Every individual experiences daily hair loss, typically around 100 strands, which is entirely normal. However, it is important to acknowledge that managing hair can often resemble a full-time commitment. The tasks of styling and preventing damage can lead to significant stress. Compounding this issue, stress itself can contribute to increased hair loss, resulting in a detrimental cycle. While daily shedding is a natural aspect of the hair growth process, the emergence of patchy hair loss may indicate a different underlying issue, such as alopecia areata. This condition occurs when the immune system erroneously targets hair follicles, leading to hair loss in small, round patches. Although it can be a complex condition, gaining a deeper understanding of it can assist in effective management and the pursuit of appropriate treatment.

What causes alopecia areata?

Alopecia areata is an autoimmune disorder characterized by the immune system erroneously attacking hair follicles, resulting in hair loss. In this condition, white blood cells mistakenly identify hair follicle cells as foreign entities, similar to bacteria or viruses, leading to hair shedding and cessation of growth. This often manifests as round, smooth patches of baldness, which can vary from small, localized areas to extensive hair loss and complete baldness in more severe instances. The precise cause of alopecia areata remains uncertain; however, several common factors have been identified:

1. Genetic predisposition

Although the reasons for these changes are not fully understood, genetics significantly contribute to the onset of this condition. Individuals with a family history of alopecia areata are at a higher risk, as noted by the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Approximately 20 per cent of those affected have a relative who also experiences this disorder. Nonetheless, the specific genetic factors involved are still not clearly defined.

2. Hormonal fluctuations and associated medical conditions

Changes in hormone levels, such as those experienced during pregnancy, childbirth, menopause, or due to thyroid disorders, may trigger hair loss. Furthermore, a 2018 review published in Clinical Reviews in Allergy and Immunology indicated a link between alopecia areata and other autoimmune diseases, such as thyroid dysfunction and vitiligo, suggesting that these conditions may share common underlying factors that disrupt immune system function.

Hormonal Imbalance may result in hair loss. Image courtesy: Adobe Stock

Symptoms of alopecia areata

Here are common symptoms of this condition you should know:

• Patchy hair loss: Alopecia areata primarily causes patchy hair loss, affecting areas like the scalp, face, eyebrows, eyelashes, and body hair. The hair typically falls out in coin-sized patches, with the scalp being the most common area.
• Nail pitting: In addition to hair loss, alopecia areata can also impact nails. Changes such as thin, split nails, loss of shine, and rough texture can sometimes be the first signs of the condition.

Hair loss can occur suddenly, either within a few days or weeks. While the patches usually do not cause other symptoms, in rare cases, they may even lead to itching (pruritus), colour changes (red, purple, brown, or grey), and visible mouth-like openings in hair follicles (follicular ostia). Other signs may include black dots (hair shafts visible in the follicular ostia), exclamation point hairs (short hairs thicker at the top and narrower at the scalp), or the growth of white hairs.

Alopecia areata is an autoimmune disease that cause hair loss. Image courtesy: Freepik

How to diagnose alopecia areata?

The process of diagnosing alopecia areata typically begins with a consultation with your healthcare provider, who will conduct a physical examination. During this visit, they will inquire about the onset of your hair loss and whether there is a family history of alopecia areata or other autoimmune disorders. Additionally, they may examine your nails, as alterations in their appearance can indicate the presence of alopecia areata. Should your provider require further information to reach a diagnosis, they may pursue additional measures.

• Looking at your scalp to rule out infections
• Taking a small hair sample to analyze in a lab
• Performing a scalp biopsy to check for any skin diseases
• In some cases, blood tests may also be done to check for other health issues that could be related to the hair loss

Treatment for alopecia areata

While there is no cure for alopecia areata, there are various treatments that can help slow down hair loss or encourage hair regrowth. However, treatment is not always successful, and some people may still experience hair loss despite trying different options.

• Topical treatments are frequently employed to facilitate hair regrowth. Corticosteroid creams are effective in diminishing inflammation surrounding hair follicles, while minoxidil is known to promote hair growth.
• Topical immunotherapy presents an alternative approach, wherein chemicals are applied to the scalp to elicit an immune response that fosters hair regrowth. In cases of infection, steroid injections are typically administered for mild instances, with a healthcare provider injecting steroids into the affected areas. This treatment requires repetition every one to two months; however, it does not prevent future hair loss.
• Oral treatments may involve cortisone tablets for extensive alopecia, although they can lead to side effects. Additionally, immunosuppressants such as methotrexate or cyclosporine may be utilized to decrease immune system activity.
• Laser and light therapy is another method that aids in promoting hair regrowth by utilizing specific wavelengths of light or lasers to stimulate hair follicles. Both therapies are regarded as safe and effective.
• Some individuals consider natural remedies, including acupuncture, aromatherapy, vitamins such as zinc and biotin, essential oils like coconut, tea tree, and castor, as well as onion juice. Modifications to one’s diet may also contribute positively to the condition.

Make sure if you notice any symptoms of alopecia areata, check with your doctor immediately.

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