What is Alopecia Areata? Understanding the Condition

Shilpi Jain
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Bald patch due to Alopecia Areata

Have you ever seen bald patches or clumps of hair fall?

It might be due to an autoimmune hair loss disorder called Alopecia Areata (AA), latin for balding in patches.

According to the National Alopecia Areata Foundation, the disorder affects around 6.8 million people in the United States and 147 million worldwide.

It is termed the most common inflammation-induced hair loss.

But, overall it is a treatable condition. 

Hair loss is temporary and in the majority of cases, it is reversible. 

The following article presents a detailed discussion of Alopecia Areata and everything you need to know about it.

What is Alopecia Areata?

Alopecia Areata is an autoimmune disorder that can lead to unpredictable hair loss.

The hair fall occurs in patches, and balding spots appear on the scalp.

The disorder results from the body’s immune system’s attack on the hair follicles.

The body’s immune system causes inflammation in the hair follicles. It can interfere with the hair growth cycle and cause hair fall.

It can occur on the scalp, eyes, eyebrows, and even face.

Above all, the autoimmune effect does not destroy the hair follicles, and hair regrowth is possible.

Types

A 2017 review study by Pratt, King, et. al, states there are four types of Areata,

  • Alopecia Areata Totalis: It occurs when you have hair loss on the entire scalp, making it completely bald
  • Alopecia Areata Universalis: A rare condition where the person loses all hair on the body, making it completely hairless
  • Ophiasis Alopecia Areata: Hair loss follows a band-like shape along the circumference of the head

Symptoms

Areata generally affects the scalp but can cause hair loss in the eyes, eyebrows, beard, and nails.

Patchy hair loss can occur in a few places for some people and multiple sites for others.

This hair loss is in the form of coin-shaped or oval bald patches.

AA can also cause hair loss of eyebrows and eyelashes.

Beard Alopecia Areata also occurs in some patients. This condition is called Alopecia Barbae.

Besides hair loss,  the disorder also affects nails.

Studies have shown around 7% of patients have experienced diffuse fine pitting and ridging in the nails.

Patients suffering from Areata can experience the severity of hair loss and nail pitting at different levels.

An early observation of these symptoms of Alopecia can be beneficial to generate an effective line of treatment.

Causes

The causes behind Areata can range from environmental to genetic. 

The exact cause of immune system attack is still under study, and the conclusions are about environment and genetics.

In genetic terms, Alopecia Areata generally occurs in families with a history of the disease, says a study by Simkaou, Butcher et al.

Polygenic Disease
Alopecia Areata is a polygenic disease, as both parents must contribute some specific genes for a child to develop it. Hence, the majority of parents will not pass Areata to their children. 

Environmental factors like physical injury, emotional stress, or disease may provoke an unusual immunological response. It may lead to inflammation in the hair follicle.

Another factor that can contribute to AA is vitamin D deficiency.

Alopecia Areata in children

According to statistics, 2% of the world population will get Areata, and 60% will get it before the age of 20.

It also says pediatric areata is more common in girls than boys but more severe in boys.

The causes behind AA in children are genetic and more prevalent in monozygotic twins.

The disorders like Down Syndrome and Turner’s Syndrome increase the chances of an immunological attack on the hair follicles.

Diagnosis

Diagnosis of Alopecia Areata is simple. The doctor can make out the disorder with the appearance of patchy bald spots.

They might also test some samples and perform a biopsy to rule out fungal infections like Tinea Capitis.

Other diagnostic tests might include blood tests for antibodies to confirm the autoimmune defect.

Tinea Capitis vs Alopecia Areata

Appearing physically the same, Tinea capitis and Alopecia Areata both cause patchy hair loss on the scalp.

But, these disorders have several differences in their causes, symptoms, diagnostic tests, and treatments.

FactorsAlopecia Areata Tinea Capitis
Definition It is an autoimmune disorder that causes coin-sized bald patches on the scalp.Tinea Capitis is caused due to a fungal infection that causes itchy bald patches on the scalp.
Commonly Affected Commonly develops before the age of 30 Commonly occurs in childhood 
Symptoms Small bald patches that develop towards complete baldness, pitting, and ridges on the nailsSwollen red patches where the hair has broken off, scaly and dry rashes, scalp flaking
Risk Factors Areata usually runs down in the family of patients with Down or Turner’s syndrome.Tinea Capitis is caused due to common contact with other children or pets
DiagnosisPhysical examination, biopsy or blood test Physical examination, culture, wood light test 
TreatmentsMinoxidil, Olumiant, Laser therapy, microneedlingAntifungal medications (oral and topical)

Treatment

Alopecia Areata is an incurable condition, but treatment options for regrowth and hair loss management are available.

The primary aim of the treatment is to restrict the immune system attack and stimulate the regrowth of hair.

These options can be effective, especially for people with mild Areata.

Treatment like Minoxidil solutions is available over-the-counter, but you should consult your doctor before using it.

Warning
The FDA does not approve Minoxidil as a treatment for Areata. It is available over the counter and should only be used after consulting the physician.

In 2022, FDA approved prescription-based Olumiant tablets as an effective treatment for severe Areata in adults.

Physicians also prescribe Corticosteroids as oral tablets or through injections to prevent further hair loss.

Surgical treatments like Laser Light treatment and  Micro-needling are prescribed in severe cases.

It is important to note that no one treatment option works for all.

Some treatments can benefit a few, while an alternate treatment can benefit others. 

If you are experiencing unpredictable hair loss, you should contact your physician as the first step.

Alopecia Areata self care

Stress due to Alopecia AreataSource: Herkisi from Getty Images Signature
Stress_due_to_Alopecia_Areata

People suffering from AA are physically fit but can experience emotional stress.

Organizations such as NAAF are working to build an empathetic community for Areata patients.

They can practice the following self-care steps for easy management of Alopecia,

  • Accept that they are otherwise healthy and only hair loss should not define their way of life
  • Contact an expert for guidance in treating and managing the autoimmune disorder
  • Observe the nail changes and inform your doctor about them
  • Protect your head from UV rays
  • Ask for support in case of stress

Living with a chronic condition can be stressful, and stress might worsen hair loss.

Hence, self-care can help people with Areata to live happier life.

You can read more articles about hair loss on WowRxPharmacy.

Conclusion

Alopecia Areata is not a life-threatening condition. But it is a life-altering condition.

Areata is an immunological disorder that attacks hair follicles like an infection and causes hair to fall in patches.

If you are experiencing hair fall in round or oval patches, contact your doctor for an early-onset of treatment.

Frequently Asked Questions

Is Alopecia Areata an autoimmune disease?

Yes, Areata is an autoimmune disorder that causes hair loss in patches. In this condition, the body’s immune system attacks the hair follicle to cause inflammation. The inflammation in the hair follicle causes it to fall out.

How serious is Alopecia Areata?

Patients suffering from Areata suffer patchy hair loss and are otherwise healthy. It is not a life-threatening disease but can cause emotional distress in patients.

How common is Alopecia Areata?

According to a statistic, Areata affects 2% of the population worldwide. It is more common in identical twins and usually runs in families.

Citations:
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