Alopecia areata (AA) is the name given to small circular patches of hair loss that occur on the scalp. Sometimes Alopecia Areata progresses to Alopecia Totalis, which is complete hair loss of the scalp or even Alopecia Universalis, which is complete hair loss of hair on the entire body (i.e. eye brows, eyelashes and body hair). The exact cause of AA is unknown but it is believed to be an autoimmune initiated disease. However not all scientists support this theory.

If we stick with the most widely accepted belief that alopecia areata is an autoimmune disease then the question that now has to be asked is what triggers the onset?

Psychological long-term stress and extreme shock have been reported as triggers for AA. But then another question has to be asked, and that is, why doesn’t everyone who goes through stress and or extreme shock develop AA? The answer to this question may lie in the fact that some people have a genetic predisposition to alopecia areata. It is generally believed that susceptibility to develop alopecia areata is polygenic, i.e. there are a number of genes that if inherited, result in the individual more likely to develop the disease. These genes are not reported to be mutations or defective genes, but normal functioning genes, with some genes carrying more weight or importance in promoting the susceptibility. The more genes inherited the more extensive the hair loss and the more persistent the alopecia areata.

Physical trauma has also been linked with alopecia areata. Cells under physical stress can produce heat shock proteins (HSPs). These proteins have been implicated in the autoimmune diseases lupus, ankylosing spondylitis and rheumatoid arthritis.

Chemicals have also reported as a trigger of alopecia areata. Workers in a paper factory developed alopecia areata after long-term exposure to the chemical acrylamide. Isolated cases have also been reported between HIV drug Zidovudine and the anti-depressant drug Fluvoxamine.

The good and bad news is that Alopecia Areata can be treated but not cured (yet). There is currently no conclusive diagnostic test for alopecia areata. Typically, the initial alopecia areata lesions appear as a smooth bald patch sometimes appearing within 24 hours. Some people describe irritation, tenderness or paresthesia (burning, tingling, numbness) in the affected area or in an area preceding the development of a new patch. Also small broken off hairs called ‘Exclamation Mark Hairs’ can be seen circumscribing the patch.
Corticosteroids, 8-methoxypsoralen plus ultra violet A light (PUVA), immune cell distractors and minoxidil are some of the documented treatment options for alopecia areata.

Seek advice from a qualified TTS Trichologist for a consultation and treatment. Treatment should only be done by a qualified professional.

J Norris.