What Is Alopecia Areata?
Alopecia areata is considered an autoimmune disease, in which the immune system, which is designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks the hair follicles, the tiny cup-shaped structures from which hairs grow. This can lead to hair loss on the scalp and elsewhere.
In most cases, hair falls out in small, round patches about the size of a quarter. In many cases, the disease does not extend beyond a few bare patches. In some people, hair loss is more extensive. Although uncommon, the disease can progress to cause total loss of hair on the head (referred to as alopecia areata totalis) or complete loss of hair on the head, face, and body (alopecia areata universalis).
Alopecia Areata Barbae
Alopecia areata may be limited only to the beard, in which case it is called alopecia areata barbae
Alopecia Areata – What Causes It?
In alopecia areata, immune system cells called white blood cells attack the rapidly growing cells in the hair follicles that make the hair. The affected hair follicles become small and drastically slow down hair production. Fortunately, the stem cells that continually supply the follicle with new cells do not seem to be targeted. So the follicle always has the potential to regrow hair.
Classification of Alopecia areata
Commonly, alopecia areata involves hair loss in one or more round spots on the scalp.
- Hair may also be lost more diffusely over the whole scalp, in which case the condition is called diffuse alopecia areata.
- Alopecia areata monolocularis describes baldness in only one spot. It may occur anywhere on the head.
- Alopecia areata multilocularis refers to multiple areas of hair loss.
- Ophiasis refers to hair loss in the shape of a wave at the circumference of the head.
- The disease may be limited only to the beard, in which case it is called alopecia areata barbae.
- If the person loses all the hair on the scalp, the disease is then called alopecia areata totalis.
- If all body hair, including pubic hair, is lost, the diagnosis then becomes alopecia areata universalis
Alopecia areata totalis and universalis are rare.
Differential diagnosis of Alopecia Areata
- Tinea capatis
- Traction alopecia
- Congenital alopecia
- Chemical induced alopecia
- Anagen effluvium
- Lupus erythematosus
- Lichen planopilaris
- Bullous pemphigoid
- Alopecia neoplastica
- Follicular mucinosis
- Granulomatous disorders
Etiology of Alopecia Areata
Genetic predisposition – family history increases likelihood
Association with autoimmune disease – (thyroid disease, Addison’s disease, vitiligo) suggests autoimmune origin; presence of lymphocytic infiltration in and around Anagen hair follicle is further evidence. Alopecia Areata differs from other autoimmune diseases in that it does not result in complete loss of function of the target organ, but in a temporary switching off of hair follicle activity, which can return to normal. This suggests that the target may be controlling growth factor or its receptor.
Microorganism, Neurogenic stimuli, emotional stress, and poor coping skills have been identified as potential causes or triggers.
Sign and symptoms of Alopecia Areata
Clinical presentation varies from recurrent, small round patch of hair loss to chronic, nonscarring total hair loss of scalp, eyebrows, eyelashes, nostrils, beard, and body, spontaneous remissions may seen.
Alopecia Areata can be psychologically painful. The hair follicle changes from Anagen hair to dystrophic Anagen, catagen, or telogen hair due to an unknown trigger.
Nail pitting may occur. Increased incidences of association with other autoimmune disease such as Hashimoto thyroiditis and vitiligo have been reported.
Investigation in case of Alopecia Areata
Detailed history and physical examination are important tools for diagnostic purpose; organ specific antibodies may be demonstrated. Scalp biopsy may be useful to exclude other disorder.
Is My Hair Loss a Symptom of a Serious Disease?
Alopecia areata is not a life-threatening disease. It does not cause any physical pain, and people with the condition are generally healthy otherwise. But for most people, a disease that unpredictably affects their appearance the way alopecia areata does is a serious matter.
The effects of alopecia areata are primarily socially and emotionally disturbing. In alopecia universalis, however, loss of eyelashes and eyebrows and hair in the nose and ears can make the person more vulnerable to dust, germs, and foreign particles entering the eyes, nose, and ears.
Alopecia areata often occurs in people whose family members have other autoimmune diseases, such as diabetes, rheumatoid arthritis, thyroid disease, systemic lupus erythematosus, pernicious anemia, or Addison’s disease. People who have alopecia areata do not usually have other autoimmune diseases, but they do have a higher occurrence of thyroid disease, atopic eczema, nasal allergies, and asthma.
Will My Hair Ever Grow Back?
There is every chance that your hair will regrow, but it may also fall out again. No one can predict when it might regrow or fall out. The course of the disease varies from person to person. Some people lose just a few patches of hair, then the hair regrows, and the condition never recurs. Other people continue to lose and regrow hair for many years. A few lose all the hair on their head; some lose all the hair on their head, face, and body. Even in those who lose all their hair, the possibility for full regrowth remains.
In some, the initial hair regrowth is white, with a gradual return of the original hair color. In most, the regrown hair is ultimately the same color and texture as the original hair.
Alopecia Areata Treatment
The following are some commonly used medicines for alopecia areata. Keep in mind that while these treatments may promote hair growth, none of them prevent new patches or actually cure the underlying disease.
Corticosteroids, Minoxidil (5%), Anthralin (Psoriatec), Sulfasalazine , Oral cyclosporine
In cases of severe hair loss, limited success has been achieved by using the corticosteroid medications clobetasol or fluocinonide, corticosteroid injections, or cream. Application of corticosteroid creams to the affected skin is less effective and takes longer to produce results. Steroid injections are commonly used in sites where the areas of hair loss on the head are small or especially where eyebrow hair has been lost. Whether they are effective is uncertain
Homeopathic Remedies & Homeopathy Treatment for Alopecia Areata
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these medicines should be taken without professional advice.
Homeopathic medicines are known to give very good results in cases of alopecia areata. The medicines most commonly found useful are –
- Apis mllifica
- Calcarea carb
- Baryta carb
- Indifference towards those loved best.
- Inability to realize responsibility.
- Complaints of old age, or the prematurely aged, with weak, distended blood vessels.
- Heaviness and weight in stomach heat in stomach before meals.
- Sour eructations. Averse to coffee, wants fancy dishes.
- Stomach symptoms relieved by tight clothes.
- Desire for highly seasoned food.
- Craves cold water, hungry.
- Warm drinks produce diarrhoea.
- Hair gray early in life; falls out.
- Dull headache after coition; from eye-strain.
- Vertigo toward evening, when standing or walking.
- Hair thins out, turns gray early.
- Impaired memory.
- Apathetic, indifferent.
- Cannot collect his thoughts or find the right word.
- Difficult comprehension.
- Effects of grief and mental shock.
- Delirium, with great stupefaction. Settled despair.
- Itching of scalp, dandruff, falling out of hair in large bunches.
- Ill effects of iodine and excessive use of salt.
- Great lowness of spirits. Easily vexed.
- Fearfulness, as if something were creeping out of every corner.
- Over-sensitive to external impressions.
- Dread of death when alone.
- Insanity, with an exaggerated idea of one’s own importance. Excitable.
- Great falling out of hair.
- Deep furrows on forehead.
- Premature baldness and gray hair.
- In nearly all cases where Lycopodium is the remedy, some evidence of urinary or digestive disturbance will be found.
- Little things annoy, Extremely sensitive.
- Averse to undertaking new things.
- Head strong and haughty when sick.
- Loss of self-confidence.
- Hurried when eating.
- Constant fear of breaking down under stress. Apprehensive.
- Weak memory, confused thoughts; spells or writes wrong words and syllables.
- Hair falls out.
- Pain over left eye; worse walking in sun, strong odors and tea.
- Scalp feels tense.
- Headache from tea drinking.
- Easy exhaustion, mental and physical, in old age.
- Debility after exhausting diseases.
- Hair falls out from brows, beard, and genitals.
- This remedy brings aid to scrofulous children, especially if they are backward mentally and physically, are dwarfish, do not grow and develop, have swollen abdomen, take cold easily, and then always have swollen tonsils.
- Brain feels as if loose. Hair falls out.
- Lost confidence in himself.
- Aversion to strangers.