Alopecia areata is a hairy skin disease that can affect all parts of the hair, leaving bald areas on the head. It creates well-separated foci from healthy-looking skin. It can affect not only the head areas but can also occur on the face or the entire body. Perhaps you want to know if alopecia Areata itches? Continue reading this article.

The time of occurrence of a given baldness and the precise cause are not characterized by stages. “The only thing that is certain about alopecia areata is its uncertainty.” The hair follicles are attacked, then the hair falls out, creating bald patches. The disease, as a rule, is rarely associated with any internal or external medical problem. However, in fact, you can find many diseases or external and internal activities that contribute to or are a consequence of alopecia areata.

Very often, the places are covered with hair again. In order to accelerate the regrowth of hair, it is worth using additional beauty treatments, cosmetics, or medical treatments. It rarely occurs before the age of 3. More than half of those suffering from alopecia areata are under the age of 30. It often affects women and men, though the prevalence of male pattern baldness has been noticed. We can inherit the tendency for this disease in our genes. In most people, the cause of alopecia areata is the development of autoimmune diseases. Recent studies show that as a result of T cell mediated autoimmune disease, there is a so-called loss of immune privilege. In order to accelerate the regrowth of hair, it is worth using additional beauty treatments, cosmetics, or medical treatments. On the other hand, male pattern baldness was more prevalent.

The causes of alopecia areata

Recent evidence suggests that alopecia areata is caused by an abnormality in the immune system. These include, first of all, autoimmune diseases. These abnormalities lead to autoimmunity of the malfunctioning immune system and attacking its own cells. It is the production of antibodies against your own antigens. As a result, the immune system attacks specific body tissues. Its own immune system attacks the hair follicles and interferes with the hair formation process.

People suffering from this disease may be at a higher risk of

• other autoimmune diseases – such as thyroid disease or vitiligo (lighter patches of skin). Hashimoto’s autoimmune thyroiditis occurs when the thyroid gland is abnormal
• asthma and allergies – mainly atopic dermatitis (commonly called eczema) and hay fever (nasal allergies)
• type 1 diabetes

Alopecia areata is often associated with other conditions such as

• autoimmune allergic disorders
• thyroid disease
• albinism
• lupus erythematosus
• rheumatoid arthritis
• ulcerative colitis

Classification by types

Limited alopecia areata are divided into

• Multifocal alopecia areata – more than one well-defined,
  oval or circular alopecia focus.
• Single-focus alopecia areata – one well-defined, oval or circular alopecia focus
• Total baldness – it covers the entire scalp
• Generalized alopecia – affects the entire scalp, hairy areas on the face (eyebrows, eyelashes), axillary hair
  and down hair
• Malignant alopecia – is the result of refractory response to long-term treatment

Diversity in shape

• Focal alopecia – alopecia foci are located within one part of the body
• Diffuse alopecia – diffuse alopecia occurs when individual lesions cannot be distinguished
• Reticular alopecia – there is erythema and central reticular telangiectasia, shimmering and oval lesions
• Serpentine alopecia – bald parts form a belt around the head, occupying the occipital, frontal and temporal areas

Types of alopecia areata

• Common – rapid spontaneous recovery
• Atopic – occurs in people with a history of atopic, alopecia is most often widespread
• Combined – occurs in people with concomitant disorders of internal organs, such as the thyroid gland
• Hypertonic- foci merge into a larger area

Symptoms of alopecia areata

It is characterized by sudden hair loss, usually in one spot on the head. It is the size of a “five zloty”. There are outbreaks that are completely hairless. At 200 times magnification, hair follicles can be seen on bald skin. The scalp looks healthy and intact with any inflammation. On the periphery of the bald cake, you can see the so-called exclamation point hair (visually resembling an exclamation mark) with the naked eye. Most often it is one cake, although more may occur. There are several basic types of alopecia areata. Each of them has its own characteristic visual symptoms.

Hair passes prematurely to the catagen phase, i.e. the regression phase, or forms dystrophic hair that falls out quickly. The hair follicles under the skin do not miniaturize and are ready to let out hair even after many years. The most severe case is malignant alopecia, which manifests itself as a complete baldness on the head and other hair, such as eyebrows or eyelashes. It occurs in both men and women regardless of race. It does not manifest itself in any physical pain.

Diagnosis of alopecia areata

An important role in making a correct diagnosis is an interview with a person struggling with a given problem. In the family history, attention should be paid to atopy, thyroid disease, and autoimmune diseases. The next step is a physical examination. If you are dealing with confined foci that are hairless, they are also extensive areas of alopecia, but the skin looks healthy, it can be slowly concluded that it is alopecia areata. Additionally, in the active phase of the disease, hair containing the dye is attacked. Often, during regrowth, there is a regrowth of white hair or tufts. The most common process of rapid “pseudo-graying” occurs with a progressive and diffuse type of alopecia.

You can see yellow points or horn pips under the camera. There may also be black points that look like a broken hair at the root and additionally visually resemble a multi-split stem. In non-scarring alopecia areata, the hair follicle outlets are properly preserved.

It is possible to perform pull tests – positive and confirming the presence of alopecia areata, if we have telogen or anagen dystrophic hair. The next step is a histological examination. In the case of acute malignant alopecia, a sample should be taken from the lesion. The examination shows a clear dense lymphocytic infiltrate around the bulb.

Treatment of alopecia areata

Alopecia areata (AA) is the only one of many types of alopecia, there is no one hundred percent specific treatment regimen that can work. Hair often grows back spontaneously, but this is a very small number of cases. In both androgenetic alopecia and alopecia areata, you should help the skin, support the reconstruction of the matrix and the formation of new hair bulbs.

The course of the disease is difficult to predict. Certain information in alopecia areata is its uncertainty in what form it will occur, and with what intense exacerbation. There are no symptoms that would indicate any given time of onset on AA skin. Treatment can help the hair regrow faster and prevent it from returning.

The trichologist may recommend one or more of the following to help you regrow faster:

• Getting rid of traumas and stresses – get rid of all traumas and stresses with the help of psychotropic drugs or with the support of a psychologist. The fewer stressors, the better the results can be achieved. It is worth remembering that alopecia areata is often activated by excessive stress or insufficient coping with it.
• Needle mesotherapy, the systematic injection of strong nutrients into the hair cells that can stimulate the follicles to produce hair
• Microneedle mesotherapy, which patients perform independently at home. It is a procedure of systematic piercing of the scalp with a special, properly selected roller on which 540 microneedles of the appropriate length are placed. Systematic puncturing increases the blood supply to the scalp, thus increasing the supply of nutrients to the hair, and thanks to the channels created by the needles, the later applied preparation is absorbed into the skin, reaching the follicle directly. Systematic use of a dermaroller stimulates the follicle and accelerates hair regrowth

Unfortunately, any method of mesotherapy in this type of alopecia does not guarantee a hundred percent effect. It often happens that the effect is meager, despite the large number of treatments performed.

• The use of strong preparations for hair growth – trichological products that stimulate hair growth for systematic use at home. These preparations are often based on stem cells, e.g. from jasmine gardenia or edelweiss, and may also contain peptides
• The use of PLACENTA (extract from the placenta) – stimulates hair growth and increases the use of oxygen by the cells. Perfectly moisturizes the tissues and cells of the epidermis
• Systematic skin irradiation with special laser combs
• The use of photochemotherapy with the use of a photosensitiser. The skin is exposed to UVA, UVB, and PUVA radiation. The number of treatments depends on the type of alopecia areata, its area, and the level of exacerbation. Treatments are repeated 3 times a week
• Cryotherapy is the local cooling of skin tissues. It is not recommended to use the treatment frequently for a long time, as a precautionary measure to avoid damaging the hair follicles
• Dermatologists recommend oral corticosteroid, DPCP and antralin (psoriasis)

Each of the methods is aimed at highlighting the inflammation on the skin.

Two types of treatment are available, including immunosuppression (drugs that inhibit the activity of T lymphocytes – cyclosporine) or immunomodulating therapy. These include glucocorticoid injections in place of alopecia and the induction of contact allergy. One of the simple ways to induce a contact allergy is to irritate the skin with ditranol, an anti-psoriasis drug.

The most innovative method of treatment is biological treatment, which currently does not provide an adequate amount of research confirming its high effectiveness. In this treatment, anti-cytokine preparations are used.

The use of topical minoxidil has a stimulating effect in the case of androgenetic alopecia, while positive effects have been noticed in the form of delaying the recurrence of alopecia areata. It stimulates the hair follicles to mitotic divisions. Skin slightly irritated by the preparation does not show any signs of treating the hair bulb as a foreign body. Hair may grow back partially or completely, while hair loss may return in one area or move to another area when minoxidil is discontinued.

Patients may use more than one method. A combination of two or more treatments often increases hair success and regrowth. It is a holistic approach that influences the intensity of therapy.

Alopecia areata can be quickly stimulated to regrow new hair, but it is not always possible to do so in all cases. The combination of many treatments, i.e. creating constant irritating stimuli to the skin affected by alopecia, allows you to heal them permanently.

Each case requires a diagnosis. A proper diagnosis and a properly prepared treatment regimen, regularity and patience guarantee a 100% recovery of alopecia areata and the regrowth of hair that has fallen out, and thus a better well-being of the patient.

Literature

• Wiesława Sudnik The role of E, L and P selectins in the pathomechanism of alopecia areata
• The New England Journal of Medicine. Alopecia areata Amos Gilhar, MD, Amos Etzioni, MD, Ralf Paus, MD

Finding a way to deal with alopecia areata helps many people to feel better. Their loss, especially in women, can cause low self-esteem. Many people feel unattractive and confused. The trichologist will offer solutions to help you feel and look better.

If you would like to know the causes of your baldness and how to deal with it below, you can book a subsidized trichological examination with a hair specialist near you.