Hair fall is a common condition in all human beings. Every day shedding 50 to 100 hairs is common. There are many common causes behind daily hair fall up to the 100 mark.
However, there is one more reason why hair fall occurs alongside pollution, medication, pregnancy, harsh chemical usage, and using hard water. In fact, for that reason, hair fall is much more severe than regular one. The condition is alopecia areata, a disease associated with the immune system.
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When the immune system attacks the hair follicles and causes hair loss, hair can be shed from any part of the body, usually the head and face. In this condition, the hair falls out in typical round patches the size of a quarter. But in some cases, the hair loss is more extensive.
Most people with alopecia areata don’t have any other symptoms. And the stages of alopecia areata differ from one person to another. In some people, hair loss occurs all their lives, while others only experience it just once.
Though recovery is unpredictable, it’s not impossible. Though there is no allocated treatment modality for alopecia areata, there are treatments that can help the hair grow back more quickly.
If you are suffering from alopecia areata or curious about the disease, this article will help you gather authentic information. This article will discuss the symptoms, causes, and the best treatment methods used by trichologists to treat alopecia areata.
So without further ado, let’s start reading the article until the end.
What Is Alopecia Areata?
In simpler words, alopecia areata is an immunity-related ailment in which the immune system erroneously bouts a part of the body; in the case of alopecia areata, it is the hair.
In a person with alopecia areata, the cells in their immune system collaboratively surround and attack their hair follicles and cause the attached hair to shed.
The more hair loss occurs, the immune system attacks the hair follicles.
It is also important to note that when this attack occurs, and hair starts falling, it rarely destroys hair follicles. This means there is still a chance for the hair to regrow. The less hair fall occurs, the more likely a person can regrow the hair.
What Are The Types Of Alopecia Areata?
Though hair loss is the only symptom in alopecia areata, there are several different types of the same disease. And we have divided the types of alopecia areata into categories-primary and secondary.
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Primary Types Of Alopecia Areata
- Patchy Alopecia Areata: Patchy alopecia areata is the form in which one or more patches of the size of a coin occurs on the scalp or other parts of the body with hair. Sometimes this alopecia areata may convert into alopecia Totalis (where hair loss occurs across the scalp) or alopecia Universalis (where the whole body loses hair). But most commonly, it appears patchy.
- Persistent And Patchy Alopecia Areata: Patchy alopecia areata appear by patchy scalp hair loss that sustains for a long time without converting into extensive alopecia areata such as alopecia Totalis or Universalis.
- Alopecia Totalis: Totalis alopecia is a chronic condition in which the complete hair from the scalp starts shading. A tiny percentage of patients suffering from alopecia areata may be diagnosed with totalis. The treatment outcomes become best when the disease is recognized early.
Many genetic and environmental factors impact the development of alopecia totalis. However, familial studies are there to support the genetic predisposition of the same disease. Also, in identical twins, the chance of getting alopecia totalis is as huge as 55%. Also, in a positive family history of alopecia areata, 20% of patients were diagnosed with alopecia totalis.
In genetic influence, where there is a 2% lifetime risk of developing alopecia areata, the risk of developing alopecia totalis is 0.03%. Alopecia totalis differs from the typical alopecia areata and the most severe alopecia Universalis.
- Alopecia Universalis: Alopecia Universalis is entirely dissimilar to other alopecia forms since it involves hair loss on the scalp and body. When a patient starts losing hair from their head and on different parts of their bodies, this can be a crucial sign of alopecia Universalis. The symptoms might include losing hair from the body, eyebrows, and eyelashes alongside the scalp.
Many patients also experienced hair loss from their pubic area and inside the nose during this condition. Sometimes, the patients do not have any other symptoms, although some itching or burning feelings in the affected areas can be noticed.
Secondary Types Of Alopecia Areata
- Diffuse Alopecia Areata: For patients who experience sudden and unexpected hair thinning across the scalp, it can be diffuse alopecia areata. But it is hard to diagnose the condition since it looks similar to other forms of hair loss, such as male or female pattern hair loss.
- Ophiasis Alopecia: In ophiasis alopecia areata, a unique pattern of hair loss can be seen that includes the lower back and the sides of the scalp losing hair in a shape of a band. This condition is more challenging to treat than other types of alopecia areata because this condition does not respond to medication quickly.
What Are The Causes Of Alopecia Areata?
As mentioned earlier, alopecia areata is an autoimmune disease in which the immune system itself attacks the cells of the body, in this case, the hair follicles.
During such a situation, the hair from a person’s head starts falling out, often in the size of a coin and the shape of a quarter. However, the extent of hair loss may vary from one person to another, and in some cases, it is only in just a few spots. But there are also cases in which the patients lose hair more significantly.
However, doctors do not know why alopecia areata happens. But most people who get it have attained it from their genes. Therefore, doctors believe that genetics make alopecia areata more likely to run in the family. If a person has the genes of alopecia areata and something happens to them that triggers hair loss, they can develop alopecia areata.
You are more likely to get diagnosed with alopecia areata if you have the following:
- Someone in your family with alopecia areata
- Asthma problem
- Seasonal allergies
- Down syndrome
How Is Alopecia Areata Diagnosed?
As we mentioned earlier, there are no other symptoms than losing hair in patches in the case of alopecia areata. Then it might be a massive question of how doctors diagnose alopecia areata. People also wonder how to differentiate between alopecia areata with common hair fall problems since, in both cases, hair shedding is mutual.
Approximately one in 50 people suffer from alopecia areata at some point. And males and females of all races are equally at risk of alopecia areata if they have the trigger mentioned above.
Humans at any age can develop alopecia areata, although, in most people, it develops before the age of 30 for the first time.
Alopecia areata is not a life-threatening disease and does not cause any physical pain. However, it might have psychological effects on the person since hair loss is devastating in the case of alopecia areata.
The diagnosis of alopecia areata is based on the appearance of hair loss. A healthcare provider with years of experience in trichology may diagnose the condition by looking at the characteristic patterns of hair loss, such as broken-off hairs around the head borders, smooth patches on the head, etcetera.
In some cases, the doctors also suggest getting a biopsy done by removing a tissue sample for the study. However, it is only necessary in some cases.
The doctors might also suggest getting a thyroid test alongside other lab studies to diagnose alopecia areata.
What Are The Treatment Options Available For Alopecia Areata
Not every patient diagnosed with alopecia areata require a serious statement plan. In many patients, it has been noticed that the hair regrows spontaneously after a while. But such a thing happens only when the disease is limited.
However, most doctors suggest treatments when the condition is more severe. And there are multiple treatment options available for alopecia areata, including:
- Corticosteroids: Corticosteroids, also known as steroids, are primarily anti-inflammatory medicines used to treat alopecia areata. Those medications can either be taken by injections, applied topically, or in shampoo format. Some patients are also prescribed corticosteroids to consume orally.
- Corticosteroid Injections: At times in adults, corticosteroid injections are prescribed, especially in adults with isolated patches of hair loss. In this treatment method, corticosteroid medications are injected directly into the affected area to promote hair growth. It may take up to 8 weeks for the patient to notice any new hair growth, and the injections can be repeated every four or six weeks until desired results are achieved. Some patients are also treated with topical anesthetic cream before the injections to reduce the discomfort and pain associated with those injections.
- Topical Corticosteroids: Some dermatologists or trichologists also suggest using topical corticosteroids as an alternative to injections. This treatment method is recommended for children or adults with very low tolerance to injections. Topical corticosteroids are applied directly to the affected area daily. Just like corticosteroid injections, topical corticosteroid is also prescribed to patients with isolated patches of hair loss. However, patients with excessive hair loss might not benefit from topical corticosteroids.
- Oral Corticosteroids: As mentioned earlier, some patients are also prescribed to consume oral corticosteroids. Patients experiencing extensive hair loss very fast are mainly suggested to use oral corticosteroids alongside another treatment module. Although oral corticosteroids can slow down hair loss and promote regrowth, long-term consumption of oral corticosteroids is strictly prohibited to avoid any severe side effects. Those medications are generally prescribed for a few weeks, and once the hair regrowth is noticed, their patients are suggested to stop the treatment.
- Topical Minoxidil: It is an over-the-counter medication that promotes hair regrowth. Minoxidil can lengthen the growth phase of hair follicles and triggers hair reproduction.
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Minoxidil is also prescribed for treating androgenetic alopecia, known as male pattern baldness. It can also help patients with mild alopecia areata. Minoxidil is available in solution or foam formulation that it’s prescribed to apply twice a day to the affected area. The medication can be used alone or in combination with other therapies. Once the medicine works for the patient, they can expect to notice hair regrowth in about 1 to 2 weeks. However, patients with severe alopecia areata or alopecia totalis might not get desired results using minoxidil.
- Anthralin: Initially, when Anthralin was developed, the scientists had another skin condition named psoriasis in mind. But later, the medicine was found to help regrow hair in some people with mild alopecia. Anthralin must be used with extensive care since it can irritate the skin and eyes alongside staining fabrics. Once the patient starts using the medication, hair regrowth can be seen within three to four months.
- Topical Immunotherapy: Topical immunotherapy means applying a specific substance that causes an allergic reaction to the area of hair loss. Due to the itching, irritation, and scaling, hair growth is often induced for reasons that are not medically identified yet.
Topically immunotherapy is not a very common treatment modality across the globe. Patients interested in trying it must talk to a dermatologist who is experienced with this treatment.
- Investigational Treatments: Every day, scientists and dermatologists are trying to find out new ways to treat alopecia areata. However, the drugs commonly known as Janus kinase inhibitors look promising, but more study is required to evaluate the efficiency and safety of those inhibitors for alopecia areata.
- Immunosuppressive Drugs: Medicines that suppress the immune system, such as methotrexate, cyclosporine, etc., are sometimes used to treat extensive alopecia areata. Though those medicines include huge risks and side effects, they are prescribed to patients with severe alopecia areata or those experiencing rapid progressive hair loss.
Cosmetic Treatments For Alopecia Areata
Since alopecia has a very negative impact on the quality of life, different types of treatment modalities are coming into existence to give patients good cures. There are some cosmetic treatments for alopecia areata alongside medications and other therapies. And now, we will discuss them one after the other.
This is a non-invasive technique in which active substances are induced below the epidermis via microinjections. The substances include vitamins, plant extracts, medications, and some bioactive compounds, including finasteride, minoxidil, and vasodilators. Those substances are injected intradermally or sometimes subcutaneously to help them reach the target tissues in the mesotherapy.
Many studies advocate the efficacy of mesotherapy in treating local pain, local fat contouring, and skin aging. However, some evidence-based studies to support the effectiveness of mesotherapy in treating alopecia areata are needed. In recent years trichologists and dermatologists are increasingly using this treatment for alopecia areata alongside other types of alopecia, including androgenetic alopecia and telogen effluvium.
How Is It Done?
Mesotherapy is started by taking consent from the patient. Afterward, the healthcare provider cleans the scalp with an antiseptic solution before giving the substances by intraepidermal papilla or point-by-point technique. A special needle is used to apply the substance.
The simple intradermal technique is the most used in mesotherapy. It takes up to 30 minutes to complete a session, and mesotherapy has no standardized frequency of sessions. The trichologist or dermatologist is the sole decider of the total number of sessions. However, two mesotherapy sessions can have 1 to 4 weeks of difference in between.
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How Does Mesotherapy Work?
Though it is not entirely known how mesotherapy works, there are several theories speculating the mechanism of its action. According to dermatologists, the skin is the point that gets stimulated and triggered by mesotherapy for sending inhibitory signals to the lateral medullary center of this spinal cord. Those signals are predicted to be produced either by needling or by the substances injected during mesotherapy. The negative signals are suggested to restore the mechanisms that cause alopecia.
In mesotherapy, the dermis is primarily targeted, including the neuronal, circulatory, and immune components. The epidermis and subcutaneous tissues are also affected by the procedure of injecting substances.
Mesotherapy aims to restore the Physiology that causes alopecia by stimulating different biological responses by injecting those active substances into the scalp. Additionally, needling mechanical stimulation also takes place, which enables mesodermal changes. For alopecia areata, mesotherapy prevents hair loss and activates new hair growth. It also improves the quality of existing hair and supplies nutrition to the hair follicles.
Microneedling is another treatment procedure for alopecia which is performed with a drum-shaped roller device with hundreds of microneedles on it. Before the treatment, local anesthesia is applied in the area.
How Is It Done?
Using the roller device, the dermatologist or trichologist applies horizontal, vertical, and diagonal pressure across the skin. The needle pierces the follicles to create numerous microchannels over the surface without damaging the epidermis. Since microneedling can directly enter the viable epidermis where it acts on and does not contact the dermal nerves and capillaries, it is a safe procedure.
Generally, doctors suggest micro-needling sessions at 4-6 weeks intervals to give enough time for new collagen to synthesize.
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Mechanism Of Action
Microneedling involves puncturing the skin to induce collagen synthesis. It leads to stimulating stem cells and activating the growth factors. Microneedling also improves blood circulation through the scalp, especially the hair follicles; therefore, hair growth occurs.
Platelet-rich plasma or PRP treatment is also beneficial for alopecia areata. In PRP treatment, PRP is prepared using the plasma of the patient and the device that centrifuges the collected blood and separates the platelets. The blend elements are separated based on their molecular weights.
Platelets are first separated from the red blood cells and then the white blood cells, and then they are concentrated to use in that treatment.
How Is It Done?
The treatment starts with signing up consent form by the patient, and the patient is also asked to take aspirin and other non-steroidal anti-inflammatory medicines. Local anesthesia is given to the patient if required. Different application methods are available, and the doctors prefer the one the patient finds comfortable.
The first method is injecting the PRP deep into the surface, while the second is administrating the PRP by puncturing holes on the scalp using a mesotherapy gun.
Mechanism Of Action
In platelet-rich plasma treatment, the PRP can enhance the growth of dermal papilla cells and also protect the cells against apoptosis. It also promotes cell growth to extend the survival of hair follicles.
Some Frequently Asked Questions Regarding Alopecia Areata
What is the leading cause of alopecia areata?
Alopecia areata is an immunity-related ailment in which a person’s immune system erroneously bouts the hair follicles, causing inflammation and hair fall. Researchers do not understand the exact cause of the immune attack on hair follicles, but they believe that environmental and genetic factors play a role in the same. Generally, it is found that people with alopecia areata in the family are more likely to suffer from the same.
Is alopecia areata reversible?
Alopecia areata is not reversible. However, some treatments can promote hair regrowth. Not all people diagnosed with alopecia areata require treatment. Many people with the limited disease can experience automatic and spontaneous hair growth. But patients with severe alopecia areata might need long-term treatment to stop hair loss and promote new hair growth.
What is the fastest way to treat alopecia areata?
Currently, there is no way to treat alopecia areata faster, although there are some treatments that can be suggested by dermatologists or trichologists to help the hair regrow more quickly. The most common alopecia areata treatment uses corticosteroids and some cosmetic treatments, including platelet-rich plasma, mesotherapy, and microneedling. But every therapy works differently for different patients.
What foods must be avoided by people suffering from alopecia areata?
A patient suffering from alopecia areata might eliminate grains, legumes, dairy, coffee, alcohol, oil, sugar, and food additives. However, it is always necessary to talk to a dermatologist or trichologist to know the proper dietary plan while suffering from alopecia areata to avoid vitamin or mineral deficiency.
Does alopecia areata happen suddenly?
The only sign of alopecia areata is sudden hair loss in patches. However, alopecia areata does not happen overnight, and it takes years for alopecia areata to form. Most commonly, the disease is seen in people with a family background of the same. But since some environmental factors also play a role in developing alopecia areata, sometimes people with other conditions like vitiligo may develop alopecia areata within a short period.
How alopecia areata affects the brain?
Alopecia areata does not cause any physical pain to the body. But most people with a condition might face emotional and psychological distress. This pain is as severe as physical and can lead to depression and anxiety.
We understand that life can be a little difficult and challenging with the condition that causes excessive hair loss, especially for those whose hairs are a matter of pride. However, since alopecia areata is a long-term disease, it is better to learn how to cope with the situation rather than feeling negative or differently. This article talked about many treatment modules that help people regrow hair after losing it, and we are sure that those treatments will help you or someone you know who needs them. Keep following us for many such articles. Stay happy, stay safe.