Also referred to as AA, alopecia areata is an autoimmune disease that brings about hair thinning and baldness AA may also be termed spot baldness since it leads to round spots of hair loss. The condition, that is relatively common, has a tendency to run in families and impacts about 1 to 2 percent of the people in the United States. Within 2 percent of sufferers, the condition transforms into a more diffuse kind of hair loss, addressing wider areas of the scalp.
Current evidence suggests that alopecia areata is caused by an abnormality in the immune system. This particular abnormality leads to autoimmunity. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body’s own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune cells inside of the hair follicles where they are not normally present. What causes this is unknown. Alopecia areata is sometimes associated with other autoimmune conditions such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis.
Alopecia areata develops each time a person?s white blood cells invade and ruin the body?s hair follicles. After hair roots are attacked, they stop generating hair, resulting in the unique localized bald patches which can be the mark of alopecia areata.
The hair loss usually occurs over a short period of time.
Severe alopecia areata can take two forms:
Alopecia totalis: All hair on the scalp is lost.
Alopecia universalis: All hair on the scalp is lost, along with hair on the eyebrows, eyelashes, and all other parts of the body.
Less severe alopecia areata can take these forms:
Alopecia areata monolocularis: Baldness occurs in only one place on the scalp.
Alopecia areata barbae: Hair loss occurs in patches in a man?s beard.
AA may appear at all ages, with a lot of sufferers determined between the ages of 15 and 29 and almost half being under age 20. The same number of males and females develop AA, plus the disease occurs equally in every race.
Diagnosing the disorder
Alopecia areata doesn?t have a predictable path. Some people feel burning up or feeling provoking scratching in the area of balding, but others don?t. 80 % of patients have only one bald spot. The bald patches could be round or oval in shape, and expose smooth, bald skin.
The condition typically influences just the scalp, but some other body hair may also be afflicted and assist in figuring out the condition. Oddly enough, for those who have fingernail abnormalities for instance small pits on the nail plate, you may also have alopecia areata. Atopic dermatitis (an allergic skin condition) and vitiligo, a disease that leads to white patches on the skin, are usually more common in people with AA.
An essential diagnostic clue to alopecia areata may be the presence of ?exclamation point hairs? on the circumference of the bald patch. These hairs outline as the body strikes the lower portion of the hair follicle, and this harm produces a finely tapered end. Since the hair is maintaining growth, it appears to be a tiny spear stuck in the scalp. Ultimately this hair is going to be lost, nevertheless its presence is a sign of alopecia areata in its active stage.
A medical expert may carefully pull hair along the fringe of a bald patch to see whether you have alopecia areata. Healthy hair doesn?t come out when pulled lightly, but hair suffering from alopecia areata is easily removed.
Exploring treatment options
If you?re diagnosed with alopecia areata, the good news is that in 90 percent of cases, hair grows back on its own and no treatment is needed. The chances of regrowth are best when the condition is localized to just a few places on the scalp and the patient is over age 40. In younger patients, unfortunately, the condition tends to be more severe. If the disease progresses to alopecia totalis or alopecia universalis.
It is accepted that alopecia areata is an inflammation mediated disorder. Several new approaches to treatment opened up for experimentation but no surefire treatment is available.
Current therapies are mainly immunosuppressive or immunomodulatory.
Immunosuppression attempts to prevent entry of the inflammatory cells into the skin and the follicle using steroids orally, interlesionally and through injections. Immunomodulation, by drugs such as contact sensitizers or PUVA therapy, change the skin environment in order to lessen the action of the inflammatory cells. However, these therapies aim at suppressing the inflammation and are not successful in combating the underlying causes.
Options for treatment include:
Steroids: One of the primary features of steroids is to decrease inflammation, however in people with AA, steroids are employed to stop the body?s immune cells from doing damage to hair follicles. Your physician may inject steroids straight into your bald patches or may suggest a topical steroid cream you could apply to the bald patches at home.
Once the condition is too substantial to take care of with multiple injections or topical creams, oral steroids are an option. Generally, you only take them for a brief time period due to many unwanted side effects of long-term use, such as osteoporosis, very fragile skin, and diabetes.
Minoxidil: This medication works because hair regrowth is a side effect of the drug that could have an effect on bald spots. You put it on directly to the bald patches. Minoxidil is commonly used to treat pattern baldness, but for unknown reasons it also sometimes helps patients with AA.
Cyclosporine: This potent immunosuppressant particularly inhibits T cells, the immune system cells that strike at follicles of hair in AA. Cyclosporine is frequently given orally. It?s more frequently used to help remedy other problems such as psoriasis, and many physicians are reluctant to put it to use as medicine to treat AA since it may cause kidney damage, high blood pressure, and curb your body?s immune system.
DNCB: This chemical substance (full name dinitrochioro benzene) rapidly produces skin sensitivity. In certain individuals with severe alopecia areata, extended applying of DNCB (enough to make a continuing rash brought on by the activation of white blood cells to boost the local immune functionality). This triggered hair regrowth in some individuals. It doesn?t often work, however. You should take DNCB only under the strict supervision of a doctor who?s familiar with this treatment.
A study showed effectiveness of aromatherapy essential oils (cedarwood, lavender, thyme, and rosemary oils) in some patients. As with many chronic disorders for which there is no single treatment, a variety of remedies are promoted which in fact have no benefit. There is no known effective method of prevention, although the elimination of emotional stress is felt to be helpful. No drugs or hair-care products have been associated with the onset of alopecia areata. Much research remains to be completed on this complex condition.