WHAT IS ALOPECIA? • IT IS ABSENCE OR LOSS OF HAIR
FORMS OF ALOPECIA • AREATA-BALD SPOTS PATCHY HAIR LOSS • TOTALIS-COMPLETELY BALD OR WITH LITTLE VISIBLE HAIR ON SCALP • UNIVERSALIS-NO VISIBLE HAIR ON BODY • CICATRICIAL-SCARRING HAIR LOSS
ALOPECIA AREATA Current evidence suggests that alopecia areata is caused by an abnormality in the immune system. This particular abnormality leads to autoimmunity. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune cells inside of the hair follicles where they are not normally present. What causes this is unknown. Alopecia areata is sometimes associated with other autoimmune conditions such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. Sometimes, alopecia areata occurs within family members, suggesting a role of genes and heredity.
Is alopecia areata hereditary? • Yes, heredity plays a role. In one out of five persons with alopecia areata, someone else in the family also has it. Those who develop alopecia areata for the first time after the age of thirty years have less likelihood that another family member will have it. Those who develop their first patch of alopecia areata before the age of thirty have a higher possibility that other family members will also have it.
ALOPECIA TOTALIS • Alopecia totalis is the loss of all head hair. Its causes are unclear, but it is an autoimmune disorder. Stress is sometimes thought to be a contributor to the hair loss caused by alopecia, however many people leading relatively stress-free lives have experienced the symptoms.
ALOPECIA TOTALIS (CONT’D) • In alopecia totalis, immune system cells called white blood cells attack the rapidly growing cells in the hair follicles that make the hair. The affected hair follicles become small and drastically slow down hair production. Fortunately, the stem cells that continually supply the follicle with new cells do not seem to be targeted. So the follicle always has the potential to regrow hair.
IS THERE A DIFFERENCE BETWEEN AREATA AND TOTALIS? • For all practical purposes, a few patches of hair loss is called Alopecia areata; while total hair loss all over the head, including eyebrows, eyes lashes is called Alopecia totalis. • The treatment approach is different and the prognosis is also difference. That is, Alopecia Areata is treatable with great success, while Alopecia totalis is not curable using homeopathy. Steroids may help but superficially. Our experience suggests that by use of steroids, most patients get more spots elsewhere on the skin. Steroids do not address internal autoimmune disorder. But, they are very useful during acute attacks.
ALOPECIA UNIVERSALIS • The most advanced form in a series of conditions all related to the same disease, Alopecia Universalis is characterized by total a loss of body hair. A member of the group of hair loss conditions called Alopecia Areata, the only difference between Alopecia Universalis and it's variants is the extent of hair loss.
ALOPECIA UNIVERSASLIS (CONT’D) • Patients are usually otherwise healthy, but have more thyroid disease and vitiligo than the general population. Those with vitiligo (patchy loss of skin color) may also develop AU in time. Many individuals with Alopecia Universalis are born with some hair, but then begin losing it very quickly. The disorder is inherited as an autosomal recessive trait. It is caused by a mutation in a gene dubbed HR in chromosome band 8p21.2 that is the human homologue of the mouse "hairless" gene -- the human version of the gene in the mouse that is responsible for hairless mice.
ALOPECIA UNIVERSALIS (CONT’D) • Is the "hairless" gene only found in people with Alopecia Universalis? Most likely. Based on the known research, we can safely assume that only individuals with this rare and severe form of Alopecia Areata carry the gene. Unfortunately, there have not been enough studies done to verify that this is true of all those afflicted.
ALOPECIA UNIVERSALIS (CONT”D) • Aside from genetic tendencies, the contributing causes of Alopecia Universalis are not known. It is important that those with it are careful to protect themselves from the sun, bacteria, and other potentially harmful elements, as the scalp, nasal cavity and eyes are not protected. According to the National Alopecia Areata Foundation, other than the hair, nails can also be affected. The nail involvement may be limited to pinprick indentations, all the way to severe distortion of the entire nail. Alopecia Universalis may be acute and short-lived, or remain permanently. The possibility of regrowth does remain however, even for those with 100% hair loss for many years. Predicting when regrowth may occur is not currently possible.
ALOPECIA IN CHILDREN • Hair loss in children is actually not very common, however it is significant enough that nearly 2 Million children suffer from at least one form of Alopecia (hair loss) or another in the United States alone. The good news is that at least 60% of children with Alopecia will "outgrow" the condition without need for treatment. As with all forms of Alopecia, a reversal and complete restoration of hair takes time - sometimes up to a year or more, but for the vast majority of children, it will spontaneously resolve. The bad news is that 40% wont have such luck, which can be quite frustrating both for the parents and the child affected by this often cosmetically embarrassing condition.
CHILDREN WITH ALOPECIA • Please keep in mind: hair loss in children is not due to vitamin deficiencies (unless extreme malnutrition is present), poor scalp circulation, headbands, hats, or cold weather. Diagnosis is typically as simple as an evaluation of the risk factors a visual examination of the type of loss, and some tests your doctor can perform. • Alopecia is not life-threatening, and children who have it are otherwise healthy. Why the hair falls out from the roots is still a mystery. What is known is that the condition is not contagious, caused by foods, or the result of nervousness, hyperactive disorders, or psychological stress. In 20% of cases another family member has been affected. Some patients with this condition will also develop a grid-like pitting of the nails.
CICATRICIAL ALOPECIA • The cause of the various cicatricial alopecias is poorly understood. However, all cicatricial alopecias involve inflammation directed at the hair follicle, usually the upper part of the follicle where the stem cells and sebaceous gland (oil gland) are located. If the stem cells are destroyed, and the sebaceous gland as well, there is then no possibility for regeneration of the hair follicle and permanent hair loss results.
WEBSITES AND SUPPORT GROUPS • WWW.ALOPECIAWORLD.COM • CHILDRENS ALOPECIA PROJECT • NATIONAL ALOPECIA AREATA FOUNDATION • WEBMD FOR INFO • WWW.HAIRLOSSTALK.COM • GOOGLE – ALOPECIA AND FIND OTHER RELATED SITES.