Hair loss condition: Alopecia areata

Alopecia areata is a common autoimmune disorder that often results in unpredictable hair loss. In the majority of cases, hair falls out in small patches around the size of a quarter. For most people, the hair loss is nothing more than a few patches, though in some cases it can be more extreme. Sometimes, it can lead to the complete loss of hair on the scalp or, in extreme cases, the entire body. Anyone can fall prey to the condition regardless of age and gender, although in most cases it occurs before the age of 30.

Causes

The condition occurs when white blood cells attack the cells in hair follicles, causing them to shrink and dramatically slow down hair production. It is unknown precisely what causes the body's immune system to target hair follicles in this way. While scientists are unsure why these changes occur, it seems that genetics are involved as alopecia areata is more likely to occur in a person who has a close family member with the disease. One in five people with the disease has a family member who has also developed alopecia areata. Despite what many people think, there is very little scientific evidence to support the view that alopecia areata is caused by stress. Extreme cases of stress could potentially trigger the condition, but most recent research points toward a genetic cause.

Symptoms

The most prominent symptom of alopecia areata is patchy hair loss. Coin-sized patches of hair begin to fall out, mainly from the scalp. Any site of hair growth may be affected including the beard and eyelashes. The loss of hair can be sudden, developing in just a few days or over a period of a few weeks. There may be itching or burning in the area before hair loss. Alopecia areata can also affect the fingernails and toenails, and sometimes these changes are the first sign that the condition is developing. There are a number of small changes that can occur to nails like pinpoint dents, white spots and lines appear. The nails become rough and lose their shine too.

Treatment

There is currently no cure for alopecia areata, although there are some forms of treatment that can be suggested by doctors to help hair re-grow quicker. The most common form of alopecia areata treatment is the use of corticosteroids, powerful anti-inflammatory drugs that can suppress the immune system. These are most commonly administered through local injections, topical ointment application, or orally. Other medications that can be prescribed that either promote hair growth or affect the immune system. Although, some of these may help with the re-growth of hair, they cannot prevent the formation of new bald patches. The use of photochemotherapy is supported by some studies and presents a potential alternative for patients unable or unwilling to use systemic or invasive therapies. In addition to its aesthetic aspect, hair affords a degree of protection against the elements. People with alopecia areata who miss the protective qualities of hair may wish to:

• Wear sunscreen if exposed to the sun.

• Wear wraparound glasses to protect the eyes from the sun and debris which the eyebrows and eyelashes would normally defend against.

• Use headwear such as hats, wigs, and scarves to protect the head from the sun or keep it warm.

• Use ointment inside the nose to keep membranes moist and to protect against organisms that are normally trapped by nostril hair.

Home remedies

As conventional treatments for alopecia are extremely limited, studies that support natural treatments for alopecia are even thinner on the ground. There are some people that recommend rubbing onion or garlic juice, cooled green tea, almond oil, rosemary oil, honey, or coconut milk into the scalp. While none of these are likely to cause harm, their effectiveness is also not supported by research. Some people turn to alternative treatment methods such as acupuncture and aromatherapy, although there is little, if any, evidence to support these treatments.

Things to remember

Alopecia areata does not directly make people sick, nor is it contagious. It can, however, be difficult to adapt to emotionally. For many people, alopecia areata is a traumatic disease that warrants treatment addressing the emotional aspect of hair loss, as well as the hair loss itself. Support groups and counseling are available for people to share their thoughts and feelings, and to discuss common psychological reactions to the condition. Alopecia areata has been compared by some to vitiligo, an autoimmune skin disease where the body attacks melanin-producing cells, leading to white patches. Research suggests that these two conditions may share a similar pathogenesis, with similar types of immune cells and cytokines driving the diseases and common genetic risk factors. As such, any new developments in the treatment or prevention of either disease may have consequences for the other.

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