Alopecia Areata: Causes, Symptoms & Treatment

Written By: Dr. Maha Sultan

Dr. Maha Sultan is a Specialist in the Department of Dermatology at the Jumeirah branch of Medcare Medical Center. She obtained her basic medical education – an MBChB, followed by an MD and MSc in Dermatology and Venereology, all from the Al-Azhar University’s Faculty of Medicine for Girls in Egypt. She is a member of many national and international societies like IMCAS and EMS.

Updated On:February 14, 2024

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What is Alopecia Areata?

Hair loss in patches is a symptom of the disorder alopecia areata. These patches might unite and then stand out more. When your immune system destroys the hair follicles, a disorder called alopecia areata develops. Alopecia areata can start in adolescence or later in life. Additionally, it varies from person to person but can have an impact on persons of any age, sex, or ethnicity.

Causes of Alopecia Areata

White blood cells target the cells that make up the hair follicles, causing the cells to contract and significantly impede the growth of new hair. It is unclear why the immune system specifically targets hair follicles in this way.

Even though the precise cause of these alterations is uncertain, those who have a close family member with the illness are more likely to suffer from alopecia areata.

Symptoms of Alopecia Areata

Patchy hair loss is the most typical symptom of alopecia areata. Small coin-sized hair flakes start to fall out, usually from the scalp. But any place where hair grows could be impacted, including the beard and eyelashes.

Several days or even a few weeks may pass before hair loss can be seen. Prior to hair loss, there may be burning or itching in the area. New hair can grow if the inflammation in the hair follicles goes down since the hair follicles are not destroyed. People who only have a few hair loss patches usually make a full recovery on their own without the need for any kind of medical help.

When to see a doctor for Alopecia Areata?

Make an appointment with your dermatologist if you are having persistent hair loss and you want to get treatment.

A dermatologist should be consulted if your hair starts to fall out suddenly, in patches, or more frequently than usual while being brushed or bathed. The sudden loss of hair may be a sign that there is a medical issue that needs to be addressed.

Alopecia Areata Risk Factors

Researchers are unsure of the precise cause of alopecia areata. Several acknowledged possible risk factors exist, including:

  • Hereditary factors, such as having a family cousin with alopecia areata
  • Having Down Syndrome, thyroid issues, or vitiligo, among other conditions
  • Vitamin D deficiency
  • Nivolumab-induced alopecia areata from the cancer drug nivolumab; the drug's ability to treat certain conditions is demonstrated by hair loss.

 

Alopecia Areata Complications

As a result of their hair loss, people with alopecia are generally more likely to have socio-psychological issues like anxiety and sadness. If left untreated, alopecia can cause lifelong hair loss, embarrassment, and psychosocial struggles for adults and children. Moreover, the complications of alopecia would be the same as the underlying disease if it is related to another condition such as hypothyroidism, syphilis, Cushing syndrome, malnutrition, or systemic lupus erythematosus.

Alopecia Areata Diagnosis

Alopecia areata is typically pretty simple for doctors to identify by looking at symptoms. They could examine hairs from the affected areas under a microscope and gauge the extent of hair loss.

A skin biopsy might be done if the doctor is unable to diagnose the patient following an initial clinical examination. A blood test may be used if they need to rule out other autoimmune illnesses.

Making a diagnosis of alopecia areata is typically rapid and simple because the symptoms are so striking.

Alopecia Areata Treatment

When patients exhibit symptoms of alopecia areata, a dermatologist will frequently examine their hair, nails, and scalp under a derma scope to look for any indications of the condition. A dermoscopy is a portable visual magnifying tool used by medical professionals to assess skin lesions. Doctors may request a blood test in specific circumstances to find out more.

After making a diagnosis, a dermatologist could wait to start therapy to see whether hair might grow back naturally. Options for treatment, if necessary, will depend on a number of variables, which may include: Age, degree of hair loss, and where hair is lost.

The dermatologist may try several therapies to relieve symptoms because not everyone reacts to treatment in the same manner. Treatment choices could be:

  • Applying lotions or ointments to the skin directly for topical therapy
  • Injectable treatments
  • Medications that influence the immune system

With their doctor, patients should go over the various therapy options and develop a treatment strategy.

People with alopecia areata need to cover their heads or apply sunscreen to their scalps to protect themselves from the sun's harmful rays. Wearing sunglasses or applying artificial eyelashes or stick-on eyebrows for persons who have lost their eyelashes or eyebrows may help protect the eyes.

Alopecia Areata Prevention

Alopecia areata is an autoimmune condition with unknown causes; hence, there are no known strategies to stop it.

References

Delamere, F. M., Sladden, M. J., Dobbins, H. M., & Leonardi-Bee, J. (2008). Interventions for alopecia areata. Cochrane database of systematic reviews, (2).

Hordinsky, M. K. (2013, December). Overview of alopecia areata. In Journal of Investigative Dermatology Symposium Proceedings (Vol. 16, No. 1, pp. S13-S15). Elsevier.

MacDonald Hull, S. P., Wood, M. L., Hutchinson, P. E., Sladden, M., & Messenger, A. G. (2003). Guidelines for the management of alopecia areata. British Journal of Dermatology149(4), 692-699.

Pratt, C. H., King, L. E., Messenger, A. G., Christiano, A. M., & Sundberg, J. P. (2017). Alopecia areata. Nature reviews Disease primers3(1), 1-17.

Rajabi, F., Drake, L. A., Senna, M. M., & Rezaei, N. (2018). Alopecia areata: A review of disease pathogenesis. British Journal of Dermatology179(5), 1033-1048.

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