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Alopecia areata is a common cause of sudden onset episodic non-scarring hair loss. Patients can experience a single small coin-sized patch or multiple patches. It most commonly occurs over the scalp but can involve other areas such as beard, eyebrows, eyelashes, and body hair. The skin overlying the patch can be red, itchy, or scaly. Sometimes patches may join together to involve the whole of the scalp (alopecia totalis) or loss of all body hairs (Alopecia Universalis). As this disease mostly affects pigmented or black hair so patients can feel that the patch area has suddenly developed white hairs. Nails can also develop roughness in 10-15% of the patients.
Alopecia areata, a condition characterized by sudden hair loss, can affect individuals across all age groups but is most commonly observed in those under 40 years old. While it doesn’t cause physical illness, the emotional impact on the patient can be profound. This autoimmune disorder occurs when the body’s immune system mistakenly attacks the hair follicles, resulting in unpredictable hair loss patterns.
The experience can be traumatizing for individuals, especially when episodes of hair loss coincide with periods of heightened stress. Although there might be instances of familial occurrence, it’s essential to note that alopecia areata is not contagious. Understanding that it is an autoimmune disease sheds light on its potential associations with other autoimmune conditions. Patients with alopecia areata may also have coexisting autoimmune disorders such as hypothyroidism, vitiligo, psoriasis, and atopic dermatitis.
The multifaceted nature of alopecia areata underscores the need for comprehensive medical evaluation and management. While the condition itself may not pose a direct threat to one’s physical health, its psychological impact emphasizes the is importance of providing support, both medically and emotionally, to individuals grappling with this challenging and often unpredictable hair loss disorder.
Diagnosis of alopecia areata is essentially clinical. A dermoscopic examination can help aid in the diagnosis. Investigations such as fungal culture and biopsy might be required to rule out other causes. Blood tests to rule out other autoimmune diseases can be done.
Diagnosis of alopecia areata is essentially clinical. A dermoscopic examination can help aid in the diagnosis. Investigations such as fungal culture and biopsy might be required to rule out other causes. Blood tests to rule out other autoimmune diseases can be done.
Single or small patches can be treated with the help of topical or injectable corticosteroids which locally suppresses the immune system which is attacking the hair bulb. Intralesional steroids might have to be repeated after a month if a patch has not resolved completely.
Other topical medicines can also be given such as minoxidil, anthralin, tacrolimus, vitamin D analogs, and topical irritants. If the patient has an extensive disease or it is not resolved with topical or injectables phototherapy or oral medicines have to be given.
Phototherapy can be done after topical application of a photosensitizing agent or after oral ingestion. It can be done with solar light or an ultraviolet light chamber. Oral medicines such as corticosteroids, cyclosporine, methotrexate, apremilast, or tofacitinib may be given to control the disease activity. Patients with extensive hair loss can benefit from wearing hairpieces, scarves, wigs, or bandanas. Eyebrow tattooing can be used to conceal the loss of eyebrow hairs.