Alopecia areata is a disease that affects the hair follicles. It usually causes hair to fall out in small, round patches about the size of a quarter. Although many people with alopecia areata will have only a few bare patches, some people may lose more hair. In rare cases, alopecia areata can cause complete loss of hair on the head (alopecia areata totalis) or complete loss of hair on the head, face, and body (alopecia areata universalis).
Who Gets Alopecia Areata?
In the United States, it is estimated that alopecia areata has affected four million people. It affects both men and women of all ages and ethnic backgrounds, and it usually begins in childhood. The disease tends to run in families. Approximately one in five people with alopecia areata will have a family member who is affected with alopecia areata.
Alopecia areata is an
autoimmune disease. Normally, the immune system protects the body against infection and disease. However, in an
autoimmune disease, your immune system mistakenly attacks a part of your own body. In alopecia areata, the immune system attacks the hair follicles.
Scientists do not know why the immune system attacks hair follicles in alopecia areata. However, scientists do believe that a person's genes may play a role in triggering the attack on the hair follicles.
Common Symptoms
It is important to note that alopecia areata is not a life-threatening disease. It does not cause any physical pain, and people with alopecia areata symptoms are generally in good health.
The most common symptom of alopecia areata is hair loss. In most cases, hair falls out in small, round patches. Although many people with the condition get only a few bare patches, some people may lose more hair. The effects of alopecia areata are primarily socially and emotionally disturbing.
Alopecia areata varies from person to person. Hair may continue to fall out, or hair loss may stop. The hair you have lost may or may not grow back, and you may or may not continue to develop new bare patches.
Current Treatment for Alopecia Areata
There is no cure for alopecia areata, and there are no medications that are approved for
alopecia areata treatment. However, doctors may prescribe medications that are approved for other diseases to help hair grow back. Talk to your doctor about how to best
treat alopecia areata.
The following treatments may help hair grow back. However, none of them will prevent new patches of hair loss or cure alopecia areata.
Corticosteroids
Corticosteroids are drugs that reduce swelling and pain and affect the immune system. Corticosteroids may be given in three ways:
- Injected in the skin
- Swallowed as pills
- Rubbed on the skin as a cream or ointment.
Other Topical Medicines
Drugs that are rubbed on the skin as a cream or lotion include:
- Minoxidil (5 percent)
- Anthralin
- Squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP).
Immune System Medicine
Drugs that affect the immune system include:
Photochemotherapy
In photochemotherapy, a person is given a drug called a psoralen, which is affected by light. The drug can be swallowed or rubbed on the skin. Once the drug is taken or applied, the area with hair loss is exposed to an ultraviolet light source. This combined treatment is called PUVA (psoralen and ultraviolet A).
Alternative treatments for alopecia areata include:
- Acupuncture
- Aromatherapy
- Evening primrose oil
- Zinc
- Vitamin supplements
- Chinese herbs.
Alternative therapies have not been studied in clinical trials and they may or may not help hair grow back. In fact, alternative therapies may cause more hair loss. Talk with your doctor before trying any alternative therapies.
Prognosis
The course of alopecia areata is highly unpredictable. You may continue to lose hair, or your hair loss may stop. The hair you have lost may or may not grow back, and you may or may not continue to develop new bare patches.
Living With Alopecia Areata
Living with alopecia areata should not affect activities such as going to school, working, marrying, raising a family, playing sports, and exercising. The condition does not cause pain and it does not make you feel sick. You cannot give alopecia to others, and those who have the disease are, for the most part, healthy in other ways.
Coping With Alopecia Areata
- Learning as much as you can about the disease
- Talking with others who are dealing with alopecia areata
- Learning to value yourself for who you are, not for how much hair you have or don't have
- Talking with a counselor, if necessary, to help build a positive self-image.
Tips on how to reduce the physical dangers or discomforts of hair loss include:
- Using sunscreens for the scalp, face, and all exposed skin
- Wearing eyeglasses (or sunglasses) to protect eyes from sun, dust, and debris, when eyebrows or eyelashes are missing
- Wearing wigs, caps, or scarves to protect the scalp from the sun and to keep the head warm
- Applying antibiotic ointment inside the nostrils to help keep germs out of the nose when nostril hair is missing.
Tips on how to reduce the effects of alopecia areata on your looks include:
- Wearing a wig, hairpiece, scarf, or cap
- Using a hair-colored powder, cream, or crayon applied to the scalp to make hair loss less obvious
- Using an eyebrow pencil to mask missing eyebrows.
Research on Alopecia Areata
Researchers are seeking a better understanding of the disease by studying:
- Genes
- Hair follicle development
- The immune system
- Drugs and treatments for other autoimmune diseases like rheumatoid arthritis and lupus
- Better ways to get drugs directly to the hair follicles
- Stem cells in the skin.
