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Alopecia is an autoimmune disorder that causes excessive hair loss without any prominent reason. Alopecia primarily causes hair loss on the scalp but can also affect eyebrows, eyelashes, face, or other body parts.

 

What is Alopecia?

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Partial or complete loss of hair is called alopecia. A few alternative names that are associated with alopecia is loss of hair, baldness, scarring alopecia, non-scarring alopecia just to name a few. One of the most common types of alopecia is alopecia areata a condition in which the body’s immune system attacks its own hair follicles resulting in rapid hair loss. Alopecia areata begins with small bald patches but can affect wider areas on the scalp.

Alopecia areata is a common condition that affects nearly 147 million people worldwide. While in the US, Alopecia affects almost 6.8 million people with a lifetime risk of 2.1%, according to the National Alopecia Areata Foundation.

In many cases of Alopecia, hair regrows after a while; however, it can fall again. Alopecia can affect any person regardless of gender, ethnicity, age, or race and can develop in adulthood or childhood. It mostly develops in

people before age 30 and is different for everyone.

 

Causes of Alopecia

In Alopecia, the white blood cells attack the cells in the hair follicles resulting in hair loss. The exact cause of Alopecia is unknown as it can affect an otherwise healthy-looking individual.

Scientists are unable to find the root cause of why the immune system behaves this way and attacks the hair follicles. They attribute multiple factors which lead to Alopecia. However, it is observed that Alopecia occurs due to genetics. Almost one in every five people who develop Alopecia has a family member diagnosed with the condition.

Many scientific researches have shown that people who have a family history of Alopecia have a family history of many other autoimmune disorders such as atopy, thyroiditis, and vitiligo.

People with Down’s syndrome also experience Alopecia.

Alopecia is not hereditary as it is a polygenic disease meaning that both parents need to contribute a significant number of genes to make it appear in the progeny. As a result, parents don’t pass Alopecia to their children. In the case of identical twins, if one has it, there is a 55% chance that the other twin would also develop it.

Many people assume that Alopecia results due to stress; however, that is not true as there is minimal scientific data to support the cause. Some cases of extreme stress may lead to hair fall, but many researchers conclude genetics to be the primary reason for Alopecia.

 

Another case of Alopecia is known as nivolumab-induced alopecia. This condition occurs in people being administered nivolumab, a drug to cure cancer. If hair loss occurs in such treatments, then it means that the drug is working.

While Alopecia is an autoimmune disorder, hair loss may occur due to many significant factors such as:

Aging: Hair loss mostly occurs due to aging, especially characterized by male-pattern and female-pattern baldness. This type of hair loss is known as androgenic Alopecia. It is a gradual process of hair loss resulting in a receding hairline in men and thinning hair in the crown of women’s scalp.

Hormonal Changes: Hair loss may also occur due to hormonal changes as a result of pregnancy, childbirth, or menopause.

Medical Conditions: Alopecia areata is a leading cause of hair loss. Scalp infections such as Ringworm and Trichotillomania, an obsessive hair-pulling disorder, also causes temporary or permanent hair loss.

Medications: Certain drugs and medications used to treat cancer, arthritis, heart problems, gout, high blood pressure and depression also cause hair loss.

Stress: Some people experience hair thinning a few months after a shocking or stressful incident.

Hairstyles: Pulling your hair tight and making certain hairstyles such as cornrows or pigtails can cause traction alopecia, hair loss associated with excessive hair pulling due to hairstyling. Using heating tools or hot oil excessively can also lead to hair loss.

Nutrition: Poor nutrition, vitamin D deficiency, and rapid weight loss also cause hair loss.

 

Types of Alopecia

Alopecia is not just limited to the scalp. It can affect many body parts such as the chest, eyebrows, eyelashes, beard, arms, or legs. There are different types of Alopecia, such as:

 

  • Patchy Alopecia areata

Coin-sized bald patches appear on the scalp, which may affect other body parts too. The patches may regrow after some time.

 

  • Persistent Alopecia areata

Alopecia areata which continues for a long time without transforming into Alopecia totalis or Alopecia universalis is known as persistent Alopecia areata.

 

  •  Alopecia totalis

If Alopecia causes complete hair loss on the entire scalp, this condition is known as Alopecia totalis.

 

  • Alopecia universalis

If hair loss is observed in the entire body, this condition is known as Alopecia universalis.

 

  • Diffuse alopecia areata

This type of Alopecia resembles male-pattern or female-pattern baldness and results in extensive hair thinning all over the scalp.

 

  • Ophiasis alopecia

If hair loss occurs on the sides and the lower back of the scalp, then this is known as Ophiasis alopecia.

 

 

Symptoms of Alopecia

The most noticeable symptoms of Alopecia are the development of quarter-sized bald patches (Alopecia areata) on the scalp and hair loss. They can also form on the beard, eyebrows, or other parts of the body. The hair loss is sudden and may extend from a few days to several weeks.

Alopecia can affect fingernails too. Some of the symptoms of Alopecia are:

  • Many people experience a burning and stinging sensation on the affected areas before hair loss.
  • Significant hair loss within a short period and on one side of the scalp.
  • Chunks of hair fall out and accumulate on the pillow and
  • Formation of white spots and lines on the Nails also lose their shine and become brittle.
  • White hair appears on the affected
  • Occurrence of cadaver hair where hair break before reaching the skin’s
  • Formation of exclamation mark hairs (hairs that are narrow at the bottom) at the base of the

The good news is that hair regrows after a while as the hair follicles are not completely destroyed. Once the inflammation subsides, the hair starts regrowing and covering the bald patches.

You can witness full hair regrowth even if you have more than 50% hair loss. About 30% of people with Alopecia report that they experience an extensive cycle of hair loss and hair regrowth.

More than half of people with Alopecia recover within a year. Only 10% of individuals experience chronic Alopecia and Alopecia totalis or Alopecia universalis.

 

Hair Loss Prevention

Some types of genetic hair loss, such as male-pattern baldness, are irreversible but considering the following tips can lead to hair restoration and protection.

  • Avoid pulling your hair when wet. Use a detangler or a wide-toothed comb to brush your Limit your use of hair styling tools and hot oil treatments. Keep your hair loose and avoid using too many rubber bands or pulling your hair tight to prevent traction alopecia.
  • Deep Conditioning can add strength to the scalp and hair shaft
  • Avoid hair styles that create excess tension and pulling
  • Ask your doctor about the medication and treatments you are taking and see if they are causing hair loss.
  • Wear a cap when going out and protect your hair from direct
  • Ask your doctor to give you a cool cap during chemotherapy sessions to prevent rapid hair loss.
  • Seeking the treatments of a non-invasive hair replacement specialist is a viable option
    • Scalp Micro Pigmentation
    • Platelet Rich Plasma (PRP)
    • Microneedling

Hair Loss Treatment

Hair loss is treatable in most cases the hair follicles can be rejuvenated. There are treatments and therapies that can be effective and produce visible results. Scalp micropigmentation is a non- invasive procedure that uses microneedles to inject pigment into the scalp precisely duplicating one’s natural hair follicles and color. Platelet-rich plasma (PRP) is a preparation of plasma from their own blood with concentrated platelets containing various growth factors and cytokines that enhance the body’s innate capacity to repair and rejuvenate hair follicles. There are also certain medications that can lead to hair restoration and hair regrowth. The most prescribed drugs to treat Alopecia are corticosteroids that suppress the immune system. They can be taken orally, applied as an ointment, or injected. Consult your doctor before starting any medication as every Alopecia case is different, and not every medication may work for you.

References:

  1. https://www.niams.nih.gov/health-topics/alopecia-areata
  2. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc- 20372926
  3. https://www.naaf.org/alopecia-areata
  4. https://www.medicalnewstoday.com/articles/70956#Causes
  5. https://www.healthline.com/health/alopecia-areata#diagnosis

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