A certain amount of hair fall is normal, even natural. Many factors, including stress, hairstyling products and chemicals, medications and even hormonal changes, can cause hair loss in both men and women. In fact, a person loses between 50-100 hair strands a day on an average and there's nothing much to do about it. However, if you have extreme hair shedding and no treatments seem to work against it, then it could be alopecia areata, an autoimmune condition that can lead to massive hair loss. But how to know whether it's alopecia or a regular hair fall? Dr Ramdas, Senior Dermatologist, Kamineni Hospitals, L.B Nagar, Hyderabad, sheds light.
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What Causes Alopecia Areata?
Alopecia areata is an autoimmune disorder. Dr Ramdas explained, “In this condition, the immune system mistakenly targets and attacks healthy hair follicles, leading to hair loss.”
This loss of hair is not just limited to your head, but can also affect other parts of the body that grows hair, including your eyelashes, eyebrows, arms, or legs, as per the American Academy of Dermatology.
According to the National Alopecia Areata Foundation (NAAF), 16 crore people worldwide have alopecia areata or have had, or will have the condition. In the US, about 7 lakh people have some form of alopecia areata.
Another reason that could cause alopecia areata is genetics. It often runs in families, suggesting a hereditary component, said Dr Ramdas, adding, “While triggers for the autoimmune response are not fully understood, factors such as viral infections, environmental triggers, or stressful life events have been proposed as potential contributors to the onset or exacerbation of alopecia areata in some individuals.”
Difference Between A Regular Hair Fall And Alopecia Areata
Explaining the difference between a regular hair fall and alopecia areata, Dr Ramdas said that the former is a common occurrence and is a natural part of the hair growth cycle, which typically involves the shedding of a few hairs each day, and new hairs grow in their place.
In contrast, alopecia areata causes sudden and often unpredictable hair loss. It often results in distinct, round or oval patches of hair loss on the scalp or other parts of the body, the doctor noted. Unlike regular hair fall, which can be a gradual process, alopecia areata can lead to noticeable bald patches relatively quickly, the doctor added.
The Location Matters
Regular hair fall usually affects any part of the body where hair grows. However, alopecia areata usually affects the head and face.
According to the expert, it primarily affects the scalp and common symptoms include small, round bald patches, rapid hair loss, and regrowth of white or grey hair in affected areas.
"Some individuals may also experience tingling or itching in the affected areas before hair loss," Dr Ramdas emphasised.
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Risk Factors To Consider
Although alopecia areata can occur at any age, most people develop it early in life.
The NAAF said, "More than 80% show signs of the disease before age 40, and 40% experience symptoms by age 20. Research suggests that women are more likely to develop alopecia areata than men and people of some races and ethnicities may have a higher chance of developing the disease. Several US-based studies found the odds of developing alopecia areata were higher among Asian, Black,and Hispanic individuals than among whites."
In addition, a family history of alopecia areata or other autoimmune disorders, a personal history of autoimmune diseases, and exposure to stressful life events or emotional trauma could also trigger or worsen the condition, Dr Ramdas shared.
Diagnosis And Treatment Options
Diagnosing alopecia areata starts with a thorough physical examination of the affected hair loss areas. This helps assess their size, shape, and distribution. A doctor may also examine the texture and condition of the remaining hair and examine the nails for any associated changes. In some cases, additional diagnostic measures may be recommended to rule out other potential causes of hair loss. These can include scalp biopsies or blood tests to assess thyroid function, iron levels, or autoimmune markers, according to the doctor.
When it comes to alopecia areata treatments, it includes topical corticosteroids to reduce inflammation, over-the-counter topical minoxidil to stimulate hair growth, localised corticosteroid injections to suppress the immune response, immunotherapy to provoke an immune response, oral medications for severe cases, and light therapy to calm the autoimmune response. Depending on the individual’s condition and severity, treatment options may vary.
