Alopecia Areata – Causes & Facts on Patchy Hair Loss

People often get confused between alopecia areata (patchy baldness) and androgenetic alopecia (pattern baldness). They sometimes consider both the same, but these are two very different conditions. This article covers alopecia areata causes, latest research, facts, and pretty much all you need to know about patchy hair loss.

Alopecia Areata usually sparks both confusion and intrigue at the same time. It’s common enough that most of us have heard of it, and may even know someone who has to deal with this type of hair loss. It’s also rare enough that it still seems somewhat of a mystery.

Alopecia Areata Definition

Alopecia areata is baldness that occurs in patches; hence, it’s called patchy hair loss. Its medical definition states:
“Alopecia Areata is a common condition of undetermined etiology characterized by circumscribed, non-scarring, usually asymmetric areas of baldness on the scalp, eyebrows, and bearded portion of the face.”

In America, it affects nearly 6.5 million or 2% people annually, not necessarily males and regardless of age. However, a majority of cases occur after the age of 30.

Alopecia Areata vs Male Pattern Baldness (and female)

The confusion generates from the term Alopecia. Alopecia is an ancient Greek term that means hair loss. Androgen means hormones and hair loss that results from hormonal imbalance or genetics is called androgenetic alopecia. Areata means to occur in patches or limited areas; therefore, it is a condition in which hair loss happens in patches. It’s often the result of an autoimmune condition instead of genetics.

Male pattern baldness is also known as androgenetic alopecia, and again, this is where a lot of the confusion comes from. This is the more common type of hair loss, and it affects almost half of all men at some point in their lives. It’s signature look is the horseshoe shaped area around the back and sides of the head. Male pattern baldness is largely believed to be caused by a genetic vulnerability to dihydrotestosterone (DHT), but it’s far more complicated than that. It’s causes are very different from alopecia areata causes.

You can read more on this in the article DHT and Hair Loss.

Women experience a similar type of DHT related hair loss, known unsurprisingly as female pattern baldness. Unlike men, women tend to experience this type of hair loss mostly in the mid to front area of the scalp only. Fewer women suffer from pattern baldness than men, but it is still a common problem, and one less easily tolerated by women. A man can shave his head for example, and feel less awkward than many women may feel.

Alopecia areata and pattern baldness both can affect males and females, so there’s a common ground here with both types of hair loss. Let’s find out more about patchy baldness and pattern baldness and understand how these affect the scalp.

Alopecia Areata Causes

Alopecia areata causes can be various, but basically it is an autoimmune disorder due to which unpredictable hair loss happens. An abnormal collision between cells in the hair follicles and immune system compels the immune system to attack hair follicles and cause inflammation. As a result, hairs start falling out from particular areas of the scalp, eyebrows and even beard. In fact, with alopecia areata, eyebrows and beards are often affected. This is NOT restricted to just the scalp!

The patches are usually about the size of a quarter. It may also lead to a complete loss of hair, which is called alopecia totalis. It may even spread more and cover the entire body, which is called alopecia universalis.

It’s worth noting that alopecia areata can develop suddenly, and it can take just a few days for the patches to appear. At the moment, there is no specific cure available for alopecia areata, but there are certain treatment options available, which will be discussed in detail later in this article.

Alopecia Areata Pictures

Alopecia Areata on a man's scalpPhoto: Hair Transplant Abroad

Alopecia Areata, Man’s Scalp Back

Alopecia Areata Side of Man's HeadPhoto: Prevention.com

Alopecia Areata, Man’s Scalp Side

Are the Causes of Alopecia Areata Genetic, Stress or Diet?

It is yet unclear why the immune system starts targeting hair follicles to cause their shrinking and reduced hair production. Scientists are of the opinion that genetics might be playing a role as one of the leading alopecia areata causes. A majority of patients (around one in five) have at least one member of their family with the disease. Generally, people having family history of this disease also have family members with autoimmune disorders like Atopy, Vitiligo and Thyroiditis.

There has been no connection between Alopecia areata, stress and diet proven. It is in fact a common misconception that it is caused by stress or diet, since no particular research has been able to prove this. Although extreme stress can trigger it; but in a majority of cases, genes are the main culprit.

Alopecia Areata Symptoms

Patchy Hair Loss is one of the most prominent alopecia areata symptoms where quarter size patches of hair start falling out from the scalp, or the beard and eyebrows. Alopecia areata is characterized by sudden hair loss developing in only a few days followed by itching, burning feeling at the affected area. Since hair follicles aren’t completely destroyed, regrowth of hair is possible after the follicle’s inflammation subsides.

Alopecia Areata FingernailsPhoto Credit: AAD.org

Fingernails with Alopecia Areata

The disease can also affect toe and finger nails, and generally these are among the very first symptoms of the developing disease. You will notice white spots, lines and dents on fingernails and toenails, while they will lose their shine and become rough, thin and weak.

Alopecia Areata Treatment

Unfortunately, a complete alopecia areata cure is not available as yet, but things are looking extremely positive with using the janus kinase inhibitor Ruxolitinib, which you can read more about in the ruxolitinib alopecia treatment article on this site. Also worth mentioning, many people choose to hide their hair loss using a quality concealer such as Toppik Hair fibers. You can learn more about using hair fibers in this Toppik review.

There are certain forms of treatment that doctors can suggest to encourage re-growth of the lost hair. There’s not a big lot of alopecia areata medicine available in the market, but more research in alopecia areata causes is underway to identify a permanent, potential cure to the disease. Let’s analyse some of the currently available alopecia areata treatment options.

Alopecia Areata Corticosteroids

One of the most commonly suggested treatments include using corticosteroids, which are strong anti-inflammatory drugs that suppress the immune system. These are administered via local injections, oral consumption and are applied as ointment.

Alopecia Areata Minoxidil, Anthralin, SADBE and DPCP Treatments

These are names of other medications that doctors generally prescribe for promoting quicker hair re-growth or to control activities of the immune system. Some of these medications may help in reducing the severity of the disease but with alopecia areata, regrowth cannot be guaranteed through these means.

When using minoxidil to treat alopecia areata, initial re-growth can be seen after around 12 weeks. It needs to continue being applied though, for the regrowth to reach levels that most people would be happy with. Minoxidil will stimulate hair growth, but does not stop hair loss. In most cases, minoxidil would be used to treat alopecia areata in conjunction with other treatments, including corticosteroids, as mentioned above.

Minoxidil is a popular choice because it does not require a prescription, is not taken orally as a pill, and is generally more safe than other medications. Two of the best minoxidil solutions on the market are Rogaine and Lipogaine. You can read more on the later in the Lipogaine Review article on this website.

Latest Alopecia Areata Research

Research has proven that quercetin, a bioflavonoid extracted from fruits and vegetables, can substantially curb and prevent development of alopecia areata as well as treat hair loss. In a 2012 research conducted by a team at Tongyu Cao Wikramanayake Lab, mice experiencing spontaneous alopecia areata were treated with both sham and subcutaneous quercetin injections. Hair regrowth was observed in lesional areas in quercetin treated mice only. If it is proven to be effective on humans in the future, we can get an alopecia areata natural treatment through quercetin dietary supplement. It still remains important to learn as much as possible about alopecia areata causes, if we are to eventually create a permanent cure.

In a 2014 research, Luzhou Xing and his team concluded that the Jak Inhibitor drug Ruxolitinib can play a pivotal role in reversing alopecia areata. The team systematically administered Janus kinase, or JAK family of enzymes’ pharmacological inhibitors on three human patients using the oral JAK 1 and JAK 2 inhibitor Ruxolitinib. Within 5 months they observed elimination of the IFN signature, and nearly full hair regrowth. Divito and Kupper also studied the impact of JAK inhibitors on alopecia areata using human clinical samples and a mouse model, and concluded that JAK inhibitors can treat the disease.

There are alternative treatment options available such as acupuncture and aromatherapy, but there isn’t enough evidence available regarding their effectiveness. Some studies also support photochemotherapy as a potential alternative for alopecia areata patients who cannot use invasive therapies. Please remember that this is NOT a contagious disease, and never makes people sick directly. It is a traumatic disease that is difficult to adapt to emotionally.

The future looks very hopeful, and as science uncovers more about alopecia areata causes, we move closer to a cure. Check back and stay up to date with ‘Hair for Keeps’!

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  1. Travis
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