hair loss

What is Alopecia Areata ?:

• Alopecia areata is a particular form of hair loss that can affect any part of the body in either sex. The hair loss is noticed as a round bald area. There are no other symptoms. The commonest site for alopecia areata is the scalp, but frequently the beard area in men is affected. More rarely, eyebrows and eyelashes are affected. In some individuals it can spread over the whole body, when it is called alopecia universalis. Often, only a single area is found, but sometimes multiple areas occur affecting different parts of the scalp or beard area. The bald skin is smooth and soft, and small broken hairs may be seen at the edge of the patch. Any age group can be affected.

How does Alopecia Areata occur ?

Alopecia areata is an "auto-immune" disease. This means a condition in which the body's defense or immune system acts as if its own hair is abnormal and attacks it. This results in hair loss. Why certain small areas are involved is not known. It is occasionally found with other auto-immune diseases affecting the blood, thyroid gland and adrenal glands, and skin pigment cells.

Why does Alopecia Areata occur ?

Alopecia areata may affect several members of your family, because the tendency to it is partly inherited, exposure to toxins like pesticide, vitamin deficiency, autoimmune process or a fungal or bacterial infection. In some people, emotional stress or injury to the involved area may trigger the problem.

Treatment Involved for Alopecia Areata

Common sense approach to the treatment is by treating the cause.

When the hair starts to grow, you may notice that the hairs are often fine and white and may not be obvious in the mirror. With time, the hairs thicken and darken and so become more easily seen. Occasionally, the hairs thicken but remain white. Hair grows very slowly and it may take many months before the bald patch becomes covered with hair.

After Treatment for Alopecia Areata

Once the patches have regrown, they are unlikely to go bald again.

If Alopecia Areata is Left Untreated

Alopecia areata may occur in other family members but this is unusual. Patients with severe alopecia need considerable support from family and friends.

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• Corticosteroids--Corticosteroids are powerful anti-inflammatory drugs similar to a hormone called cortisol produced in the body. Because these drugs suppress the immune system if given orally, they are often used in the treatment of various autoimmune diseases, including alopecia areata. Corticosteroids may be administered in three ways for alopecia areata:

   

  • Local injections--Injections of steroids directly into hairless patches on the scalp and sometimes the brow and beard areas are effective in increasing hair growth in most people. It usually takes about 4 weeks for new hair growth to become visible. Injections deliver small amounts of cortisone to affected areas, avoiding the more serious side effects encountered with long-term oral use. The main side effects of injections are transient pain, mild swelling, and sometimes changes in pigmentation, as well as small indentations in the skin that go away when injections are stopped.
  • Oral corticosteroids--Corticosteroids taken by mouth are a mainstay of treatment for many autoimmune diseases and may be used in more extensive alopecia areata. But because of the risk of side effects of oral corticosteroids, such as hypertension and cataracts, they are used only occasionally for alopecia areata and for shorter periods of time.
  • Topical ointments--Ointments or creams containing steroids rubbed directly onto the affected area are less traumatic than injections and, therefore, are sometimes preferred for children. However, corticosteroid ointments and creams alone are less effective than injections; they work best when combined with other topical treatments, such as minoxidil or anthralin.
• Minoxidil (5%) (Rogaine*)--Topical minoxidil solution promotes hair growth in several conditions in which the hair follicle is small and not growing to its full potential.

A 35-year-old woman presented with severe recalcitrant atopic dermatitis, in association with disseminated mollusca contagiosa and alopecia areata universalis. After several weeks of systemic interferon gamma, which was administered subcutaneously,the viral infection cleared and, surprisingly, four weeks after starting treatment hair re-growth was observed. Complete remission of alopecia areata was documented few weeks later and persists. After four cycles of high-dose intravenous immunoglobulin, a sustained remission of the atopic dermatitis was achieved.
J Dtsch Dermatol Ges. 2005 Jun;3(6):441-4

We report a patient with CVID and AU treated with IVIG who experienced significant hair regrowth. An 8-year-old girl with CVID and AU was treated with IVIG 400 mg/kg every 4 weeks. Since her second dose of IVIG, regrowth of eyelashes, eyebrows, body and scalp hair was observed in this patient. At present, about 1 year treat-meant of IVIG, significant hair regrowth is noted with 5-6 cm of scalp hair. We believe that IVIG may be beneficial in the treatment of AU, at least in patients with CVID.
Asian Pac J Allergy Immunol. 1999

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