scalp hair follicles. The hair follicles shrink from thick large “terminal” hairs in to small “miniaturized “hairs. The degree to which the scalp hairs are sensitive to the influence of androgens may be passed down i.e. inherited from one generation to another.
Treatments available these days include lotions and tablets, where warranted. The two main treatments are minoxidil and finasteride.
Similarly, many women also suffer from "female-pattern hair loss". Again, treatments include lotions and appropriate prescription oral medication, where indicated. These may include minoxidil, spironolactone, cyproterone acetate and other anti-androgen medications.
Cosmetic camouflage and hair transplants may also be useful.
Telogen effluvium is a common hair shedding disorder that occurs when a large number of hair follicles enter the resting phase at the same time. This “synchronization” of the hair can be caused by a number of different triggers, including major illness, psychological stressors, and giving birth.
The resting phase, “telogen”, typically lasts about 3 months, after which the hair follicle passes into the growth phase, “anagen”. During this transition, the old hair shaft is shed. The shedding usually resolves on its own within 2-3 months, as the hair cycles naturally fall out of sync again.
Multiple episodes of telogen effluvium may occur in the lead up to androgenetic alopecia.
The above hair loss conditions are all forms of “non-scarring alopecia”, where the hair follicle remains alive. In some rare forms of hair loss, a “scarring alopecia” or “cicatricial alopecia” occurs, where the hair follicle may be lost permanently. If a scarring alopecia is suspected, a biopsy is usually indicated to confirm the diagnosis, and early referral to a dermatologist should be considered, as prompt treatment may be able to limit the extent of permanent hair loss.