Cause

 

Alopecia areata is thought to be an auto-immune disease.  This means that the body makes antibodies to some unknown  substance such as a virus or a medication which the body recognises as foreign.  These antibodies then attack the hair follicles in areas.  The hairs within the attacked area are subsequently lost.  Stress appears to play an important role in its development

 

Does alopecia areata ever recover?

 

Most individuals recover spontaneously within about 6 months, even if nothing is done about it.  However, in a small proportion, the hair loss is progressive and should be treated.

 

What treatments are available?

 

• Application of steroid creams/ ointments/ lotions

• Irritation of the scalp with Diphencyprone/ Dinitrochlorobenzene/ DNCB or dithranol

• Minoxidil solution applied to the areas of hair loss

• Injections of the scalp with corticosteroids (cortisone)

• Oral steroids (only very extensive alopecia areata)

• PUVA including Turban PUVA

• Oral Sulfasalazine

• 308nm excimer laser

 

The 308nm excimer laser has been used successfully to treat 9 patients with AA.  treatment was administered twice weekly for a maximum of 24 sessions.

Ref:  J Am Acad Dermatol 2004;51:837-8

 

Tofacitinib is a new treatment for alopecia areata which is currently undegoing clinical trials. This medication is classified as a Janus Kinase inhibitor which interferes with communication signals from immune cells (lymphocytes). Ruxolitinib is another member of this new class of medication.

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Another JAK inhibitor, Baricitinib (Olumiant) has just become the first systemic treatment to be approved by the US FDA for alopecia aerata (13 June 2022) . 

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How long does it take to recover?

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The recovery period could take several months, even with treatment

 

Could the hair be lost again?

 

Yes, alopecia areata could be a recurrent condition.  In some it is seasonal and in others, it worsens with stress such as at exam time.

 

Where can one obtain information and support if one is suffering from this condition?

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Alopecia Areata (National Alopecia Areata Foundation USA)

New Zealand Dermnet

Alopecia Areata:  emedicine.medscape.com

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