Alopecia Areata

Alopecia Areata is a term used to describe a loss of hair.

It’s often rather imprecisely used to describe a range of hair-related conditions.

Background

It is perfectly normal for human beings to lose hair.

The natural cycle is that the follicles in your scalp will produce hair. That process will include a phase where the hair will fall out to eventually be replaced by new growth.

As we get older, the capacity of the follicles to produce hair diminishes and some may die.

Once ‘dead’, currently it is generally accepted that they cannot be re-animated.

However, follicles also go through a ‘resting phase’ and there are some treatments that appear to be able to reduce the period of inactivity and stimulate growth.

Therefore, seeing moderate hair loss over time on things such as combs or pillowcases is perfectly natural as is a gentle reduction in hair thickness and quantity as you age (though not all researchers accept that).

If you are experiencing these forms of mild hair loss and this loss appears to be having no visible effect overall, then you probably do not have alopecia.

Other hair loss

There are though, other forms of hair loss that are less ‘natural’ and which may be cause for distress.

• Alopecia areata
• Androgenic alopecia.

Both of these describe conditions where the hair loss is considered to be abnormal in the sense that it does not conform to the above natural cycle of loss and replacement.

For many years androgenic alopecia (also known as male/female pattern baldness) was also considered to be part of a normal life process that meant some people, predominantly males, would start to lose their hair early.

This is now being increasingly question by medical professionals and is coming to be regarded as a condition – even though some doctors may still be relatively unsympathetic.

Androgenic alopecia – symptoms and causes

In males this condition is typically characterized by the hairline receding from the temple areas and the development of a thinning crown and central area of the head.

Initially this may result in the appearance of a ‘peak’ in terms of hair shape but over time the thin crown often advances down the middle of the scalp until the hair has virtually gone leaving only hair on the sides.

In women the progression is different (it may not, in fact, be best described as androgenic as this implies that male hormones are the cause – which they may or may not be for women).

The thinning of hair appears to be more uniformly distributed and bald spots are relatively uncommon. The end effect is often hair that looks normal from a distance but which close-up, is seen as being very thin with areas of scalp visible.

The causes of this condition are not well understood.

Hormones and genetics are generally accepted to play a part in both sexes (e.g. pregnancy or the menopause in women).

Alopecia Areata

The symptoms here are quite different.

Typically small round bald patches will appear on areas of the body – usually the scalp or male beards etc. This may be accompanied by odd sensations or very slight pain. The hair loss may be relatively fast.

Sometimes these patches will clear up with hair growth resuming.

The condition may simply disappear, re-appear after an extended period or may progress and become more problematic.

In a very small percentage of cases, the condition may progress to Alopecia Areata Totalis, which essentially means that hair is lost over the entire head.

Even more rarely, the condition affects the entire body. That may include the chest, eyebrows and even pubic hair.

Once again, the causes are not clearly understood and they remain the subject of research and debate.

Currently some researchers incline towards the view that this condition may be linked to an autoimmune problem whereby the function of hair follicles is stopped or inhibited by immune system attacks.

There is also evidence that stress may play a significant part in triggering alopecia areata in susceptible individuals.

Other hair loss

There are other medical conditions and environmental situations, which may cause hair loss.

Sometimes also referred to as alopecia, these may form a variety of patterns depending upon the causative agent (e.g. chemo or radiation therapies etc).

Treatments

In the case of androgenic alopecia, there are some treatments (e.g. Minoxidil) that may be able to help some individuals although the entire field remains the subject of heated debate and is home to many treatments of doubtful benefit.

For sufferers of alopecia areata, the outlook is slightly better.

There are a number of treatments including corticosteroids and Minoxidil, where the effects are pronounced and clear – however even here some individuals appear to obtain only limited benefits.

Given that the exact mechanisms behind these two conditions are simply not yet fully understood, it may prove difficult to identify a definitive ‘cure’ in the near future.