Hair Loss Causes
Alopecia areata is an unpredictable autoimmune skin disease that affects approximately 1.7% of the US population, according to the National Alopecia Areata Foundation. It often appears first in childhood and its most benign form presents as non-inflamed bald spots on the scalp. Alopecia areata can progress to total hair loss on the scalp (alopecia totalis) or complete hair loss all over the body (alopecia universalis).
In alopecia areata, the pattern of hair loss is usually diffuse, and eyebrows, eyelashes and beards may also be affected. During active hair loss, “exclamation mark” hairs are often seen: broken-off hairs 3-4 millimeters in length that taper in width from the end of the hair. Diagnosis of alopecia areata may be made through a hair biopsy. Viewed under a microscope, affected individuals’ hairs usually contain lymphocytes (white blood cells) within the hair follicles.
In the majority of cases, hair regrowth occurs spontaneously within about one year. However, for individuals affected early in life and/or who exhibit larger bald patches, regrowth is less certain, and the condition may also be associated with hypersensitivity to environmental allergens (a condition called “atopy”). Many people affected by alopecia areata experience recurrent episodes during their lifetime.
The underlying cause of alopecia areata, alopecia totalis and alopecia universalis is unknown. Studies suggest that the body’s inflammatory response somehow begins to attack hair follicles, an event that precipitates hair loss. The process continues unless the immune response is somehow halted, either spontaneously or with drug therapy. Approximately 20% of affected individuals have a family history of the condition. Moreover, the occurrence of alopecia areata is often linked with other autoimmune conditions, such as atopy (allergy) or lupus erythematosus.
Treatment
No cure exists for alopecia areata. The most effective treatment often includes a combination of different therapies, depending on the extent of hair loss. In mild cases, steroid injections are given and hair regrowth usually occurs within a few weeks. Minoxidil, which is indicated for treating androgenetic alopecia, has also been prescribed to treat alopecia areata. Oral cortisone is often given to people with more significant hair loss, but is associated with side effects over longer-term use. Topical treatments include corticosteroids, cyclosporine (an immunosuppressive agent) and anthralin, a synthetic substance primarily used to treat psoriasis.
Permanent hair cosmetics are a common drug-free approach to coping with hair loss caused by alopecia areata.