Written by: Jasmine Biju
Medically reviewed by: Dr. Lohi Pratti
Alopecia areata is an autoimmune disorder that causes hair loss on the scalp and other areas of the body. The exact cause of the condition is unknown, but it is thought to be related to a combination of genetic and environmental factors. Symptoms include round or oval patches of hair loss, and in some cases, the hair loss can be severe and widespread. There is no cure for alopecia areata, but treatments such as corticosteroid injections, topical minoxidil, and immunotherapy may help in hair growth. In most cases, spontaneous remission occurs. Thus, reassurance of patients with alopecia is a major key to treatment.
The primary symptom of alopecia areata is hair loss, which can occur on the scalp or other areas of the body, such as the beard, eyebrows, or eyelashes. The hair loss usually appears in patches but can also be sudden and rapid. The affected areas may be smooth or have short, broken hair. In some cases, the hair loss can be severe and widespread, leading to complete baldness on the scalp (alopecia totalis), or on the entire body (alopecia universalis). In some cases, people with alopecia areata may also experience itching, burning, or tingling sensations on the scalp or in the affected areas.
Some treatment options for alopecia areata include:
1. Corticosteroid injections: These are given directly into the affected areas and can help to suppress the immune system and promote hair regrowth. The injections contain a type of steroid, such as triamcinolone acetonide, that is injected directly into the affected areas of the scalp. The steroid works by suppressing the immune system and reducing inflammation in the hair follicles, which can help to promote hair regrowth. Corticosteroid injections are typically given every 4 to 6 weeks and may need to be repeated several times. The treatment can be effective in promoting hair regrowth in up to 50% of people with alopecia areata. However, the hair regrowth is usually not permanent and the hair loss can recur once the treatment is stopped.
2. Topical minoxidil: Topical minoxidil is a medication that is applied to the scalp and is commonly used to treat hair loss, including alopecia areata. Minoxidil works by increasing blood flow to the hair follicles, which can help to promote hair growth. It is thought that the increased blood flow brings more oxygen and nutrients to the hair follicles, leading to the growth of stronger and thicker hair. Minoxidil is available in a 2% and 5% strength solution and is typically applied twice a day, every day, to the affected areas of the scalp. The treatment can take several months to see results, and the hair growth is usually not permanent, so treatment must be continued to maintain results.
3. Immunotherapy: This treatment involves applying a topical agent, such as diphencyprone (DPCP) or squaric acid dibutylester (SADBE) to the scalp. The agent is applied in increasing concentrations, starting at 0.0001% and increasing to 1%. The goal is to create a mild allergic reaction on the scalp, which can stimulate the immune system to attack the hair follicles. Immunotherapy treatment is usually applied every 2-4 weeks. The treatment may take several months to show results, and the hair growth is usually not permanent, so treatment must be continued to maintain results.
4. Excimer therapy: a type of laser therapy this can be used as an effective alternative to other treatment options when applied twice a week. Children have been shown to respond better to this type of treatment.
5. Phototherapy: this treatment option combines a medicine called psoralen with UVA light.
There are many treatment options for alopecia, but patient support and reassurance are a major priority, as alopecia can have a significant impact on a person's mental well-being. Hair loss can lead to feelings of self-consciousness, embarrassment, and a loss of self-esteem. It can also lead to depression, anxiety, and social isolation. The sudden and unpredictable nature of alopecia can also be distressing, as it can be difficult for a person to plan for or cope with hair loss. People with alopecia may also feel a sense of loss or grief, as hair can be an important aspect of a person's identity and appearance, especially culturally. It's important for people with alopecia to seek support from family, friends, and healthcare professionals.
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