alopecia areata

Is My Hair Loss Due to Alopecia Areata?

Experiencing hair loss can be extremely distressing, and is an affliction that can affect men, women and children. The first step that needs to be taken when dealing with hair loss is to determine the underlying cause, after which the relevant treatments and solutions can be sought. 

One condition that results in hair loss, across all ages, is an autoimmune disease known as alopecia areata. In any autoimmune disease, the immune system attacks the body, and in the case of alopecia areata, the immune system specifically attacks the hair follicles which results in hair loss. 

Alopecia areata effects about 5 percent of people but is in no way contagious or started as a result of nerves and anxiety. The severity of the disease will vary from person to person, with some people losing hair in a few spots, while others might lose large clumps of hair. The hair loss could be on the scalp, as well as the body – really anywhere hair grows. 

Alopecia areata could last for many years, or return at a later stage in your life. If you’ve noticed a lot of extra hair on your pillow, brush, or in the shower drain – or if you’re experiencing unusual bald spots – then you might have alopecia areata. 

What types of Alopecia are there?

With all forms of alopecia, the body’s immune system effectively attacks healthy hair follicles on the scalp and body, causing them to slow down production and effectively stop hair growth. The evidence of this is sudden hair loss, however, there are different types of alopecia with varying degrees of hair loss:

  • Alopecia areata – this is the most common and well-known type of alopecia, and generally results in one or more coin-sized bald patches (usually round or oval) on the scalp or other areas of the body. 
  • Persistent patchy alopecia areata – this is when patchy scalp hair loss continues over a long period of time without ever developing into extensive alopecia areata.
  • Alopecia totalis – this is the total loss of hair on the scalp.
  • Alopecia universalis – this is the total loss of hair on the scalp, face and body. 
  • Diffuse alopecia areata – this results in a sudden thinning of the hair on the scalp but is often mistaken for other types of hair loss such as male or female-pattern hair loss, or telogen effluvium. 
  • Ophiasis alopecia areata – this is a unique pattern of hair loss where the occipital region (sides and lower back of scalp) loses hair, resulting in a band-shaped balding pattern. 

Alopecia areata might develop into alopecia totalis or alopecia universalis if left untreated, but in most incidences, it will remain in its original patchy state. Depending on the type of alopecia experienced, hair loss and re-growth could be unpredictable and even cyclical. 

What are the symptoms of alopecia areata?

While the most common symptom for alopecia areata is understandably hair loss in men, women and even children, there is no way to predict the pattern of hair loss or re-growth. Here are some indications that hair loss is actually alopecia areata and not another condition:

  • Small, round patches of hair loss on the scalp, face or body.
  • Sudden hair loss over a short time period.
  • Asymmetrical hair loss, particularly on one side of the scalp. 
  • Hair loss and regrowth at the same time in different areas of the body (six to 12 months).
  • The emergence of ‘exclamation point’ hairs which are narrow at the base.
  • Sudden rows of indentations on the fingernails. 

If you recognise any of these alopecia areata symptoms in yourself, it is important to consult a doctor for a medical diagnosis before any treatment options are explored. 

What causes alopecia areata?

There is still a lot that is unknown about what actually causes this particular autoimmune disease, with viruses, bacterium and external factors still being considered. Understandably, men and women with alopecia areata might be concerned that they will pass it on to their children. Unfortunately, the complexity of the disease makes it difficult to accurately determine whether parents are likely to pass it on to their offspring or not. 

As a polygenic disease, both parents would have to contribute a number of specific genes for a child to develop alopecia areata, which means it is less likely to be hereditary. In fact, many scientists believe there are multiple factors – genetic and environmental – that trigger alopecia areata, making the risk of a child inheriting the disease quite small (although not non-existent). 

Alopecia areata in children

While there is no set rule for when alopecia areata will become evident, it often appears in childhood and is something that the child will have to learn to live with. Children under the age of five years generally experience little emotional difficulty as a direct result of the disease. This is most likely to change as they get older, particularly in teenage years when body awareness and self-image is heightened. 

Parents can start researching treatment options and hair loss solutions early on as a way to address self-confidence issues, and support groups are always a great space for sharing and insight.

What are the treatments?

Alopecia areata is currently an incurable disease although there are possible treatment options for those living with the condition. One of the benefits is that, even during an ‘active’ phase of the disease, the hair follicles remain alive which means hair could grow back again at any point. For those wanting to address the hair growth without waiting, then here are some treatment options available:

  • Corticosteroids – these anti-inflammatory drugs are prescribed for autoimmune diseases in a variety of forms (injections, pills, ointment, cream and foam) but they can take some time to show results. 
  • Minoxidil/Rogaine – this is a treatment for both alopecia areata and pattern baldness and is placed directly on the scalp. Results will show in about 12 weeks. 
  • Topical immunotherapy – chemicals are placed on the scalp to produce an allergic reaction which actually triggers hair growth. Treatment may need to be repeated to encourage hair growth. 
  • Other treatment options to consider are laser therapy, surgical hair replacement therapy or mesotherapy. 

Alopecia areata does not cause rashes and inflammation, however, it is important to protect the exposed skin to prevent damage from sun exposure. Outside of medical treatments, wearing wigs, hats or scarves will assist in covering the hair loss and protecting the skin.