Alopecia Aerata 

 

What is alopecia aerata ?   

Alopecia is an autoimmune dermatological condition that affects the hair follicles, most often resulting in hair loss in patches that are usually reversible. It is important to note that this is not a serious condition. This loss of hair is localized, limited to certain areas of the skull. The affected area loses its hair, similar to baldness. Hair loss can also affect the beard, eyelashes, eyebrows and any other hairy area of the body. Alopecia has a significant impact on self-esteem, especially in women. However, alopecia is not common: an estimated 1% of North Americans are affected by this condition. 

 

What causes alopecia?  

Scientific research has not yet succeeded in elucidating the reasons that trigger alopecia. However, it is believed that certain hereditary factors are responsible. 

As it is an autoimmune disease, certain immune cells, the lymphocytes, begin to attack the hair roots which they consider as foreign elements to the body and destroy them. The result is hair loss and/or hair loss in the affected area. However, the affected hair root is not permanently destroyed, which explains the possibility of recovery from hair loss.  

In the affected area, the skin becomes smooth, loose and white and the hair, weakened, falls out easily as soon as it is pulled a little.  

 

Who is at risk? 

 Hair loss can affect men, women and children. However, the risk of developing alopecia in a lifetime is low. People at risk may include  

  • those who have a relative with hair loss (genetic influence);  
  • those who suffer from allergies (asthma, hay fever, atopic eczema, allergic rhinitis, etc.); 
  • those who suffer from an autoimmune disease such as autoimmune thyroiditis, type 1 diabetes, rheumatoid arthritis, allergic rhinitis, lupus, vitiligo or pernicious anemia. 

 

What are the symptoms of alopecia? 

Alopecia begins unpredictably and at any age, but often in children or young adults. It manifests itself in the form of hairless patches that are usually round or oval in shape, 1 cm to 4 cm in diameter. Small patches of hair loss are the most common form.  

Sometimes, it can start at the base of the skull and progress to the sides of the head and up over the ears. But it is rare that it affects the entire skull. At the edges of the patches, small broken hairs of a few millimeters can be seen.  

The nails may be affected by the disease and become rough and brittle, sometimes with white patches.    

 

What is its evolution?  

Alopecia evolves unpredictably in episodes that may recur over the course of a lifetime. It even happens that white hair grows back on a patch. This is often the case with mild alopecia. In this case, it will take several months for the new white hair to regain its normal color. In general, the condition worsens over time, especially if the person is affected at a young age.   

 

How is alopecia treated?  

Nowadays, it is perfectly possible to treat alopecia. The treatment will depend on the nature of the hair loss.

a) Without treatment:

 When the patches are small and not very extensive, hair regrowth is possible naturally.  

b) Local treatments:

– Corticosteroids in application (TOPICAL-INSTEAD OF IN APPLICATION) or intralesional injection: Lotion applied to light surfaces. 

–Superficial injections in the affected area :  Monthly injections for 3 to 6 months. Repeat injections. Injections not recommended in cases of diabetes and high blood pressure.

– Minoxidill (ONLY ONE L- MINOXIDIL) : Helps with hair growth. Often combined with local corticosteroids and 
anthralin.

– Anthralin : Treatment often offered to children. Effective but irritates the skin. Short use (10 to 30 minutes). Not recommended with photochemotherapy (PUVA).

– Contact immunotherapy with diphencyprone (DCP) : Weekly or biweekly application. Suitable for severe hair loss. Very effective. Causes an allergy (USE THE WORD REACTION INSTEAD OF ALLERGY) that helps hair grow back in 60-80% of cases. Has side effects such as eczema and skin depigmentation. 

c) Other treatments

– Systemic corticosteroids : Use of systemic cortisone to stop hair loss in advanced stages of alopecia while waiting for another effective treatment. 

– Photochemotherapy (PUVA ): An old treatment requiring many sessions before the first results appear. The effectiveness of ultraviolet A rays coupled with a photosensitizer is an old treatment that sometimes gives good results. Risks of skin cancer.  

– Methotrexate : Excellent results for severe alopecia. 

    • Hair transplants can be a good solution for severe hair loss.  
    • Excimer laser at 308 nm. 

 d) Camouflage solutions 

  • Hair powders of different colors and based on keratin fibers can camouflage the patches.
  • Hair prosthesis (wig) which requires a medical prescription. 

 

 If you notice any of the symptoms of alopecia, do not wait long. Contact us quickly to make an appointment at 514 400 3291. We will be happy to answer your questions and provide you with the help your situation requires.