Alopecia Areata

Alopecia areata is an autoimmune condition characterised by sudden, patchy hair loss. The immune system mistakenly targets hair follicles, causing hair to fall out, typically in small patches. While it primarily affects the scalp, it can also impact other hair-bearing areas. The condition is unpredictable, varying from minor, temporary patches to more extensive, persistent hair loss. It can significantly affect an individual’s psychological well-being.

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Key Points

What is alopecia areata?

Alopecia areata is a disorder where the immune system attacks the hair follicles, leading to hair loss. This loss typically occurs in small, round patches on the scalp but can affect any hair-bearing area.

Who gets alopecia areata?

Alopecia areata can affect individuals of any age, gender, or ethnicity. It often begins during childhood or young adulthood. A family history of the condition increases the risk.

Clinical features

The main symptom of alopecia areata is the sudden appearance of round, smooth, bald patches on the scalp. It may also affect the eyebrows, eyelashes, and body hair. The skin in the affected area is usually normal.

Diagnosis and differential diagnosis

Diagnosis of alopecia areata is primarily clinical, based on the characteristic non-scarring pattern of hair loss. A punch biopsy may be needed for confirmation. It is differentiated from conditions like tinea capitis, trichotillomania, and other forms of alopecia.

Impact and complications

Alopecia areata can lead to significant psychological distress due to its unpredictable nature and visible hair loss. It does not cause physical pain or direct health issues, but the emotional impact can be profound.

Subtypes and variants

  • Alopecia Totalis –  Complete loss of hair on the scalp.
  • Alopecia Universalis –  Loss of all body hair, including scalp, eyebrows, eyelashes, and body hair.

Causes and triggers of alopecia areata

Alopecia areata is driven by an autoimmune response with the body’s immune system mistakenly attacking the hair follicles, leading to hair loss. Genetic factors play a significant role, as a family history of the condition can increase an individual’s risk. Additionally, environmental factors, including stress, can trigger the onset of this condition, indicating a complex interplay between genetics, immune response, and external triggers in its development.

Treatment Options for alopecia areata

The primary goal of treating alopecia areata is to promote hair regrowth and tackle the autoimmune basis of the disease. To achieve this, a variety of treatment options are available. Topical treatments, such as corticosteroids and minoxidil, are commonly prescribed to stimulate hair growth. For more extensive cases, oral treatments, including immunosuppressants and JAK inhibitors, may be recommended. Additionally, corticosteroid injections can be administered directly into the affected areas to encourage hair regrowth. However, it’s important to set realistic expectations regarding outcomes. Responses to treatment can vary significantly among patients – while some may experience complete hair regrowth, others may have recurrent episodes of hair loss.

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