One fine evening you just took a shower and you were getting ready for a party…while styling your hair you suddenly felt something odd…you just asked your mom to look and oh my goodness me…what is this…a round patch of baldness suddenly came from nowhere. That just might be alopecia areata.
Or
You are having hair fall issues for few
weeks. Suddenly people start asking you why your hair is becoming greyer day
by day. Are you suddenly becoming old? Certainly not. That might be
alopecia areata as well.
Or
You just have had a clean shave few
days back for a date. After few days when the beard starts to grow, you
suddenly realize there is a round area where the beard is not coming back.
And you might be thinking who ate that. Sorry, no one. It’s also a type of
alopecia areata.
Though it’s not as common as pimples
but alopecia areata has a global prevalence of around 2% (https://pubmed.ncbi.nlm.nih.gov/31437543)
I used to work in a govt. hospital OPD,
where around 200-300 patients used to come daily. Among them I found at least
2-3 patients with alopecia areata daily. Most of them are aged between 10-40.
What is alopecia
areata?
It is a hair losing disease, causing
rapid and complete loss of hair from one or more round or oval patches, most
commonly from scalp, bearded areas, eyebrows and less commonly from other hairy
parts of the body.
How can you
diagnose alopecia areata as a patient?
1.
Sudden appearance of a round or oval patchy
hair loss of 1-5 cm in diameter over scalp or bearded area or eyebrows or
any other hairy part of body.
2.
There may be single or multiple patches. Patches
may join to form large area of hair loss. Complete loss of scalp hair can occur
(alopecia totalis). Complete loss of all body hair may also occur (alopecia
uliversalis).
3.
Spontaneous regrowth can occur over a
patch. Newly growing hairs are typically grey or white which can regain
pigmentation later on.
4.
White hairs are rarely affected. So if you have
white and black hair evenly distributed over your scalp then you may notice
that hairs are becoming greyer or whiter within days. It can occur in
case of diffuse alopecia areata which is difficult to diagnose.
5.
There may be some changes in your nail in severe
cases like pitted nail (small depressions on nail surface), rough
nail etc.
Why does alopecia
areata occur?
See, our immune system is built to
protect us from foreign particles like bacteria or virus. But when our own
immune system works against our own body then it causes autoimmune disease
(over simplified). Alopecia areata is a type of autoimmune disease. Here T-Lymphocytes
(a cell of our body which is a part of our immune system) gets activated and
attacks hair producing cells. That causes hair loss. But it does not destroy
the hair follicle fully. And that is why hair loss in this disease can be
reversible.
Genetic factors also have some role.
About 25% patients have positive family history.
What are the other
important things to keep in mind?
1.
Other autoimmune diseases like thyroiditis, lupus
erythematosus, psoriasis or vitiligo may be associated with it.
2.
Patients with atopic dermatitis (a type of eczema
in short) may present more severe disease and at an earlier age.
3.
So if you have other health issues or problems, you
must share everything in details with your doctor.
Why should you
visit a qualified dermatologist ASAP?
See, my intention to create this post
is to enlighten and to educate the patient, not to diagnose the disease and
start self-medication. This is not a kind of disease where you can treat
yourself at home without consulting a doctor.
In children, a similar looking
alternate possibility is tinea capitis (a fungal infection of scalp).
Androgenetic alopecia, early lupus erythematosus, syphilis are some other
possibilities. You can’t differentiate between these diseases by your own.
Neither you can treat any of these diseases by yourself.
As there may be spontaneous regrowth
of hair in some cases, you might be reluctant to go to a doctor. You may think
that the problem will get cured by its own. But during that phase of regrowth
suddenly a new patch of hair loss may appear within days.
If the re-growing hair remains grey or
white for long duration, there is a possibility of associated vitiligo.
So you must visit a qualified dermatologist as soon as you detect the problem.
Prognosis
In my practice I have seen more than
50% patients had complete recovery within 6-12 months. Even in a patient
with alopecia totalis, compete hair regrowth was achieved by proper treatment
within 8 months. But unfortunately most of the patients come with similar
episodes in the future.
Association with atopic dermatitis,
early age on disease onset and more extensive involvements are
some bad prognostic factors.
What can you do?
1.
Try to recognize the problem as soon as possible.
2.
Maintain proper diet rich in vitamins, minerals and
antioxidants.
3.
Avoid foods with high sugar content.
4.
Seek help of a specialist ASAP.
What should you not
do?
1.
Don’t panic and don’t get over stressed.
2.
Don’t delay in seeking help from a qualified
dermatologist.
3.
Do not self-medicate yourself or apply anything on
your scalp without consulting your dermatologist.
Treatment
Multiple treatment modalities are
available. Let your dermatologist chose the best treatment for you.
Source
1.
https://pubmed.ncbi.nlm.nih.gov/31437543/
2. Andrew’s diseases of the skin – clinical dermatology, 12th edition, chapter 33
3. Rook’s textbook of dermatology, 9th edition, chapter 89
Lovely presentation sir. Thank you
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