Alopecia is the medical term for hair loss. Alopecia Areata is the most common form of an unusual auto-immune skin disease resulting in patchy hair loss on your scalp. It usually starts with a small patch of hair loss and continues with one or more small, round patches of hair loss on your head.
Alopecia Areata affects approximately 2% of the overall population, including more than 5 million people in the United States, according to the National Alopecia Areata Foundation (NAAF). Alopecia Areata is considered a skin disease because it occurs on the skin of the hair, or scalp, and is usually diagnosed by your dermatologist. Luckily, agree experts, it includes no rashes, hives or itching, although exposed scalp areas do require extra care.
In the 1990’s, Alopecia Areata was classified as an auto-immune disease. Researchers found that the disease is the result of the body producing an inappropriate immune response against itself. However, “I find that most patients report a history of acute stress which precipitated the condition,” says Sara Wasserbauer, M.D., a Board Certified, California-based hair transplant surgeon.
The Normal Hair Growth Cycle
Dr. Wasserbrauer explains that the normal growth rate of scalp hair is about a fourth to a half an inch every month. Hair growth is a repeating cycle that can be disrupted by genetics, diseases, medications, infections or other more common factors that may cause hair loss. During the anagen growth phase, a follicle actively grows hair until the catagen phase in which the follicle slows down growth. During the telogen phase, the follicle rests prior to the start of a new anagen phase or growth of a new hair shaft. As the new hair shaft pushes out the ‘dead’ hair shaft, the old hair is shed. “About 50 to 100 telogen hairs are normally shed every day and you find them in your comb, brush and shower drain,” says Dr. Wasserbrauer. About 10 percent of scalp hair follicles are normally in telogen phase at any given time if the scalp is healthy and not affected by any condition that causes hair loss.
What Does “Autoimmune” Mean?
According to The Johns Hopkins Medical Institutions Autoimmune Disease Research Center, a healthy human body uses an effective set of weapons, the immune system, against viruses, bacteria, and parasites that can attack your body. Unfortunately, this powerful immune system sometimes mistakenly attacks the body itself. Misdirected immune responses are called auto-immunity. In Alopecia Areata, it’s your hair follicles that are mistakenly attacked by your own immune system, resulting in the disruption of the hair growth stage.
Types of Alopecia
The NAAF classifies three types of Alopecia. The first is Alopecia Areata which presents as random patches of hair loss. When hair loss involves the total head, it is called Alopecia Totalis and when it extends to the total body hair loss it is called Alopecia Universalis, There is no sure cure for the conditions but many doctors prescribe medications to help control the episodes. In all forms of Alopecia, the hair follicles remain alive and are ready to resume normal hair production whenever they receive the appropriate signal from the body. In all cases, hair re-growth may occur even without treatment and even after many years, according to the NAAF.
Do You ‘Catch’ Alopecia…or is it Genetic?
Experts believe there is a genetic component to Alopecia Areata, because one out of five people who have the symptoms, have a family-member also affected by hair loss, according to the NAAF. Current research has found that if onset begins after age 30 you are less likely to have an affected family member. When onset of the first patch of Alopecia Areata begins before age 30, it is more likely other family members are affected. The NAAF has focused a lot of its research into investigating the genetic elements of the disease to finally identify who is most susceptible to the disease and why. “Androgenetic Alopecia (AGA) is the name for the inherited condition neither associated with a specific gene (or genes) nor yet identified with certainty,” says Dr Wasserbauer.
Alopecia Treatment Options
According to the NAAF there are no FDA-approved treatments specifically for Alopecia Areata, however, many medical professionals are willing to try treatments off-label. There are treatment options available for mild, patchy Alopecia Areata (less than 50% scalp hair loss) however none of the acceptable treatments work in all cases. Many hairstylists are using low-light laser therapy to stimulate the follicles to create new hair which only works on clients who still have active hair follicles at the beginning stages of hair loss.