HomeHealth articleshormonal changesWhat Is Alopecia?

Alopecia - Types, Causes, Diagnosis, Treatment, and Prevention

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Alopecia is hair loss that appears on any part of the body where the body acts against its hair follicles. Read below to know more about alopecia.

Medically reviewed by

Dr. Dhepe Snehal Madhav

Published At October 12, 2022
Reviewed AtMay 15, 2023

Introduction:

Hair loss can affect the scalp or the entire body, and it can either be temporary or permanent. It can occur due to hormonal changes, heredity, medical conditions, or a normal part of the aging process. It is more common in men than in women.

What Are the Types of Alopecia?

The main types are:

  • Alopecia Areata commonly known as bald. Areata means patch. It can develop in the scalp, eyebrows, eyelashes, beard area, armpits, inside of the nose, or ears.

  • Alopecia Totalis is a complete loss of hair on the scalp.

  • Alopecia Universalis is a rare condition where hair loss occurs in all parts of the body, leaving the entire body hairless.

What Are the Causes of Alopecia?

Alopecia is an autoimmune disease which means the body’s own immune system attacks a part of the body.

Hair loss is related to the following factors:

  • Family history and personal history called androgenic alopecia, male-pattern baldness, and female-pattern baldness.

  • Hormonal changes like pregnancy, childbirth, menopause, and thyroid problems.

  • Medical conditions like immune system-related, ringworm infection, and trichotillomania.

  • Medications for cancer, pregnancy, childbirth, menopause, thyroid problems, gout, depression, heart problems, and high blood pressure.

  • Radiation therapy to the head.

  • A very stressful event like physical or emotional shock can cause temporary hair loss.

  • Excessive hairstyling or hairstyles such as pigtails or cornrows, can cause traction alopecia. Hot-oil hair treatments also can cause hair fall.

Who Gets Alopecia?

  • Close blood relative with alopecia.

  • Asthma, hay fever, thyroid disease, atopic dermatitis, vitiligo, or Down syndrome.

  • Cancer therapy with Nivolumab drug.

What Are the Clinical Features of Alopecia?

Alopecia more often causes hair loss on the scalp, but hair loss can occur in any part of the body. There are no signs of a rash, redness, or scarring when the hair fall occurs. It is commonly present as round or oval bald patches on the scalp but can take any shape. Gray and white hairs remain where there is hair loss. Alopecia can also be widespread, leaving a little hair or losing all the hair on the head. Sometimes a band or strip of bald skin develops on the scalp known as ophiasis. Hair regrows on its own where it fell out. Alopecia generally does not cause pain. However, some people say that right before they lose their hair, they feel tingling, itching, or burning on the skin where the hair will fall out.

Beard: In men, alopecia may develop one or more bald patches even in the beard area.

Eyelash / Eyebrow: Alopecia can cause a complete or partial loss of eyelashes, eyebrows, or both.

Nails: Alopecia can cause red nails, pits in the nails, and ridges run the length of the nails and become brittle and rough. This can be painful.

How to Diagnose Alopecia?

Because there are so many reasons for hair loss, testing is sometimes necessary to make sure alopecia areata is the cause of your hair loss.

  • A blood test is done to diagnose if the immune system is involved.

  • Pull test to determine the shedding stage.

  • Scalp biopsy to examine the hair roots.

  • Light microscopy to find disorders of the hair shaft.

How to Treat Alopecia?

When treatment becomes necessary, many factors like age, the amount of hair loss, and the location of hair loss.

For Children Below 10 Years:

Alopecia often begins during childhood. If your child has difficulty coping with hair loss, treatment can often help regrow hair.

Treatment options for children 10 years of age and younger are:

  • Apply topical Corticosteroid once or twice a day to the bald spots, or corticosteroid injection every four weeks to eight weeks.

  • Apply Minoxidil two to three times a day to maintain the regrowth of hair. It is helpful for the scalp, eyebrows, and beard area.

  • Apply Anthralin to the bald spots and allow it to sit on the skin as prescribed by the dermatologist.

Loss of Eyelashes:

Eyelashes protect the eyes. Treatment options for loss of eyelashes are:

  • False eyelashes.

  • Wear protective glasses to protect the eyes and make the hair loss less visible.

  • Bimatoprost helps grow longer eyelashes.

Loss of Eyebrows:

Alopecia of eyebrows is treated by:

  • Semi-permanent tattoo.

  • Stick-on eyebrows.

  • Intralesional corticosteroids and applying Minoxidil help the regrowth of eyebrows.

Rapid Hair Loss:

People with alopecia totalis or alopecia universalis, regrow their hair by:

  • Contact or topical immunotherapy to change the immune system so that it stops attacking the hair follicles.

  • Methotrexate Is prescribed when extensive hair loss is seen and other treatments fail to work. Hair regrowth begins in about three months after taking it and fully regrows hair in six to 12 months.

  • Corticosteroids taken for six weeks can help regrow hair.

  • JAK inhibitors like Tofacitinib, Ruxolitinib, and Baricitinib can treat extensive hair loss.

  • As the treatment takes time, a wig, or hairpiece can cover up hair loss. This is essential if hair loss lowers self-esteem or makes one feel anxious or depressed.

  • Custom-made scalp or hair prosthesis.

  • Shaving the head or beard can hide patches or diffuse hair loss on the head or beard area.

How to Prevent Alopecia?

The following tips help avoid hair loss:

  • Be gentle with the hair. Use a detangler and avoid tugging, curling irons, and hot oil treatments.

  • Protect hair from sunlight’s ultraviolet light.

  • Quit smoking.

  • Cooling caps can reduce the risk of losing hair during chemotherapy.

What Is the Prognosis of Alopecia?

The prognosis of alopecia is usually good. Sometimes, when alopecia is present as a patch, hair regrows without any treatment. When hair fails to grow back, other treatments are done.

Conclusion:

Alopecia refers to excessive hair loss from the scalp or any other area. Some people leave it untreated and unhidden while others cover it up with hairstyles, hats, hair prostheses, or scarves. And still, others prefer treatments to prevent further hair loss or restore growth. Before seeking any hair loss treatment, talk with a dermatologist about the cause of the hair loss and treatment options.

Frequently Asked Questions

1.

How Serious Is Alopecia?

Alopecia is a common condition, and medically this disease is not that serious. Most of the people with this condition are healthy and do not show any symptoms. The severity of alopecia may vary from person to person. Some people may have a high amount of hair loss throughout their life, and some others may experience only one episode of this condition.

2.

How to Get Rid of Alopecia?

Currently, there is no specific cure for alopecia. However, various forms of treatment can be suggested by the healthcare professional to help regrow the hair more quickly. Some of the common treatment therapy includes using corticosteroids and strong anti-inflammatory drugs that can suppress the immune system.

3.

How Long Does Hair Loss Last?

In the majority of patients with alopecia, the episodes of hair loss may last for less than a year, and the hair may also grow back without treatment. However, these patients may experience recurrent episodes of hair loss that may also regrow or respond well to the treatment.  

4.

How to Get Rid of Alopecia Naturally?

Some natural remedies can help stimulate hair growth and may also enhance the strength of existing hair, which include -
- Massage - Massaging the scalp or head helps stimulating hair growth.
- Aloe Vera - This can be beneficial in the treatment of hair loss.
Coconut Oil - This contains fatty acids that help in the growth of hair.
- Fish Oil - This oil contains fatty acids that can improve hair growth.
- Onion Juice - Helps in promoting hair growth.

5.

Which Food Prevents Hair Loss?

People affected with hair loss may start including some of the following food in their diet to prevent hair loss, which includes -
- Eggs.
- Carrots.
- Oats.
- Spinach.
- Sweet potatoes.
- Avocado.
- Prunes.
- Beans.
- Meat.
- Kiwi.
- Lentils and chickpeas.

6.

Is Alopecia Permanent?

Hair loss or alopecia can affect the scalp or the entire body. This can either be temporary or permanent. The condition may be a result of hormonal changes, genetics, an underlying medical condition, or due to normal aging. Anyone can get this condition, but is most commonly seen in men.

7.

How Does Alopecia Spread?

Alopecia may spread when new patches of baldness occur. These bald patches may join the existing bald patches. These large bald patches may be seen, while in the old patches, the hair may start regrowing. However, in some cases, the loss may be permanent as the hair follicles may deteriorate.

8.

What Fruits Help Regrow Hair?

Some of the hair-friendly fruits that can help in regrowing hair include -
- Bananas.
- Papaya.
- Strawberries.
- Gooseberries.
- Oranges.
- Apples.
- Guavas.

9.

At What Age Does Alopecia Start?

Alopecia can start at any age, and anyone can have alopecia. It can impact all racial and ethnic groups equally, and men are most commonly affected by this condition. The onset of alopecia can occur at any age, but most people get it during their teens, twenties, or thirties. However, when it is seen in young patients of age less than ten, it is found to be extensive and progressive.

10.

What Is the Last Stage of Alopecia?

As the disease progresses, more and more bald patches can be seen, and the hair from the scalp usually falls out in small patches, and this does not cause any pain. This can also be seen on different parts of the body, such as eyebrows and eyelashes. With time as the disease progresses, it can lead to complete hair loss or alopecia totalis.

11.

Is Stress and Alopecia Related?

Yes, stress can be one of the common causes of alopecia. Stress can lead to hair loss or may be one of the causative factors to it. Three types of hair loss can occur due to stress, which includes telogen effluvium, alopecia areata, and trichotillomania. However, the hair loss caused by stress is usually temporary.

12.

What Blood Test Is Done for Alopecia?

One of the blood tests can be done in case of alopecia to understand its severity and progression. The C-reactive protein (CRP) blood test is commonly advised, which may help in determining the inflammation levels associated with alopecia. This test is one of the prime diagnostic parameters used in the case of autoimmune inflammation.

13.

Can Alopecia Be Treated With Ayurveda?

There are a few Ayurveda treatments that may help in reducing hair loss and stimulate hair growth which includes - 
- Ayurvedic hair oil application.
- Panchakarma therapy which includes five methods to cleanse the body.
- Nasya therapy includes taking ayurvedic medicines through the nasal cavity.
- Following the Ayurvedic diet.
Dr. Dhepe Snehal Madhav
Dr. Dhepe Snehal Madhav

Venereology

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hormonal changeshair loss
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