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 nose, or ears.
Alopecia Totalis, it is complete loss of hair in the scalp.
Alopecia Universalis, it 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.
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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?

A 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 at 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 complete or partial loss of eyelashes, eyebrows, or both.

Nails: Alopecia can cause red nails, pits in the nails, ridges run the length of the nails and become brittle, 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, the location of hair loss.

For Children Below 10 Years:

Alopecia often begins during childhood. If your child has difficulty coping with the 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 for loss of eyelashes are:

False eyelashes.
Wear protective glasses to protect 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 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.
Corticosteroid 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, 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 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 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 prosthesis 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.