About Alopecia
The causes of alopecia include:
- Auto immune conditions: An autoimmune condition is where the immune system mistakenly attacks the hair follicles, leading to hair loss.
- Genetic conditions: A genetic condition may cause hair follicles to be sensitive to androgens (male hormones), resulting in patterned hair loss.
- Chronic (long-term) inflammation: Inflammation may play a role in the development and progression of certain types of alopecia.
Non-modifiable risk factors are risk factors that cannot be changed. The non-modifiable risk factors of alopecia include:
- Genetics: Having a family history of alopecia increases the risk of developing the condition.
- Age: Alopecia can occur at any age, but certain types, like androgenetic alopecia, are more common as people get older.
Modifiable risk factors are risk factors that can be changed or influenced. The modifiable risk factors of alopecia include:
- Hormonal imbalance: Hormonal changes due to conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can contribute to hair loss.
- Stress: Psychological stress has been associated with the development of alopecia areata.
- Trauma or Injury: Physical trauma or injury to the scalp can lead to localized hair loss.
- Certain hairstyles or hair treatments: Frequent use of tight hairstyles or harsh chemical treatments can damage the hair follicles and contribute to hair loss.
It's important to note that these risk factors can vary depending on the specific type of alopecia. If you're concerned about your risk or experiencing hair loss, it's best to consult with a healthcare professional for an accurate diagnosis and appropriate management.
The main symptom of alopecia is hair loss. Additional symptoms may include:
- Small round or oval patches of baldness on the scalp
- Smooth and normal-looking bald skin in the affected areas
- Mild itching, tingling, tenderness, or a burning sensation in some cases
As alopecia progresses or reaches higher severity, additional symptoms may occur:
- Complete loss of all head hair (alopecia totalis)
- Loss of hair on the entire body, including eyebrows, eyelashes, beard, underarm hair, and pubic hair (alopecia universalis)
- Brittle and pitted nails
It's important to note that not everyone will experience these later-stage symptoms. Some individuals with alopecia areata may have spontaneous recovery without any treatment. However, about 30% of individuals may experience more extensive hair loss or a continuous cycle of hair loss and regrowth. If you're experiencing symptoms of alopecia or have concerns about your hair loss, it's best to consult with a healthcare professional for proper evaluation and guidance.
To diagnose alopecia, the following examinations, tests, and procedures may be performed:
- Physical exam: The healthcare provider will look for physical signs of hair loss, including the pattern of hair loss.
- Medical history: Gathering information about your medical history and any previous diagnoses.
- Lab tests: Specific lab tests like a blood draw may be recommended to assess any underlying conditions or deficiencies.
Additional examinations, tests, and procedures may include:
- Trichoscopy: This non-invasive technique uses a dermoscope to examine the scalp and hair follicles closely.
- Scalp biopsy: A small sample of scalp tissue is taken for microscopic examination to confirm the diagnosis and determine the extent of inflammation.
- Hair pull test: A gentle tug is applied to a group of hairs to assess their strength and determine if excessive shedding occurs.
- Phototrichogram: This procedure involves taking close-up photographs of the scalp to measure hair density and growth rate.
It's important to consult with your healthcare provider who can recommend the most appropriate examinations, tests, and procedures based on your individual situation.
The goals of treatment for alopecia are to suppress hair loss and promote regrowth. The specific treatment options and their mechanisms of action include:
- Topical steroids: These medications, applied directly to the affected areas, help reduce inflammation and immune system activity that contribute to hair loss. They are often the first choice for patients with limited, patchy alopecia due to their minimal side effects and good response rates.
- Local steroid injections: Administered by a doctor, these injections deliver steroids directly into the scalp to target inflammation and immune activity.
- Topical irritating medications: Certain medications like squaric acid or anthralin can be applied to the scalp during doctor's office visits. These medications aim to reset the autoimmune process and stimulate hair regrowth.
- JAK Inhibitors: A newer class of medications, known as Janus Kinase Inhibitors, has shown promise in improving even advanced alopecia. However, there is a high relapse rate if treatment is stopped.
- Ultraviolet light therapy: This therapy involves using ultraviolet light to promote blood circulation and activate hair follicles.
It's important to note that not everyone with alopecia will choose treatment, as it is a personal decision. The choice of treatment depends on factors such as the extent of hair loss, age, and individual preferences. Discussing treatment options with a healthcare professional is crucial in understanding the benefits and potential side effects of each approach.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.