Alopecia Areata: Types, Diagnosis, and Management

What causes alopecia areata?

Alopecia areata (AA) is a condition where the immune system mistakenly attacks hair follicles, causing hair loss. Alopecia areata is a common condition with millions of people in the United States affected. We do not completely understand the reasons for AA. Researchers believe that genetics, environment, and stress play a role in its development.

Individuals with a family history of autoimmune diseases or a genetic predisposition to alopecia are more susceptible to experiencing this condition.

Environmental factors such as exposure to certain toxins, pollutants, or allergens may trigger or exacerbate AA in susceptible individuals. Your diet and lifestyle can affect your immune system, which may impact how a condition develops and progresses.

People with alopecia areata recognize stress as a potential trigger for patchy hair loss. Emotional stress, trauma, or major life changes can disrupt the body’s immune system, leading to AA.

Diffuse Alopecia Areata (Biopsy Confirmed)

How do alopecia areata occur?

Losing hair patch in alopecia areata may start slowly or suddenly, sometimes even overnight. Some individuals notice hair loss happening gradually.

Losing hair patch in alopecia areata may start slowly or suddenly, sometimes seemingly overnight.

This sudden manifestation of hair loss can be alarming and distressing, leading individuals to seek prompt medical attention.

Patients may notice small, coin-sized patches appearing on the scalp, beard area, eyebrows, or other parts of the body.

Over time, these patches may enlarge or multiply, resulting in more extensive hair loss.

What other problems may happen in patients with alopecia areata?

Alopecia areata (AA) often comes along with other health issues. Some of these include depression and anxiety. The researchers noted low vitamin D levels, lupus, vitiligo, metabolic syndrome, eczema, and thyroid problems among others.

Studies also suggest that if you have allergies or sensitivities, you might be more likely to get AA. If you have hay fever, eczema, asthma, or allergies to pollen or pet dander, you are more at risk.

How alopecia areata present?

Alopecia areata (AA) causes round bald patches on the scalp, but it can also affect eyebrows, eyelashes, and beard. Hair loss in arms and legs, as well as body, can happen. These patches can grow bigger over time, and sometimes all the hair in the affected area falls out completely. In some cases, people with AA might also have issues with their nails.

Nail Involvement in Alopecia Universalis

What are the types of alopecia areata?

Alopecia areata (AA) presents differently. The most common types of alopecia areata are:

Patchy Alopecia Areata

This type is common, with hair falling out in circular patches on the scalp or other parts of the body. These patches may later progress to become alopecia totalis or alopecia universalis.

Alopecia Totalis

Alopecia totalis results in complete hair loss across the entire scalp. Compared to patchy alopecia areata, the prognosis for alopecia totalis is often less favorable, with fewer individuals experiencing spontaneous hair regrowth.

Alopecia Universalis

Alopecia affecting the scalp, face, and body is called alopecia universalis. Individuals who develop alopecia areata universalis experience hair loss throughout their body, including eyebrows and eyelashes.

Ophiasis

Ophiasis is a distinct pattern of hair loss that affects the sides and lower back of the scalp, often resembling a wave-like pattern.

Diffuse alopecia areata

Diffuse alopecia areata is a type of hair loss that happens all over the scalp. In this form, hair loss occurs diffusely, leading to thinning or balding of the scalp without clear-cut patches.

Can doctors cure alopecia areata?

Regrettably, there is currently no known cure for AA. However, regrowing hair is possible with tailored treatments. Emerging as a beacon of hope for long-term management are a new class of treatments known as JAK inhibitors.

Will alopecia areata spread?

Most individuals experiencing hair loss typically present with the localized form of AA, known as the patchy type. Others have it spread to larger areas on their scalp or body. However, predicting the extent of hair loss can be challenging, as it varies greatly among individuals.

The presence of other autoimmune disorders can sometimes exacerbate the severity of alopecia areata. However, this correlation is not always definitive. While certain individuals may experience more aggressive balding when other health conditions coexist, it is not a universal rule.

Treatment of Ophiasis Alopecia with Steroid Injections
Successful Treatment of Alopecia Areata with JAK Inhibitor

Who treats alopecia areata?

Board-certified dermatologists have special training to treat various skin, hair, and nail conditions, including alopecia areata. Doctors usually conduct a comprehensive clinical examination and questionnaire to assess the condition. Additional tests like blood tests and biopsies may be needed. These tests help ensure the accuracy of the diagnosis and aid in developing a suitable treatment plan.

What treatments do doctors use for alopecia areata?

The treatment of alopecia areata varies depending on the extent of the disease. Doctors commonly prescribe topical steroids or non-steroidal medications like topical calcineurin inhibitors or JAK inhibitors for hair growth. Additionally, injections of steroids are considered a standard approach. For more extensive forms of alopecia areata, systemic medications may be necessary, including systemic steroids, immunosuppressants, or JAK inhibitors.

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