Alopecia areata is an autoimmune condition that causes sudden hair loss, usually in small, round patches on the scalp. It can also affect other areas of the body such as eyebrows, eyelashes, and facial hair. This condition occurs when the immune system mistakenly attacks hair follicles. While the exact cause is unknown, healthcare professionals believe genetics and environmental factors can play a role. Alopecia areata can be unpredictable, with the hair sometimes growing back on its own or leading to more severe hair loss. Various treatments can help stimulate hair growth and manage symptoms, but the effectiveness varies from person to person.
Causes
Autoimmune response: the body's immune response attacks its hair follicles and disrupts hair growth because it thinks the follicles are foreign invaders. Scientists aren't sure exactly why the immune system attacks healthy hair follicles.
Genetics: alopecia areata can be related to multiple different genetic factors. However, not all people with the genes develop the condition. The genetic makeup of a person may trigger the autoimmune response for alopecia areata. Additionally, a family history of alopecia areata or other autoimmune conditions increases the risk of developing the condition.
Environmental triggers: Stress, infections, or other external factors may trigger or worsen the condition.
Other autoimmune conditions: People with conditions like thyroid disorders, vitiligo, or type 1 diabetes are more likely to develop alopecia areata.
Symptoms
The main symptom of alopecia areata is sudden, patchy hair loss that is usually on the scalp but sometimes on the eyebrows, eyelashes, or other body hair. There can be one patch, or multiple that are typically smooth and round. Typically, they present with no signs of redness or irritation. In some cases, hair may regrow on its own. In other cases, the condition can progress to more severe forms like alopecia totalis (total scalp hair loss) or alopecia universalis (complete body hair loss). Some people may also experience changes in their nails, such as ridges, dents, or brittleness.
Treatment options
While there is no cure to permanently resolve alopecia areata, there are options to temporarily treat the condition and possibly promote hair regrowth:
Corticosteroids:
Injections: anti-inflammatory drugs can be directly injected into the bald patches. This treatment option is commonly used for mild to moderate cases. Injections can help suppress the immune attack on hair follicles and can promote regrowth.
Topical creams/ointments: steroid creams can be applied to the scalp to reduce inflammation but may be less effective than injections.
JAK Inhibitors:
Medications such as baricitinib work by blocking Janus kinase (JAK) enzymes, which play a role in the immune response.
These drugs can significantly improve hair growth in some patients but may have side effects, including increased risk of infections.
Immunotherapy:
Topical immunotherapy: Chemicals are applied to the skin to create a mild allergic reaction. This distracts the immune system from attacking hair follicles which can allow room for hair regrowth.
This treatment option require ongoing treatment and can cause skin irritation.
Sources
National Alopecia Areata Foundation. “Alopecia Areata.” National Alopecia Areata Foundation | NAAF, 2024, www.naaf.org/alopecia-areata/.
Cleveland Clinic. “Alopecia Areata: Causes, Symptoms & Management.” Cleveland Clinic, 30 Aug. 2023, my.clevelandclinic.org/health/diseases/12423-alopecia-areata.
Ludmann, Paula. “Alopecia Areata: Overview.” Www.aad.org, 30 Aug. 2023, www.aad.org/public/diseases/hair-loss/types/alopecia.
“DermNet NZ – All about the Skin | DermNet NZ.” Dermnetnz.org, dermnetnz.org/.
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