Alopecia Areata - Causes and Treatment

Alopecia Areata - Causes and Treatment
 - Hyderabad

Dermatologist

Hyderabad   |   20 Apr 2024

Hair is an important part of their physical appearance for most people, and thinning of hair and hair loss can prove to be quite traumatic, as it can directly affect the psychological and social wellbeing of an individual. Hair loss can occur anywhere on the body, while its visible impact is more when it is lost from the scalp, and this is referred to as balding. According to dermatologists, thinning of hair and hair loss are a normal part of aging, and in some people, it is associated with heredity, while in others there may be other underlying causes that contribute to its development. There are a number of factors that can cause or trigger hair loss in an individual. While it is normal to lose about 75-100 follicles in a day, these are replaced by new hair follicles that grow in their place. When the rate of replacement is either too low or completely absent, then hair thinning or hair loss becomes apparent.

What are the different types of hair loss?

There are several types of hair loss that are seen to occur in individuals. The most common among them is androgenic alopecia or male pattern balding, and it is seen in both men and women. In this, the loss of hair or thinning is at the back of the head and at the temples leaving a U-shaped area of hair, although, in women, the loss of hair at the temples is not much noticeable and is more pronounced at the top of the head. Some types of hair loss are brought on by abnormal activity of the immune system in which the immune system mistakenly targets the hair follicles resulting in the loss. Some of the types of immune system-dependent hair loss include alopecia areata, alopecia totalis, alopecia Universalis, and alopecia mucinosa (caused by the deposit of mucinous material in the hair follicles that triggers an immune system reaction). Excessive pressure or pulling on the hair follicles can also result in hair loss and traction alopecia and Chignon alopecia are examples of this type of hair loss. In some people, the growth and shedding of hair during the normal hair life cycle can be affected leading to heavy shedding and anagen/telogen effluvium are examples of this type of hair loss. Some genetic factors can result in the absence of hair growth in some places or the complete absence of hair follicles in the body, congenital triangular alopecia and Hypotrichosis are examples of this. Another form of alopecia known as Cicatricial or Scarring Alopecia is hair loss that is accompanied by scarring.

What is alopecia areata?

Alopecia areata is described by trichologists for hair as a repeated type of hair loss that does not cause scarring and can affect any part of the body that is hair-bearing. According to hair loss specialists, it can present in many different patterns, unlike androgenic alopecia which has a classic appearance or manifestation. Alopecia areata is often seen without any other symptoms, but in a few people, it can be preceded by a burning or a tingling sensation before the hair loss occurs. In most people, the balding starts in one region before it spreads to other parts of the body, and in a majority of them, it appears as a single patch of hair loss, while in a few others, it can present as a double patch or rarely as multiple patches. According to doctors for baldness treatment, the number of patches at the time of presentation of the condition is not an indication of its future severity. Alopecia areata can affect the scalp, beard, eyebrows, and extremities (arms and legs).

What are the different types of alopecia areata?

Alopecia areata can be broadly classified into five types namely 

  • Reticular alopecia in which the hair loss is extensive and the patches of baldness fuse together
  • Ophasis alopecia in which the hair loss is seen on the sides and the back of the scalp
  • Sisaphio alopecia in which the back and sides of the scalp are spared of hair loss
  • Alopecia totalis in which there is complete hair loss on the scalp
  • Alopecia Universalis in which there is complete hair loss in all the hair-bearing areas of the body.

What causes alopecia areata?

The exact cause of alopecia areata is not fully understood, but it is believed that there is a genetic predisposition for the development of the condition. This genetic predisposition is believed to result in T cell-mediated immunity targeting the hair follicles, their damage and destruction, and ultimately hair loss. During the phase of this abnormal immune system activity, it has been observed that there is an increased concentration of white blood cells known as lymphocytes during the growth phase, resulting in hair loss, and some hair grows back in the region after these white blood cells are naturally removed from there. It has also been observed that people with alopecia areata have other associated conditions such as atopic dermatitis, vitiligo, thyroid disease, collagen disease affecting blood vessels, psychiatric disorders such as anxiety, depression, or other disorders of personality or paranoia, and stressful life events.

How is alopecia areata treated?

According to dermatologists for hair fall treatment, alopecia areata is not a serious condition, and repeated occurrences with spontaneous remissions are seen in a majority of the people affected by it. Management is usually involves either topically applied agents or systemic drugs that help to reduce the abnormal activity of the immune system. Treatment consists of injections of corticosteroids into the affected area, and in children who cannot tolerate injections, topical steroid application is made on the affected areas. In people with alopecia areata other than alopecia universalis and alopecia totalis, agents such as minoxidil may provide benefits. The use of wigs may also be advised for some people.

For people suffering from alopecia areata, it is advisable to consult a dermatologist nearby and take their advice on the best hair fall treatment for the condition. One can also utilize the services of Skedoc to identify the right specialists for hair loss and easily book an appointment for online consultation with the best trichologists.

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Dr. Harini.C

Dermatologist, Hyderabad

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