Alopecia Areata Can Be
Rapid And Extensive

Alopecia areata can lead to alopecia totalis or alopecia universalis - this is complete hair loss across the whole body.

Of the many forms of hair loss, this is, perhaps, the scariest.
That's because this disease can be horrifyingly rapid.

How many people suffer from it?

Fortunately, not that many - only 1.7% of the population in western countries develop this condition. It can affect both sexes, and at any age (including children). It affects all races equally but is not a contagious disease.

Alopecia areata most often affects the scalp, but can occur in any hair-bearing part of the body. As such, many variations exist:

1. Alopecia areata barbae This hair loss is limited to just the beard. 2. Alopecia areata monocularis This will appear as a single bald spot perhaps no more than 2cm across. 3. Alopecia areata multicularis Appears as multiple bald spots. 4. Diffuse alopecia areata Involves hair loss spread over a wide area. (Due to the rapid nature of areata, this may cause someone with mixed dark and grey hair appear to go white overnight).

5. Alopecia totalis
Causes total scalp hair loss (this may include the eyebrows and eyelashes too).

6. Alopecia universalis
This is loss of all hair (including the head and pubic hair).

Learn more about alopecia totalis and alopecia universalis, click here.

So, how do you recognise alopecia areata?

Symptoms of alopecia areata If severe hair loss happens quite literally overnight, or rapidly falls out in patches, chances are it's alopecia areata. This very frightening disease can cause complete scalp hair loss in as little as one week! In about 30% of cases, a bald patch develops but quickly disappears (e.g., within six months) and never returns.

Another 30% experience a relapse after perhaps six months
and recovery takes longer. Others may experience patchy areata throughout their lives - they may lose and regrow their hair a number of times.

For some, hair regrowth might initially be white, before gradually returning to their original hair colour.

This is a very unpredictable disease - any recovery may be tempory or permanent. But, the longer the hair loss persists, the less chance it will grow back.

Many symptoms as well as other conditions can be associated with alopecia areata:

• Thyroid disease - Those with alopecia areata may have an increased tendency to develop thyroid problems.
• Vitiligo - This autoimmune disorder causes patchy loss of skin colour. (Those with vitiligo may go on to eventually develop alopecia universalis).
• Other autoimmune diseases - If disorders such as Addison's disease, diabetes, rheumatoid arthritis, systemic lupus erythematosis, etc, run in your family, your risk of experiencing areata may be increased.
• Atopic conditions - If the allergic disorders of eczema and/or asthma are a family trait, then you may have an increased chance of developing this form of hair loss.
• Fingernails - Keratin (dead protein cells) forms both hair and nails. In more severe or prolonged cases of areata, unusual nail formation (e.g. ridged and, especially, pitted fingernails) can occur.
• Stress and loss of self-esteem
All forms of hair loss can cause anxiety and depression. But, due to its sudden onset and unpredictable nature, areata probably has the most severe psychological impact on the lives of those affected by it.

It should also be stated that areata is not a physically painful disease - those who have it are otherwise in general good health.

Ok, next question:

What causes alopecia areata?

Alopecia areata is widely believed to be an autoimmune skin disease. The body's white blood cells (lymphocytes) release chemical messengers (cytokines) that treat the hair follicles as foreign bodies. They then reject and attack the hair follicles which stops (or suppresses) hair growth.

Unfortunately, the actual trigger mechanism for this process remains unknown. However, it seems likely that there may be several different ways that this autoimmune response could be set off:

Inflammation - This is often associated with autoimmune diseases such as those already mentioned above.

Genetic inheritance - Family history can influence whether you have a predisposition towards the atopic state (i.e., if you suffer from asthma or eczema). And either of these conditions may lead to alopecia areata. In some parts of the world, up to 50% of people with areata are also atopic.

Over 20% of people with areata also have a family member who suffer from it too. So, genetic trait can give you some idea about your own likelihood of developing this disease. However, the risk a child has for inheriting alopecia areata is not as high as 50-50 if one parent has it (as is the case in many other genetic diseases).

There have been a few reported cases of babies born with Congenital alopecia areata. Congenital disorders (i.e., from birth) may result from genetic abnormalities, the intra-uterine environment (i.e., within the womb) or unknown factors.

Hormone imbalance - Certain conditions cause hormone disruption within the body, which can then lead to different types of hair loss. But, some might also trigger the autoimmune response that causes areata.

During an initial diagnosis, this apparent overlap between alopecia areata and these other types of hair loss can add to the confusion that already surrounds this perplexing disease.

Here are two examples:

• Pregnancy - Up to 50% of all women experience hair loss following childbirth. This is normally diffuse thinning and is associated with post-partum telogen effluvium. However, 10% of women suffer a thyroid disorder 6-12 months following pregnancy and this can cause bald patches to form. In some cases even total hair loss may result.
• Thyroid gland disorders - A hormone imbalance
  caused by thyroid conditions such as hyperthyroidism and hypothyroidism can lead to hair loss. Whilst this is not normally areata, in some cases, this disease may be triggered. Note: unlike the last example, these thyroid disorders are not connected to pregnancy. This, of course, means that they could affect men as well as women.

Learn more about hair loss caused by thyroid disorders -
Other types of hair loss.

Langerhans cells - Areata patients appear to have an excessive amount of Langerhans cells in their bodies (up to ten times more than normal in fact). These cells seem to be involved in the immunological process and research is ongoing to identify the significance of this observation.

Nervous disorders and stress - Some studies show that over 70% of people with alopecia areata believe it was caused during a period of emotional stress. It’s a fact that stress can constrict the capillaries that supply blood to the hair follicles. However, whilst stress was once widely considered to be a major cause of alopecia areata, it is now thought to be less significant in most cases.

Chemical imbalance within the body - This might be caused by a mineral deficiency (e.g., iodine) or something entering the body from the environment (e.g., a chemical reagent).

Infections - perhaps a virus or allergen from the environment.

Treatment for alopecia areata

To accurately diagnose areata, it's important to first eliminate all other treatable diseases. You should, therefore, consult with a hair specialist if you suspect you have this condition.

Given the complexity of alopecia areata, it's not surprising that there are many avenues of research into this disease. As a result, many forms of treatment also exist - these are listed below.

• Immunosuppressive drugs
• Steroids
• PUVA
• Minoxidil
• Surgery
• Primula obconica
• Nutrition, herbal remedies, etc.