Hair loss in any form can be devastating. Even if you had a feeling that you would eventually start losing your hair, because of your family history, that first evidence of a thinning hairline can throw you for a loop.
But, not every form of hair loss is due to male or female pattern baldness or external factors. In some cases, people lose their hair because their immune system mistakenly attacks the hair follicles, causing the hair to fall out.
The condition is known as alopecia areata. It’s one form of the autoimmune disorder and usually cause hair to fall out in patches. Other forms of the disorder, such as alopecia totatlis, can cause a person to lose all of the hair on the scalp, while others, such as alopecia universalis, cause hair loss all over the body.
What’s the Cause?
When a person has alopecia areata, the immune system thinks that the hair follicles are outside attackers. The body produces white blood cells, which go after the cells of the follicles. The hair follicles, under attack, eventually shrink, causing the hair to fall out. Unlike male pattern baldness, the immune system doesn’t completely destroy the hair follicle. The cells responsible for new hair follicle cells aren’t attacked, so the hair can potentially grow back.
Who Gets It?
Alopecia areata can affect anyone. It occurs in about 2 percent of people in the U.S., according to the National Institute of Arthritis and Musculoskeletal Diseases. The condition can begin in childhood, or later in life. It can also be passed down through family members. There’s a greater chance that a person’s children will also have alopecia areata if that person started to lose hair from the condition before age 30.
How Will I Know If I Have It?
Usually, alopecia areata causes a very distinct type of hair loss. It most often occurs on the scalp, in the form of patches of lost hair. The “patches” can be an inch or more in diameter. The skin of the patch is usually very smooth and the patch itself is often round. Sometimes, there are very short hairs along the edge of the patch. These hairs are often wider at one end than at the other, so they are known as “exclamation mark hairs.”
One of the first signs that a person might have alopecia areata doesn’t appear in the hair, but instead in the nails. Little dots or pits often form on the nail’s surface. In some cases, the nails become more brittle or break easily. They can also fall off.
If a person thinks he or she has the condition, it’s important to see a doctor for a diagnosis. There’s a possibility that the hair loss could be due to another condition or that the person has an autoimmune disease that isn’t alopecia. During the appointment, the doctor will most likely examine the area of hair loss. He or she might pull out a few hairs to look at under the microscope or perform a skin biopsy. There’s also a chance the doctor will order a blood test to rule out other conditions.
What Are the Treatment Options?
While there are several treatment options for alopecia areata, it’s important to understand that there is no cure for the condition. But, the right treatment can help a patient manage the condition and encourage new hair growth.
One possible treatment for alopecia is to use minoxidil on the affected hair. The impacted hair follicles haven’t completely died, so it is possible for them to continue to produce hair. Applying minoxidil as directed can encourage follicle growth and ultimately hair regrowth.
Another treatment option is for a doctor to prescribe a corticosteroid. Corticosteroids keep the immune system from functioning at its best, which can be a benefit when a person’s immune system is too active. The medication is available in several forms, including topical creams, oral pills and injections. There are advantages and drawbacks to any form of the medicine. For example, the pill form usually causes a range of side effects, including weight gain and high blood pressure, when taken for an extended period of time. The topical form isn’t as potent as the injections or oral form, and might not provide optimal results.
What About Hair Restoration Surgery?
Unfortunately, hair restoration surgery is usually not an appropriate treatment for people with alopecia areata. The hair loss can occur all over the head, so there is no way to to find an appropriate donor site.
There is still hope, though, as there is always the potential that the hair lost will return in time. Hair restoration is more appropriate for people who have permanent hair loss and who have a sufficient amount of donor hair to be transplanted.
Dr. Kyle Choe is a hair restoration specialist in the Virginia Beach area. He can answer any questions you have about hair loss, from male pattern baldness to alopecia areata and can recommend the appropriate course of treatment for you. To schedule your consultation with Dr. Choe, call (757) 389-5850.