Who gets Alopecia Areata?
Alopecia Areata occurs in males and females of all ages and races; however, onset most often begins in childhood and can be psychologically devastating. Although not life-threatening, Alopecia Areata is life changing, and its sudden onset, recurrent episodes, and unpredictable course have a profound psychological impact on the lives of those disrupted by this disease. But there is hope. In all cases, hair re-growth may occur even without treatment and even after many years.
What causes Alopecia Areata?
The mechanism is known – inflammation develops around the hair roots and the hair roots become inactive and shrink in size. However, the cause of this inflammation is not understood. It is safe to say that no simple explanation such as deficiency of vitamins or other food, methods of hair care or external injury can be given. The cause is not any fungal bacterial or viral infection and it cannot be transmitted to any other person. It is likely that eventually the condition will be found to be “auto-immune”, with another body tissue attacking the hair roots.
Is it infectious?
No. There is no way in which a person with Alopecia can transmit the problem to anyone else
Is Alopecia Areata inherited?
Over 20% of people with Alopecia Areata have a family member with it. If you have had eczema, asthma or a thyroid disease you are more prone to alopecia. However, the majority of people with Alopecia are not aware of being in either of these categories and susceptibility is then probably due to their combination of genes.
Is it common?
Roughly 1-2% of the population have some form of Alopecia Areata. It is perhaps best to say that it is “not uncommon”.
How does it start?
The body’s immune system wrongly attacks the growing cells in the body’s hair-producing follicles, where the hair starts to grow. This stops them producing new hair and causes existing hair to fall out. The cells which produce the hair, the follicles, do still remain active so the potential for hair to start re-growing is always there.
What areas are affected?
The scalp is the usual area, but the beard in men, and eyelashes or eyebrows may be affected alone, or together with scalp hair loss. In the uncommon severe forms, body hair may be lost as well. The only other structures affected are the nails and people with severe Alopecia Areata may show dulled and ridged fingernails.
What does it look like?
The patches are smooth, with few remaining hairs in the centre. Round the edge of the patch some stub-like hairs can usually be seen (often called “exclamation mark” hairs, as they are thicker at the tip than at the scalp level).
Can the loss be diffuse?
Less commonly, some hair may be lost over wide areas, causing general thinning of the hair. This can cause “hair to turn white overnight” by selectively affecting dark hairs and leaving grey hairs.
Will my hair grow back?
The vast majority of people with Alopecia Areata experience some degree of re-growth. The growing cells that supply the hair follicle remain active, so the potential for hair to re-grow is always there. There is a possibility of complete re-growth. But you may also experience the condition worsening or improving at any time. It is unpredictable, which is one of the most difficult aspects of the condition – nobody can tell you with certainty what the pattern of your Alopecia will be. So, at the extremes of the condition, you may have a single patch with complete re-growth within a short time and no further occurrence; or you may, as in a small minority of cases, experience all your body hair being lost with no re-growth at any time. It is most common to experience hair loss and re-growth over many years. The re-growth can be any texture and colour, from fine, downy hair that’s white, to hair identical to your original hair colour and texture.
How is it diagnosed?
Alopecia areata is diagnosed through a medical history and physical examination Your doctor will ask you questions about your hair loss, look at the pattern of your hair loss, and examine your scalp. A slight tug on a few hairs or pull some out.
Hair can be plucked and examined under the microscope and if tinea is suspected, hairs may be taken for culture. For very careful study, a small biopsy may be performed for microscopic examination of the scalp skin.
In most cases, tests are performed only if there is a need to assess general health. Blood tests do not show any abnormality in Alopecia Areata.
Does Alopecia Areata affect general health?
No. All aspects of general health are unaffected- apart from the rare associations with other diseases. Young people who are affected are usually otherwise healthy.
What treatments are available?
There is no cure for Alopecia Areata and no universally proven therapy to induce hair re-growth and sustain remission. The effectiveness of treatments tends to vary and something that works well for one person may not for another. So if you find one treatment doesn’t work, don’t assume others won’t either. But do bear in mind that for some people none of the treatments are effective. No treatment at all is another option.