What's this
Alopecia areata is a chronic inflammatory disease that affects the hair follicles of the scalp and the rest of the body. It is typically characterized by a sudden hair loss in small patches of round or ovular shape; the temporal and occipital regions are the most commonly affected. In the most severe cases, alopecia areata reaches the whole scalp (total alopecia areata) or all body hair (absolute alopecia areata).
Differences with androgenetic alopecia
See More Photos Alopecia Areata
Alopecia areata affects, in the course of life, about 2% of the world population (10% of that affected by Down syndrome).
Far more widespread is instead another form of alopecia, called androgenetic or "common", which comes to affect more or less severely about 80% of the male population and 50% of the female population.
Instead, alopecia areata occurs with equal frequency in both sexes, in all ethnic groups and at any age, even if it prefers young adults and is rare after 60 years. This last characteristic also represents a point of clear division from androgenetic alopecia, which is instead typical of the second adult age and of senescence.
Furthermore, in most cases (around 90%) hair that has fallen due to alopecia areata tends to regrow SPONTANEOUSLY (about 50% within a year). Nevertheless the disease can recur. In androgenetic alopecia, on the other hand, the hair bulb undergoes a slow involution process until complete and irreversible atrophy (when this is complete there is no treatment capable of "regrowing" the hair).
Causes
There are also different origins, mainly hormonal and genetic in common alopecia, multifactorial with an important autoimmune and genetic component in that area.
In fact, in alopecia areata, the cells of the immune system attack the hair follicle, thus preventing it from performing its function and from growing hair and hair.
It is not yet clear why the immune system attacks the hair follicles, but generally people with a particular genetic predisposition are combined with other factors (severe psychological stress, iron deficiency, malnutrition).
We have seen, for example, that alopecia areata is slightly more common in patients with other immune disorders, such as atopic dermatitis, thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, chronic atrophic gastritis, celiac disease, vitiligo, type I diabetes mellitus and various forms of allergy. Due to the severe damage caused by immune aggression, hair follicles cease to replicate, thus causing hair loss.
Both forms of alopecia are not contagious.
Symptoms
To learn more: Symptoms Alopecia Areata
Of course, the main symptom of alopecia areata is the loss of hair and / or hair in localized areas - more or less extensive - and with a rounded shape.
In addition to this, patients suffering from this disorder may also experience symptoms such as:
- Nail pitting;
- Brittle nails;
- Opaque and coarse nails;
- Leukonychia.
Types of Alopecia Areata
The clinical manifestations of alopecia areata are very variable, although the appearance, often sudden, of one or more patches without hair and / or hair remains typical.
Depending on how it manifests itself, we can distinguish different types of alopecia areata, such as:
- Alopecia Areata monolocularis : it is a type of alopecia that occurs in only one point of the scalp.
- Alopecia Areata multilocularis : it occurs in multiple areas of the scalp.
- Total Alopecia : is a form that occurs on the whole scalp.
- Universal Alopecia : it is a type of alopecia that occurs on the whole body (including eyelashes, eyebrows, armpits and pubis). This form is particularly tenacious and rarely responds to therapies.
- Alopecia Barbae : is an alopecia areata that occurs only at the level of the beard.
- Alopecia Areata Ophiasis : this particular form of alopecia areata occurs in the peripheral regions of the scalp, such as the back of the head that goes from ear to ear and / or the occipital and temporal region. The term "Ophiasis" comes from the Latin and means "snake". This type of alopecia areata has earned this particular nomenclature due to the typical sinuous shape that it assumes when it occurs.
Although hair loss is often asymptomatic, a slight sensation of itching, tingling or burning may precede the development of the patch.
Care and Therapy
To learn more: Drugs for the Treatment of Alopecia Areata
As mentioned, in many cases, alopecia areata tends to self-purify and the hair grows back spontaneously. However, unfortunately, this does not mean that the disorder has resolved in this way, since alopecia can manifest itself again after some time.
When alopecia areata reappears, it becomes a particularly disabling illness from the psychological point of view, especially when the regrowth phenomena are particularly slow and / or characterized by temporary graying (the hair can be white and then gradually return to its original color). The prognosis is conditioned by several factors such as: age of onset, presence of familiarity, duration of the disease, extension of the patches, response to previous treatments and association with atopy or autoimmune diseases.
Adults who have only one or two patches of alopecia have the best prognosis. On the contrary, alopecia areata is more difficult and more resistant when it occurs in children, has been present for more than a year, has affected the occipital region and has rapidly progressed to a total or universal form.
The therapy of alopecia areata involves the use of various pharmacological aids, such as corticosteroids that counteract the attack of the immune system on the hair. Given the side effects of prolonged use of these medicines, local administration (creams or lotions) is preferred over systemic (pills or injections).
These drugs include betamethasone, fluocinonide and clobetasol.
Another active ingredient to be used topically that has proved useful in the treatment of alopecia areata - as well as in the treatment of androgenetic alopecia - is minoxidil in 5% lotion. The use of this active ingredient, based on a double application for at least four months, can stimulate hair regrowth.
Also the phototherapy with UVA rays associated with the intake of photosensitizers such as psoralens (P-UVA therapy) is commonly used in the treatment of alopecia areata, as well as the excimer laser.
No therapeutic intervention, however, guarantees with certainty the rapid resolution of the most severe cases of alopecia.
