Alopecia: The Causes, Signs, and Treatment Options for a Unique Form of Hair Loss

Losing your hair happens naturally to both men and women during the aging process. But what if you’re still young and are suddenly struggling with hair loss?

Hair loss at a younger-than-usual age can be caused by a condition called alopecia. And alopecia can strike anywhere on the body, at any age.

Here’s everything you need to know about alopecia, from its causes and symptoms to how it’s diagnosed and treated.

What is Alopecia?

Alopecia may seem like a specific hair loss condition, but it’s actually more complex. It’s an autoimmune disorder that causes hair loss on the head – but it can also cause hair loss on the face and other parts of the body. Though it occurs most often on the scalp, alopecia can also cause bald patches or hair loss on your eyebrows, beard, or even your entire body depending on the severity of the condition.

Autoimmune disorders like alopecia occur when your immune system mistakenly attacks your own body. Specifically in alopecia sufferers, the white blood cells target and shrink the hair follicles, slowing or even stopping hair growth. This autoimmune disorder can occur in varying degrees.

Men and women of all ethnicities can suffer from alopecia. It’s estimated that around 6.8 million Americans and 147 million people worldwide are currently living with alopecia or will develop the condition at some point in their lives.

Some people may only experience hair loss in one place (alopecia areata monolocularis) or multiple places on their head (alopecia areata multilocularis), others can lose all the hair on their scalp (alopecia areata totalis) or even their entire body (alopecia areata universalis). In most cases of alopecia, the loss of hair is temporary or cyclical. With time and treatment, the hair follicles will begin to grow again. But for some, the condition is permanent and irreversible.

The good news is that alopecia sufferers are otherwise healthy. While some people may find the condition embarrassing or distressing, it isn’t painful or life-threatening.  

The Signs and Symptoms of Alopecia

Hair loss due to alopecia can begin at any age. However, in approximately 44 percent of all cases, the condition appears before age 20.

The first sign of alopecia you may notice is abnormal hair loss in the shower or in your hairbrush. This is typically followed by the most common early symptom: small, coin-sized bald patches appearing on the scalp, which can occur quickly over the course of a few days or slowly over weeks or months.

In some cases, your skin may itch or burn before the hair loss happens. After the hair is gone, the skin appears smooth and healthy. For others, the bald patches grow and can cover most or all of their scalp as well as the face and body.

Oftentimes any hair that does grow may appear abnormal. Some people grow white hairs, “exclamation mark hairs” where the hair follicles get narrower at the bottom, or “cadaver hairs” where the follicle breaks before reaching the surface of the skin.

Symptoms of alopecia can also be seen in the fingernails and toenails. Some sufferers of the condition notice dents, white spots or lines on their nails, or find that nails become dull and brittle.

Alopecia Causes

Experts can’t really say for sure what leads the body to attack the hair follicles and cause alopecia. However, it’s believed that the condition may be caused by a combination of genetic and environmental factors.

You’re more likely to develop alopecia if you have a close family member who suffers from it. But, unlike many conditions which only require genes to be passed down from one parent, alopecia is a polygenic disease – meaning that both parents need to contribute certain genes in order to pass the disease along to children. Even in the case of identical twins, there’s only a 55 percent chance that both will have alopecia, which has led experts to believe that environmental factors also play a role in the condition.

Research also shows that alopecia occurs more often in people with a genetic history of other autoimmune disorders such as type 1 diabetes, arthritis, vitiligo, hypothyroidism, psoriasis, eczema, or Addison’s disease. If you’re diagnosed with or at risk for any autoimmune disorders, you may be at risk of developing alopecia as well.

Diagnosing Alopecia

If you’re experiencing hair loss, you’ll want to pay close attention to the way in which your hair is falling out. Are you noticing bald patches appearing on your scalp or body? Are you feeling any itching or burning in areas where hair loss is happening?

If you’re concerned about hair loss, you should visit your doctor or see a dermatologist to get a diagnosis before attempting any treatments. Your hair loss could be caused by alopecia, or it could be the result of another health issue.

The first step in diagnosing alopecia is a physical examination of the sites of hair loss. Your doctor or dermatologist will also examine your fingernails to check for any abnormalities. They may take hair samples in order to better examine them under a microscope.

You may also need to do a skin biopsy and a blood test to check for other autoimmune diseases.

Regrowing Hair Lost from Alopecia

Once you’ve officially been diagnosed with alopecia, it’s time to start seeking treatment options. While treating your hair loss may be your first concern, it’s important to target the specific condition.

Re-growing hair after being diagnosed with alopecia can be unpredictable. That’s one of the most challenging aspects of the condition.

Some alopecia sufferers may start to regrow hair quickly without any treatment and may never have any further issues. For others, regrowth may be slow and take years; it could even be cyclical, as you may experience hair loss and regrowth in different places over the course of your lifetime. Others still may never grow their hair back at all.  

While there is no cure for alopecia, there are many ways you can slow or perhaps reverse hair loss.

Steroid Treatments

Perhaps the most common way to tackle an alopecia diagnosis is through steroid treatment, which is best applied in mild cases. It’s an option for you if less than 50 percent of your scalp hair has been lost.

During steroid treatments, the bare skin is injected, using fine needles filled with cortisone. You’ll receive these treatment on a monthly basis. You may also be able to apply a topical steroid cream or gel. Oral steroids may also be prescribed, but they can often lead to unpleasant side effects such as acne, weight gain and menstrual cycle changes in the case of female patients.

Medication-Based Treatments

There are a number of topical medications that are often prescribed to treat hair loss from alopecia.

Anthralin ointment, which is a tar-like substance that’s also commonly used to treat psoriasis, can encourage hair growth if applied to bald patches daily. Some patients find that anthralin ointment can irritate and discolor their skin. but the side effects are typically short-lived.

Other topical medications, such as Minoxidil or Ciclosporin, may also be recommended and combined with one another for maximum effectiveness.

Coping with Alopecia: Get Diagnosed First

While losing hair may be shocking and upsetting, alopecia doesn’t means you’re losing your hair permanently. It’s important to take the right steps to get a diagnosis before you worry. And alopecia sufferers have to take a little extra care of themselves in order to stay healthy.

So, if you suspect you may be suffering from alopecia, consider talking to your doctor or dermatologist about getting a diagnosis as soon as you can. The sooner you know for sure, the sooner you can start treatment.

Alex Papp / Shutterstock

Jun 17, 2019