Is your hair falling out too? Let's talk about Alopecia Areata!

Hair is something that we all love and is very important to our appearance. So when hair suddenly starts to fall out, it is normal for anyone to feel a little scared and worried. Today we are going to talk about a condition that causes hair loss in such places, namely Alopecia Areata.

What exactly is Alopecia Areata?

Simply put, Alopecia Areata is a condition in which hair falls out in patches due to a change in our body's immune system. Doctors call it an autoimmune disease . That is, our own body's defense system mistakenly attacks our own hair follicles. 'Alopecia' means 'hair loss' or 'baldness' in medical terms. 'Areata' means 'in small, random areas'. So, although this condition most commonly affects the hair on the scalp, it can occur anywhere on the body where there is hair.

Are there different types of this?

Yes, there are several types of this, depending on how much hair you've lost and where on your body it's coming from. Keep in mind, this can affect everyone differently.

• Alopecia Areata Totalis: This is when all the hair on the head falls out. Imagine losing your entire head of hair.
• Alopecia Areata Universalis: This is a bit more extreme. Not only does the hair on the head fall out, but all the other hair on the body, including the eyelashes, eyebrows , and even the hair on the limbs, falls out.
• Diffuse Alopecia Areata: In this condition, instead of large patches of hair falling out, the hair becomes very thin. It feels like the thickness of the hair has decreased.
• Ophiasis Alopecia Areata: In this, hair grows in a band on the back of the head, close to the neck, and on both sides.

Who is more likely to develop this condition?

Now you're probably wondering who gets this, right? Actually, this condition can happen to anyone. But some people are more likely to get it.

• Young children: Yes, don't be surprised, young children can develop this too.
• If someone in your family has the condition: If someone in your family has alopecia areata, you have a small risk of developing it too. It may be genetic.
• If you or your family members have other autoimmune diseases : DiabetesPeople with other autoimmune diseases , such as diabetes mellitus, lupus, or thyroid problems, are also more likely to develop this condition.

How common is this situation?

This is actually a more common condition than you might think. We see patients like this in Sri Lanka too. Millions of people around the world suffer from this condition. According to some reports, about 20% of the new cases of this disease every year are children. When compared to other major causes of hair loss, it can be said that this is the second most common hair loss condition.

What happens when you develop Alopecia Areata? What are the symptoms?

Okay, now let's see what happens when Alopecia Areata develops, and what are the symptoms. The main thing is that the hair falls out in patches, in a circular shape, sometimes the size of a coin . But sometimes these patches can be larger or smaller. The amount of hair loss also varies from person to person. Not only that, you can also see changes in your nails . You can have small pittings in your nails. It looks like they've been pricked by a needle. Sometimes your nails can become rough and feel like sandpaper. This condition usually doesn't have a big impact on your physical health. However, it can have a big impact on your mental health. Because hair is such an important part of our appearance, when this happens suddenly, things like sadness, anxiety, and sometimes depression can occur. It can also be uncomfortable when you're socializing.

What are other symptoms?

Common symptoms are:

• Hair loss in places on the head, beard, eyebrows, eyelashes, and other parts of the body.
• Nail pitting.

However, very rarely, you may also see the following symptoms in areas where hair has been lost:

• Itching (pruritus).
• Skin discoloration (may be red, purple, brown, or gray).
• Where there were hair follicles, the mouth-like openings (follicular ostia) are visible.
• What looks like black dots (these are actually cadaver hairs inside the hair follicles).
• Short, thick, and thin hairs that grow toward the skin are called ``exclamation point hairs.'' This means that the hairs grow like an exclamation mark.
• Gray hair.

Why does Alopecia Areata occur?

Why does this actually happen? As I said before, Alopecia Areata is an autoimmune disease .Autoimmune disease. This means that our body's immune system - the system that protects us from disease - mistakenly attacks our own hair follicles, the hair follicles at the base of our hair. The immune system thinks that these hairs are a harmful invader, like bacteria or a virus. When this attack occurs, the hairs start to fall out. Often, they are in the shape of a coin. The amount of hair that falls out varies from person to person. Some people lose only a few spots. Others lose a lot of hair, sometimes even all of their hair. Our genetic makeup (the parts of the cells that determine things like our eye color, height, and hair color) may be a factor in triggering this autoimmune reaction. Or, along with genetic causes, a virus or other substance we are exposed to can trigger this reaction.

Is this contagious?

A question that many people have is whether it is contagious. No, Alopecia Areata is not a contagious disease at all. It is not spread from one person to another through skin-to-skin contact or through the air. So don't worry about it.

How does a doctor recognize this?

A doctor can usually diagnose this condition by performing a physical exam, asking you questions about your medical history, when your hair started falling out, and whether anyone in your family has this condition or other autoimmune diseases. They will also examine your nails.

What tests are done to identify this exactly?

Sometimes, if it's hard to tell just by looking, a doctor may do tests like these:

• Checking for any infection on the scalp.
• Taking a strand of your hair and sending it to a lab for analysis.
• A scalp biopsy is a procedure that involves taking a small piece of skin from the scalp and examining it. This can help determine if there is a skin disease.
• Doing blood tests .

Is it possible to recover completely from this condition?

This is a question that many people ask. To be honest, there is no cure for alopecia areata. However, available treatments can help control hair loss and sometimes regrow hair. However, they do not completely cure the disease. The two more severe forms of alopecia areata, Alopecia Areata Totalis (total hair loss on the entire head) and Alopecia Areata Universalis (total hair loss on the entire body), may be less responsive to treatment.

How do we treat this?

Okay, so how do we treat this? There are several treatment options. Your doctor will determine which treatment is best for you based on your condition.

• Corticosteroids: These are anti -inflammatory medications used to treat autoimmune diseases. They may be given as an injection into the scalp or hair follicles. They can also be taken as pills or applied to the skin as a cream or ointment. It can take a while for the body to respond to these medications. Some people may experience side effects such as increased appetite, weight gain, mood swings, and blurred vision.
• Minoxidil (brand name Rogaine®): This is a topical medication. It is used to treat baldness in both men and women. It usually takes about 12 weeks for hair to start growing back. It can cause itching on the scalp, and in some people, hair growth in other areas, and headaches.
• Phototherapy: This uses ultraviolet light from special lamps. A doctor may use either ultraviolet A (PUVA) or ultraviolet B (PUVB) light with a drug called psoralen. These rays can help with some skin and nail conditions, including alopecia areata.
• Platelet-Rich Plasma (PRP) treatment: This involves taking some of your own blood, processing it in a special way, and injecting it back into your scalp. This is said to stimulate hair growth. Some people may experience scalp pain, itching, dizziness, and nausea.
• Topical Immunotherapy: This is a slightly different treatment. A doctor applies a substance to your skin that causes an allergic reaction. The hope is that this contact dermatitis will cause hair growth. You may experience itching of the scalp, swollen lymph nodes, eczema, and skin discoloration.
• Styling techniques: Sometimes, no matter what treatment is used, the body may not respond well to it. In such cases, various hair styles, wigs, or hair weaves can be used to cover the hair loss.

Can hair grow back?

The biggest hope for many people is to see if their hair will grow back. Alopecia Areata is a condition that is a bit difficult to predict.. Some people will regrow their hair, but it may take a while for it to regrow. Others may regrow their hair and never grow it back. This means that it varies from person to person. Even if a person loses all of their hair, there is a chance that it will grow back. Depending on the treatment you receive and its success, you may see new hair between 4 and 12 weeks after starting treatment.

Is there a way to prevent this from happening?

Unfortunately, there is currently no way to prevent the development of Alopecia Areata . Treatment can only reduce the symptoms. If you have this condition, it is likely to occur for the rest of your life.

If I have this condition, what should I expect?

In mild cases, the symptoms may flare up and then go into remission. However, in the more severe cases of alopecia areata totalis and alopecia areata universalis, the body may not respond to treatment as well.

How do I take care of myself? What are the things I should and shouldn't do?

Okay, now let's see how you can take care of yourself if you have this condition, what you should do, and what you should not do. Things you can do:

• You can use makeup to cover up or minimize the appearance of hair loss.
• If your eyelashes are falling out, wear sunglasses to protect your eyes. This will protect your eyes from sunlight and things like dust.
• Wear something like a hat or scarf to protect your head from the sun and wind.
• Eat a well-balanced diet . Hair growth is a process that depends on vitamins and minerals. Although not specifically linked to alopecia areata, people who follow fad diets are more likely to experience hair loss. The Mediterranean diet (which is high in fruits, vegetables, and protein) can help strengthen hair and reduce hair loss.
• Consider taking vitamin D supplements, but be sure to ask your doctor.

Things you should not do:

• Exposure to sun and wind: Hair protects us from the sun and wind. Eyelashes stop dirt and dust from getting into our eyes. If you have alopecia areata, you need to take special care to protect your skin (and possibly your eyes) when you go outside.
• Severe stress: Although not proven by extensive research, many people who develop alopecia areata have recently experienced significant stress in their lives, such as work problems, family problems, deaths, surgeries, and accidents. So try to keep your mind as relaxed as possible.
• Avoid hair products and treatments that contain harsh chemicals: This includes things like chemical straighteners and permanent waves. Try to find gentle shampoos and conditioners that are free of silicones and parabens.

When should I see a doctor?

See a doctor as soon as you notice that you are losing hair. After starting treatment, inform your doctor again if any of the following occur:

• If you develop new symptoms.
• If there is no improvement in symptoms after treatment.
• If the hair follicles appear infected (i.e. red, purple, gray or white; inflamed, swollen, etc.).

What are the important questions to ask the doctor?

When you see a doctor, it's very important for you to ask these questions:

• How exactly do you tell if I have Alopecia Areata?
• If I don't have alopecia areata, is there any other reason why I'm losing my hair?
• What kind of medication or treatment do you recommend for me?
• What is the full list of side effects of those medications and treatments?
• After treatment, when can I expect my hair to start growing again?
• What else can I do to prevent further hair loss?
• Should I see a dermatologist?

Finally, things to remember

Losing hair can be scary and upsetting. But remember, Alopecia Areata is a very common condition. We all lose a little hair when we shampoo or comb our hair, it's part of the hair growth process. But if you have Alopecia Areata, you may notice more hair loss than normal. Or you may not notice it until you notice bald patches.

The most important thing is to seek medical advice as soon as you notice that you are losing your hair, especially if it is causing you stress, anxiety, or even depression.

A doctor can help you figure out exactly what's wrong with you and start the right treatment for you. You don't have to face this alone, ask for help.