The best way to prevent alopecia areata is to stay away from or avoid any trigger factors for the condition. These include: heat, sunlight, hair dye or other artificial coloring.
KAMPALA | NOW THEN DIGITAL — Alopecia areata occurs when there are fewer or less hair on parts of the body.
In this article, we discuss what alopecia areata is, how it is treated, and what signs and symptoms to look out for.
What is Alopecia Areata?
Alopecia areata is a condition that causes hair loss on parts of the body. People with alopecia areata may also develop patches of skin affected by a rash, which looks similar to those caused by shingles.
Alopecia areata can affect both men and women, although it is more common in women. In 2015, it was estimated that about 1.7 million people in the United States alone were affected.
Alopecia is not a condition that many people recognize as a medical condition until it is very severe. Those who have the condition describe it as feeling like the hair on their body is falling out by the handfuls.
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Hair loss can start gradually and can occur on any part of the body that is not typically covered by hair, including the scalp, arms, legs, and toes.
The exact cause of alopecia areata is not yet known, although it is believed to be linked to certain medical conditions. These include:
- Chronic viral infection of the scalp
- Genetic conditions, such as alopecia areata caused by atopic dermatitis (eczema), hypopigmentation, and rheumatoid arthritis.
In most cases, alopecia areata is caused by an autoimmune disorder. An autoimmune disorder occurs when the body mistakenly attacks the body’s own tissues and causes the hair on the body to fall out.
This condition can be caused by an overactive immune system, such as during an infection or when the body’s own cells are attacked.
Another possibility is that chemical reactions in the body’s own immune system play a role in alopecia areata. A good example is follicular mastocytosis.
People can also develop alopecia because of trauma or injury to the hair follicles or nerves. It is possible for alopecia areata to occur after cutting, plucking, or waxing the hair on one part of the body, and it can lead to an irritated rash of the skin on the affected body part.
Diagnosis (A)
To diagnose alopecia areata, doctors will review medical history and ask questions about the symptoms. A physical examination will also be performed.
The physical examination will reveal that there are no abnormal, mole-like lumps, moles, or other signs of illness. However, doctors will ask about the hair loss and the rash that often accompanies alopecia areata.
Doctors may also perform a detailed microscopic examination of the scalp, armpits, or other areas where hair loss has occurred. These examinations can show whether any thinning, loss, or balding is occurring.
The doctor may also ask you about hair loss on other parts of your body and draw blood to test for antibodies in your blood.
To diagnose alopecia areata caused by atopic dermatitis, doctors will do an oral swab test, where they look for the presence of atopic dermatitis antibodies in the blood.
If a doctor suspects that alopecia areata is caused by a viral infection, they will test for antibodies to viruses that cause human immunodeficiency virus (HIV).
Treatment (A)
There is no cure for alopecia areata. Treatment options for alopecia areata include:
- Using anti-inflammatory and anti-inflammatory drugs
- Removing the scab or rash that forms at the bald patches
- Hydroquinone lotion applied directly to the scalp
- Apply lotion containing an antibacterial agent, such as ketoconazole
- Topical and oral antibiotics, such as amoxycillin or clindamycin
- Steroids, such as prednisone
- Areas on the scalp that become infected may require antibiotic treatment, as well.
Prevention
People with alopecia areata may not know when the condition will strike. To prevent it from occurring, avoid known trigger factors, such as:
- Heat
- Excessive stress
- Getting ill
- Chemical irritants, such as some products containing lanolin, alcohol, nail polish, and other products
- Barbering, shaving, and styling, including waxing
Scars can also increase the risk of alopecia areata. People should always wear a scarf or wig in these situations.
Some of these people may also be more susceptible to alopecia areata. These include:
- A woman who has a family history of the disease
- People with a personal history of respiratory infections
- People who take drugs known to trigger the condition
- People with damaged or inflamed hair follicles, including:
- Blonde hair loss
- Red hair loss
- Hair that has been severely burned
- Hair loss that has occurred in areas where there has been trauma
Outlook
The outlook for alopecia areata is good when the condition is treatable. People may not experience any symptoms, which means that the condition may go undiagnosed.
The aim of treatment is to relieve the symptoms of the condition and improve the quality of life for the individual.
Hydroquinone lotion may be prescribed to treat mild cases of alopecia areata.
Complications of alopecia areata include:
- Bleeding into the scalp
- Dehydration
- Dry skin
- Scalp follicles that become infected
Alopecia areata is the most common form of hair loss in people under the age of 40. In the United States, it occurs in around 1.5 million people.
Many people will experience another form of hair loss, called alopecia totalis, in early adulthood. Viral alopecia areata affects about 25 to 30 per cent of people who are affected by alopecia areata.
Diagnosing Alopecia Areata (B)
An underlying medical condition should be ruled out before a doctor diagnoses alopecia areata. An underlying medical condition should be ruled out before a doctor diagnoses alopecia areata.
A doctor will typically diagnose alopecia areata based on physical examination, blood tests, and other medical tests.
A doctor will likely ask about the hair loss. They may also ask about hair health, using a thorough hair-quality assessment.
If the doctor does not suspect alopecia areata, they will likely request a doctor to perform a brief skin or scalp exam.
They will then use a tool called a partition test to test for the presence of blood in the scalp. This is a quick and non-invasive test, and a doctor will usually find little to no blood.
A doctor may also order an ear, nose, and throat swab to test for the presence of an infection.
A blood test for human immunodeficiency virus (HIV), hepatitis B, and hepatitis C may be ordered to rule out other conditions.
A hair follicle biopsy or a general ultrasound may also be ordered. These tests can look at various structures in the head and follicles.
Alopecia areata may also be diagnosed using ultrasound, magnetic resonance imaging (MRI), or endoscopic ultrasound.
In some cases, people will not know if they have alopecia areata. In these cases, they will likely seek treatment.
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Takeaway
If the diagnosis of alopecia areata is confirmed, it can be treated.
However, to prevent an adverse reaction to the medications or to avoid the need for a long-term course of treatment, it is important to treat any underlying conditions that cause alopecia areata.
It should be possible for a medical professional to prescribe specific treatment to prevent the development of such complications.
People should be aware of the importance of avoiding known triggers for alopecia areata, such as stress or too much sun exposure.
Effective medications include topical and oral hydrocortisone, ultraviolet A, and other drugs.
When a doctor does not suspect alopecia areata, a person will usually try to treat symptoms at home. People should speak to their doctor to help with treatment decisions.
Rarely, alopecia areata may develop into something more serious, such as Alopecia Universalis.
Alopecia Universalis is a form of permanent alopecia where hair loss affects more than one area of the head, typically affecting the scalp, face, and upper body.
Alopecia Universalis usually occurs with more severe or prolonged hair loss.
Eradicating Alopecia Areata (B)
During treatment, a doctor may prescribe different medications to control alopecia areata and treat the associated conditions.
People can try these methods of treating alopecia areata in the absence of a clear cause.
A doctor may recommend changing hormone replacement therapy, applying moisturizer to the scalp, or putting cream on the skin to prevent itching and dryness.
Other options include:
- Taking aspirin to treat a possible infection
- Using steroid creams, which are available over the counter
- Using topical or oral antibiotics to treat an infection
- Adding vitamin E supplements to the diet
- Cutting caffeine out of the diet, since caffeine can cause inflammation
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