Skin conditions: Alopecia areata

Alopecia is the medical term for baldness. There are various types of alopecia, including alopecia areata.

Alopecia areata is a condition that causes a person's hair to fall out. It is an autoimmune disease; that is, the person's immune system attacks their body - in this case, their hair follicles. When this happens, the person's hair begins to fall out, often in clumps the size and shape of a penny. The extent of the hair loss varies; in some cases, it is only in a few spots. In others, the hair loss can be greater.

On rare occasions, the person loses all of the hair on his or her head (alopecia areata totalis) or entire body (alopecia areata universalis).

It is believed that the person's genetic makeup may trigger the autoimmune reaction of alopecia areata, along with a virus or a substance the person comes into contact with.

Alopecia areata is an unpredictable disease. In some people, hair grows back but falls out again later. In others, hair grows back and remains. Each case is unique. Even if someone loses all of his or her hair, there is a chance that it will grow back.

Who gets alopecia areata?

Anyone can develop alopecia areata; however, your chances of having alopecia areata are slightly greater if you have a relative with the disease. In addition, alopecia areata occurs more often among people who have family members with autoimmune disorders such as diabetes, lupus, or thyroid disease.

Can alopecia areata be cured?

Alopecia areata cannot be cured; however, it can be treated and the hair can grow back.

In many cases, alopecia areata is treated with medicines that are used for other conditions. Treatment options for alopecia areata include:

• Corticosteroids: Anti-inflammatory medicines that are prescribed for autoimmune diseases. Corticosteroids can be given as an injection into the scalp or other areas, orally (as a pill), or applied topically (rubbed into the skin) as an ointment, cream, or foam. Response to therapy may be gradual.
• Minoxidil lotion: This lotion is applied to the scalp and can stimulate hair regrowth after two to three months. It is not recommended for those under the age of 16 and is not available on the NHS, but can be prescribed privately or bought over the counter. It can take up to a year for a maximum response, and its effect is dependent on continuous use.

Other medicines that are used for alopecia areata with varying degrees of effectiveness include medications used to treat psoriasis and topical sensitisers (medicines that are applied to the skin and cause an allergic reaction that can cause hair growth).

Other tips

Apart from medicinal treatments, there are various cosmetic and protective techniques that people with alopecia areata can try. These include:

• Using makeup to hide or minimise hair loss.
• Wearing sunglasses to protect the eyes from the sun and the environment.
• Wearing head coverings (wigs, hats, or scarves) to protect the head from the elements.
• Reducing stress. Many people with new onset alopecia areata have had recent stresses in life, such as work, family, deaths, surgeries, accidents, etc. However, this has not been proven scientifically as a cause of alopecia areata.

While the disease is not medically serious, it can impact people psychologically. Support groups are available to help people with alopecia areata deal with the psychological effects of the condition. Further information may be found at the Alopecia UK website (www.alopeciaonline.org.uk).