While there might be a handful of causes of hair loss, alopecia is the type that affect all hair bearing cells in the body. This non-scarring type of hair loss can manifest in many different patterns. Although it is a benign condition, it can cause emotional and psychosocial distress. The type of alopecia areata (AA) that causes emotional damages is alopecia areata on head and beard. Because this is the most type that affects self confidence and external look, specially in women.
What is Alopecia Areata ?
AA is an acquired skin disease that can affect all hair-bearing skin. It is characterized by localized areas of non-scarring hair loss. Alopecia Areata on head causes small, coin-sized, round patches of baldness on the scalp. Although hair elsewhere such as the beard, eyebrows, eyelashes, body and limbs can also be affected. It is not possible to predict how much hair will fall. In some people it can involve the whole scalp (alopecia totalis) or even the entire body and scalp (alopecia universalis). Regrowth of hair in typical AA is usually over a period of months or sometimes years.
Researchers believe AA is an autoimmune disease such as rheumatoid arthritis, but in this case the individual’s own immune system attacks hair follicles instead of bone joints. Just why or how AA develops is not clear. For whatever reason, the immune system inappropriately attacks hair follicles. Typically, it starts as one or more bald, smooth patches on the scalp, which are not scaly. It tends to affect the pigmented hair so there may be some white hairs left within the bald area in older people. Sometimes the hair loss is diffused rather than well-circumscribed patches.
Alopecia Areata on head
AA can affect men, women, and children. It often appears as circular bald patches on the scalp. Many people will get just one or two patches, but for some the hair loss can be extensive. Unfortunately, children who develop AA before puberty are most likely to develop more extensive and persistent hair loss.
Alopecia Areata on head happens due to inflammation. The cause of this inflammation is unclear but it is thought that the immune system, the natural defence which normally protects the body from infections and other diseases, may attack the growing hair. Why this might happen is not fully clear. Someone with Alopecia Areata is slightly more likely than a person without it to develop other autoimmune conditions such as thyroid disease, diabetes, lupus and vitiligo. Although the risk of getting these disorders is still very low. Alopecia totalis is hair loss that spreads to cover the entire scalp.
The hair loss can be quite sudden, developing in a matter of a few days and it may happen anywhere on the scalp. The patch is usually smooth bald skin with nothing obvious to see beyond the absence of hair. Unlike other autoimmune diseases, the target of the inflammatory response in Alopecia Areata on head, the hair follicles, are not completely destroyed and can re-grow if the inflammation subsides.
What are the symptoms?
There may be a tingling sensation in the scalp. It can be a very upsetting condition, especially if the bald area are too obvious to cover with hairstyles. If AA affects the eyelashes, then the eyes may become sore due to dust, particularly in dry and windy conditions.
People with mild early alopecia areata may need no treatment, as their hair is likely to come back anyway without it. Some treatments can induce hair growth, though none is able to alter the overall course of the disease. There are a range of treatments for AA, but none are effective for everyone. Some people with AA don’t respond to any treatment. Because some of the available treatments have a high risk of side effects, they are often not suitable for children. Available treatments include:
- Steroid creams and scalp applications.
- Local steroid injections
- Also steroid tablets.
- Dithranol cream
- Contact sensitisation treatment.
- Ultraviolet light treatment (PUVA)
- Minoxidil lotion.
- Tofacitinib and ruloxitinib are potentially new immunosuppressive treatments for AA.