What Is Alopecia and Can It Be Treated?
March 28, 2022 by Adam.lueken
With recent events, a spotlight has been shown on a widespread cause of hair loss – alopecia. But what is this condition, who does it affect and can it be treated?
Alopecia is an autoimmune disease that causes hair loss for both adults and children. This can occur on the scalp as well as on the body, such as eyebrows, eyelashes and facial hair. This happens when the immune system mistakenly attacks the body’s hair follicles, causing them to fall out and stop growing. It’s estimated that alopecia areata affects over 6.5 million people in the U.S. Often, those who have/had a blood relative with the disease have a greater chance of developing it. It usually begins during childhood and teenage years. However, it can start at any age and affects all races and genders.
There are four types of alopecia you can be diagnosed with, based on the amount and distribution of hair loss:
- Alopecia areata: This is the most common type and is characterized by round patches of hair loss, mainly on the scalp.
- Alopecia totalis: Loss of all hair on the scalp.
- Alopecia universalis: Loss of all hair on the body (most rare type).
- Traction alopecia: Non-disease related, but hair loss caused by repeated pulling or putting tension on hair, such as wearing tight ponytails, buns, braids, etc.
Typically, those with alopecia are otherwise healthy and don’t develop other autoimmune diseases. However, having one autoimmune disease can increase the risk of developing another one. For example, alopecia can increase the risk of getting vitiligo, a condition that causes the skin to lose its color. Alopecia also increases the risk of developing allergic conditions like eczema, asthma or nasal allergies. Since alopecia areata doesn’t destroy hair follicles, hair will likely regrow. But this varies from case to case. Hair can also fall out again even if it does regrow. The cycle of hair loss and growth is unpredictable.
A board-certified dermatologist can often diagnose the disease by inspecting the areas with hair loss. Sometimes removing a few hairs for biopsy (microscopic exam) may be necessary. Your scalp may also need to be examined with a dermatoscope. This can help provide a clear view of the hair follicles and assist in diagnosing.
Often, hair will regrow without treatment, although it can be slow. And many don’t get the regrowth they want or expect. There are treatment options that can help with alopecia areata. Depending on the amount and areas of hair loss, treatment plans can include the following options.
Corticosteroids can help calm the immune system so it doesn’t attack hair follicles. When treating in adults, corticosteroids may be injected into the spots with hair loss. Several shots will be needed every four to six weeks. When successful, patients typically see hair regrowth within three months of the first injection. A corticosteroid cream may also be prescribed to apply daily to bare spots. Hair growth can start after three to four months after this treatment. A combination of topical and injectable corticosteroids has shown to be effective.
Minoxidil is a topical medication that comes in various strengths, with the 5% solution or foam being the most effective for alopecia areata. When successful, signs of hair growth usually start around 12 weeks.
Anthralin is a tar-like substance that also calms the immune system. It can be rubbed daily on areas needing regrowth and left on the skin for 15-20 minutes. If successful, hair growth is usually seen in treated areas in three to four months.
Topical Immunotherapy can be recommended for extreme hair loss and includes chemicals like squaric acid, dibutyl ester or diphencyprone. When applied to the skin, these cause an allergic reaction that triggers the body to wake the hair follicles, which can result in hair regrowth. If successful, regrowth can take up to three to four months.
Oral treatments may be recommended, including prednisone, methotrexate, cyclosporine or other immunomodulators. These can have side effects, so discuss with your dermatologist.
Alopecia can lead to a poorer self-image, lower self-esteem, and a higher amount of anxiety for both men and women suffering from this condition. But with the treatment options discussed (among others), successful hair regrowth can be achieved. If you’ve noticed signs of hair loss or autoimmune symptoms, consult with a board-certified dermatologist to discuss treatment options best suited for you.