Alopecia is a condition that causes partial hair loss (alopecia areata), baldness, (alopecia totalis), or bald patches or baldness over the entire body (alopecia universalis). Both men and women can develop the several forms alopecia. Many people see their first symptoms as children or teenagers, with symptoms becoming more pronounced over the years. When alopecia is developed in later life, the symptoms tend to be milder. Around 15 in every 10,000 people in the UK will develop the condition in their lifetime.
Do I Have Alopecia?
People often don’t realise they have alopecia until it becomes distinct. In alopecia areata, the first round patches might be most noticeable where hair is thickest, at the back of the head, so usually a relative or hairdresser will be the first to make a remark.
Once a bald patch has been identified, alopecia can be recognised by the smooth, shiny and otherwise healthy look of the bald skin. However, the skin might also be a little irritated, dry, red and itchy. An exact diagnosis is not always possible immediately because other causes could responsible for baldness or thinning hair. These causes include the short-term effects of a stressful experience, a period of ill health or a reaction to certain medicines. These are one-off events that can lead to sudden bald patches that will recover and grow hair again with a couple of months.
If the condition is alopecia, the patches might grow in size or more patches could emerge over time. Likewise, the skin might appear to recover and hair growth may resume. In many cases, patches of alopecia appear while others recover.
What Causes It and Is There a Cure?
Alopecia is understood as an autoimmune disease, meaning the body’s own defences attack otherwise healthy cells. White blood cells and antibodies are at work throughout our bodies, functioning to identify and eradicate unwanted bacteria and viruses. In cases of alopecia, white blood cells misidentify hair follicles or the healthy bacteria surrounding the follicles as foreign and attempt to destroy them. This causes inflammation that weakens the hairs, causing them to fall out.
A case of alopecia can be triggered by a period of bad health, where the body’s defences have been under pressure to fight a virus or disease, or by a reaction to a course of medicine or another environmental stress factor. However, there is evidence to suggest that an underlying tendency to develop alopecia must be present.
Research on the causes alopecia is not conclusive, and no cure has been discovered. However, there are several treatment routes to follow to manage and reduce the symptoms of hair loss.
How Do I Treat It?
There are several options to consider when treating alopecia. One choice is to simply do nothing at all. If the symptoms are mild or the person doesn’t feel the need to remedy the condition, simply being patient might be the best option.
In mild cases, bald patches will recover in the course of a few months or a year. Hair re-growth might be a different colour, but this is also likely to recover after time. Alopecia areata rarely develops into alopecia totalis or universalis, and in many cases the bald patches achieve regrowth without treatment.
However, if hair loss is extensive, automatic re-growth is less likely. Seeking medical treatment could be sensible if the alopecia affects the person’s self-esteem or self-confidence.
One way to tackle the individual bald patches that appear in alopecia is with steroid injections. Steroids injected directly into the scalp suppress the immune reaction that attacks the hair follicles. Although effective, this treatment is costly and time-consuming because every individual patch needs to be treated approximately once a month.
Steroidal creams and lotions are a more affordable but less effective alternative to steroid injections. A doctor can prescribe these creams if he or she feels the patient is a suitable candidate, but if no re-growth appears after three to six months, there is very little reason to continue the treatment.
Topical Minoxidil for Alopecia
Minoxidil has been shown to be a very effective ingredient in the treatment of the symptoms of alopecia. Users apply a lotion containing the substance twice a day to promote hair growth. This product is also used in Male Pattern Baldness and other forms of baldness. Its mechanism isn’t fully understood, but as a potassium channel opener, Minoxidil aids the flow of oxygen and nutrients to the follicles, and this might play a significant role in hair re-growth.
While Minoxidil is found in many products in the US, it is only available for alopecia from a specialist or on a private prescription in the UK. For this reason, Minoxidil can be a costly option in the treatment of alopecia.
For patients experiencing extensive alopecia areata, topical immunotherapy could be worth considering. This is a treatment that is only available under the supervision of a specialist. Diphencyprone (DPCP) is applied to the skin to promote an allergic reaction. In many cases, this allows for a disturbance in the autoimmune condition and hair re-growth can occur. However, side effects include skin reactions, itching and flaking. It is also not suitable for those younger than 18.
Hair Pieces and Acceptance
Of course, re-growing hair is not the only solution. Many people living with alopecia choose to circumvent the medical route and look to other alternatives, such as using hairpieces and dermatography (tattooing) to give the illusion of eyebrows. Likewise, bald spots and baldness don’t need to be disguised unless they lead to feelings of lowered self-esteem. For both men and women, wearing hats and headscarves can be a practical and no-fuss solution to living with alopecia.
It is important to remember that alopecia in and of itself is not a sign of bad health. It is simply an episode of hair loss, and whether a person wants to treat the condition or not is a very personal decision.