Alopecia Areata occurs in males and females of all ages and races; however, onset most often begins in childhood. Although not life-threatening, Alopecia Areata is life changing, and its sudden onset, recurrent episodes, and unpredictable course can have a profound psychological impact on the lives of those affected by this disease. But there is hope. People with Alopecia Areata are fully capable of living happy, healthy lives and there is no reason the condition should hold them back from any achievement.
- 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. Many people say the condition is stress induced, but there is little consistent scientific proof of this.
Currently the condition is believed 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 condition to anyone else
- Is Alopecia Areata inherited?
Over 20% of people with Alopecia Areata have a family member with it. People who have had eczema, asthma or a thyroid disease are more prone to alopecia. However, the majority of people with Alopecia are not aware of being in either of these categories. Susceptibility is most likely due to a 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 there is always the potential for hair to start re-growing.
- What areas of the body are affected?
The scalp is the usual area, but the beard, and eyelashes or eyebrows may be affected alone, or together with scalp hair loss. In more uncommon 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. There are no physically disabling effects of any kind.
- What does it look like?
The patches are smooth and round, sometimes with few remaining hairs in the centre. Around 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 the 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 fading or returning 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 you may have a single patch of hair loss 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 common to experience hair loss and re-growth over many years. The re-growth can be any texture and colour, from fine, downy white hair, to hair identical to your original hair colour and texture.
- How is Alopecia Areata diagnosed?
Alopecia areata is diagnosed through a medical history and physical examination. Your doctor will ask questions about the hair loss, look at the pattern of hair loss, and examine the scalp.
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.
No. All aspects of general health are unaffected- apart from the rare associations with other diseases. Young people who are affected by Alopecia Areata are usually otherwise healthy.