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Alopecia areata

Written by Caidr's team of doctors and pharmacists based in UK | Updated: 22.02.2023 | 3 min read

Some of us may be familiar with the term alopecia, but a few prominent celebrities might spring to mind, and it understandably causes great fear as it threatens complete and permanent hair loss. While this is a difficult condition to treat and causes huge emotional turmoil, there are signs to look for so it can be identified early and treatments started to prevent or reverse hair loss. Let’s take you through how to recognize it.

What causes alopecia?

Alopecia simply means hair loss. Alopecia areata means patchy hair loss and is an autoimmune condition where the body attacks its own hair follicles in inflammation. This might cause tingling, burning, or itching. Patches are usually coin-sized and look smooth and pinkish. It’s not well understood what prompts this process – stress is one theory, genetics is another: 1 in 5 has a close family member with alopecia.

It can occur at any age and is slightly more common in women. Other than the psychological burden and the risk of sunburn, alopecia has no other risk to your health. There is a slightly higher chance of developing other autoimmune conditions, such as vitiligo, lupus, thyroid disease, or Type 1 diabetes.

Will I lose all my hair?

For many people suffering from alopecia, hair grows back within the first year without treatment. But it’s not guaranteed, and the condition can’t be cured: you might get flare-ups in the future.

It’s a poorer outlook if there’s extensive hair loss from the start, and the chance of full regrowth is low if you have lost more than half of your hair. Occasionally alopecia areata may progress to alopecia totalis (complete hair loss from the scalp) or, more rarely, alopecia universalis (complete hair loss from the scalp and entire body).

Are there treatments to help?

In most, the process of inflammation stops, and hair regrows, with or without treatment. If your doctor suspects alopecia areata, they may refer you to a dermatologist for a specialist opinion.

The dermatologist will look at your scalp with a dermatoscope (a specialist microscope) and they may take a skin biopsy to confirm. They may suggest treatment like a steroid cream or steroid injections into bald patches. This is with the hope of reducing inflammation and encouraging hair growth.

Depending on their assessment, they may suggest other treatments, but many risk unacceptable side effects.

Minoxidil is a treatment available to buy over-the-counter that serves to prevent hair from shedding. You may choose to try this on any bald patches, but the hair left is often very fine, so this may have limited success. And it only works for as long as you continue using it: it doesn't alter the course of the disease.

What can I do about it?

Work on your appearance to make you feel more yourself. With patchy loss, you could try out hairstyles or cuts that disguise bald spots. Wigs are another option. Artificial eyelashes, eyebrow makeup, or tattoos to mimic eyebrows or eyeliner can build self-esteem – research what might work for you.

Eyes can get sore without the protection of eyelashes to keep out dust, so wear protective glasses if it’s dusty or sandy, and use eye lubricants or artificial tears to soothe the eyes. Hair forms a protection against the sun, so bald patches put you at a higher risk of sunburn – wear sunscreen with broad UVA and UVB protection of SPF 30 or higher, and avoid the sun or cover up with a hat where possible. Also, be aware of low-hanging trees or beams, as you have nothing to protect the scalp from knocks and scrapes.

A much harder task is coming to terms with alopecia and the change in sense of identity and self-esteem that it entails. It can help to be open with trusted family and friends or see your doctor if you’re feeling very low.

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