Alopecia: a guide to causes, types and treatments

Aug. 26, 2020
Hair loss can be a distressing thing. If you’re losing hair rapidly and suddenly, you may want to find out if you’re experiencing a form of alopecia.
What is alopecia?
Alopecia is sudden and rapid loss of hair and usually begins as hair loss in patches (alopecia areata) which may or may not extend to become complete hair loss of all hair on the body (alopecia universalis). Affecting about 7 million people in the United States, it usually occurs before the age of 30. Although there is as of today no cure for this condition, people often experience full recovery without the need for treatment. 
Although this disease is not contagious or life-threatening, it can cause a lot of emotional stress, or even emotional trauma. There is therapy and support groups to help people living with this condition that you can join. 
Alopecia areata is an auto-immune condition, arising when your white blood cells fail to recognise your own hair cells and begin to attack your own hair follicles. Scientists have been able to establish some genetic link; one in five people with the disease has a family member who has developed alopecia areata, and an identical twin has a 50% chance of developing the condition if their other twin has it, but unfortunately, the exact causes of this disease still have not been established. Research has suggested that alopecia areata may share a common cause to vitiligo, also an autoimmune skin disease, except melanocytes that produce skin pigment are attacked, leading to white patches developing across the body.
Hair falling out in small patches about the size of a coin, is the main sign of alopecia areata. Alopecia areata can begin anytime, but for most people, it develops during childhood and adolescence. The condition can be spontaneous and unpredictable. In some people, hair grows back and the condition does not reappear. But in others, the hair may fall out again.
A doctor can spot alopecia areata based on the extent of hair loss and by using trichoscopy, an technique that looks at your hair and scalp at a 10x -70x magnification to examine what your hair looks like at a microscopic level. Some people, especially children, may also show nail defects like pitting or lesions.
Types of alopecia
Alopecia areata is the name given to patchy hair loss. There are subtypes of this though, including:
Diffuse alopecia areata, which is hair lost across the whole scalp.
Alopecia areata monolocularis, which is hair loss only in one spot.
Alopecia areata multilocularis, which is hair loss in multiple spots.
Ophiasis alopecia, which is hair loss in a wave-shaped formation across the sides and the lower back of the scalp.
Alopecia totalis, which is total hair loss on the scalp.
Alopecia universalis, which is total body hair loss, including public hair.
Although there is no known treatment that can definitively end the condition, there are some things you can try to help your hair grow back more quickly and slow down hair loss.
Medical treatments
There are a number of topical medications that you can apply to your scalp to stimulate hair growth:
  • Anthralin (Dritho-Scalo) induces new hair growth by irritating the skin.
  • Minoxidil (Rogaine) has been shown to be useful for people with limited alopecia areata. It’s readily available as an OTC drug.
  • Corticosteroid creams, e.g. clobetasol (Impoyz) can decrease inflammation in the hair follicle
  • Topical immunotherapy – this involves a chemical, such as diphencyprone, that causes an allergic rash in the skin and may stimulate new hair growth within six months. Continuous treatment is required to maintain the regrowth.
Steroid injections can help hair grow back on mild, patchy bald spots. Although it can’t stop further hair loss, it can help you to regrow hair, although an injection is needed every one to two months.
Oral tablets like cortisone and immunosuppresants such as methotrexate and cyclosporine are only reserved for more extensive alopecia covering a large area or multiple parts of your body. They have severe side effects and so should only be considered after a discussion with your doctor.
Natural treatment
Natural treatments haven’t gone through the same rigorous clinical tests that medical treatments have, so they may not necessarily work for everyone. However, there are some commonly used natural treatments that some people swear by.
  • Onion juice
  • Rosemary essential oil
  • Vitamins like zinc and biotin
  • An “anti-inflammatory” diet consisting mainly of meat and vegetables
  • Ginseng
  • Aromatherapy
  • Acupuncture
Have you experienced hair loss before? How did you treat it and cope with it? Show your support and share your experiences with us in the comments section below.
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