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Alopecia areata (or loss of lightheadedness) Causes, Symptoms and Treatment

Alopecia areata differs from baldness, which causes hair loss (not hair) for mainly hereditary reasons. On this subject, see our Alopecia sheet.

The alopecia areata: what is it?

The areata causes loss of hair in patches, usually in the scalp. The skin of the skull retains its normal appearance, but is simply devoid of hair in places. It is also called alopecia in plates.

About 1% of North Americans would be affected by alopecia areata. In almost half of the cases, symptoms appear before the age of 20. It represents 2% of consultations in dermatology in France.

There is no cure for it. Some treatments can stimulate hair regrowth. However, in almost 80% of people, hairiness reappears itself 6 to 12 months after the fall. The hair can even grow back years later. But nothing protects against a relapse (it is even common).

 

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Causes of Alopecia areata (or loss of lightheadedness)

Scientists do not know what triggers the loss of hair and hair: a viral infection, heredity, stress, exposure to a chemical. However, hereditary factors seem to play in 20% to 40% of people affected. The researchers speculate that the destruction mechanism involves an autoimmune reaction, where the antibodies of the affected person would mistakenly attack the hair follicles. The alopecia areatais associated with the presence of other autoimmune diseases, such as vitiligo, type 1 diabetes, rheumatoid arthritis, discoid lupus and Hashimoto’s thyroiditis. Luckily, hair follicle stem cells, which allow hair regrowth, remain intact. This explains why the hair can grow again, even after several years of dormancy.

Evolution

The evolution of alopecia areata is quite unpredictable and very variable from person to person. The majority of people will be cured after 1 year, but about 10% will be chronically affected and will have no hair regrowth.

Alopecia areata usually remains localized to the scalp and is restricted to small, bare patches. Nevertheless, in its extensive form, it can progress and extend to the beard and the entire scalp. Universal alopecia (loss of all body hair) is very rare.

In some individuals, the disease also attacks the nails: they take the form of a bumper and become marked at the tip, rough and without radiance.

Symptoms of Alopecia areata (or loss of lightheadedness)

  • Suddenly, one or more circular or oval areas 1 cm to 4 cm in diameter becomes completely strippedof hair or hair. Occasionally, itching or burning sensation may be felt in the affected area, but the skin will look normal. Usually, it regrows in 1 to 3 months, often followed by a relapse in the same place or elsewhere;
  • Sometimes nail abnormalities such as striations, cracks, spots and redness. Nails can become brittle;
  • Exceptionally, a loss of all hair, especially in the youngest and, more rarely, all the hair.

People at risk for Alopecia areata (or loss of lightheadedness)

  • People who have a close relative suffering from alopecia areata. This would be the case for 1 in 5 people with alopecia areata;
  • People who have or have a family member with allergies (asthma, hay fever , eczema, etc.) or an autoimmune disease such as autoimmune thyroiditis, diabetes type 1, rheumatoid arthritis, lupus, vitiligo or pernicious anemia.

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Medical treatment of alopecia areata (loss of lightheadedness)

Important. Sudden and severe hair loss can be a sign of nutritional deficiency, hormonal fluctuation, or other illness. It is advisable to consult a doctor.

No treatment offers definitive cure to alopecia areata. The drugs described below stimulate hair follicles to enter the normal growth process, but they have no long term effect. In addition, the alopecia often disappears of itself in less than 1 year, the hairs repelling without the contribution of any therapy. This is why many people with alopecia areata choose not to start treatment. In this case, one can opt for the natural, or for a camouflage makeup, a complete shave of the head, a wig or a scarf.

The medical consultation also makes it possible to evaluate the relevance of a support in psychotherapy. Depending on its severity, alopecia areata can cause discomfort in society and a lack of self-confidence. Participation in a support group can also be helpful.

For light forms of alopecia areata

Corticosteroids in application or injection. When hair loss is limited, small amounts of corticosteroids can be applied or injected directly to bare areas. This is the most effective treatment when alopecia areata is not spread to a large part of the body. Corticosteroids are anti-inflammatory drugs similar to cortisol, a natural hormone produced by the body. Because these drugs suppress the immune system, they are commonly used to treat autoimmune diseases. Hair regrowth usually begins in the weeks following treatment, although concomitantly other areas may become bare. Injections should be repeated at approximately 4 weeks intervals. Children tolerate it less well. But it must be remembered that the treatment has no influence on the course of the disease in the long term.

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Minoxidil solution. A solution of minoxidil (2 or 5%) can be applied twice a day to promote regrowth. It appears after about 12 weeks of treatment. This solution is of no use in people who have lost all their hair.

Cream or ointment with anthralin. Product commonly used in the treatment of psoriasis, anthralin is an oxidant that modifies the immune response. If the cream is applied daily to the scalp at bare spots (then rinsed 20 to 60 minutes later), the hair should regrow in 8 to 12 weeks. Anthralin is used in combination with corticosteroids or minoxidil for best results.

For extensive forms of alopecia areata

For larger hair losses (which affect more than 50% of the hair), more powerful treatments are suggested and can be combined with those described previously. These treatments are rarely used in children.

Contact immunotherapy. Topical sensitizers that cause an allergic skin reaction can lead to regrowth of hair. Regrowth is usually observed after about 8 to 16 weeks.

Oral corticosteroids. When given orally, corticosteroids have a stronger effect on the immune system. This treatment is little used to treat the alopecia areata because of the health risks it causes in the long term.

Photochemotherapy (PUVA). Photochemotherapy involves combining UVA exposure with a photosensitizing drug (which sensitizes the skin to the action of these rays), psoralen.

Practical advice

  • Protect your skin from the sun, because areas without hair or hair are more sensitive to UV rays. A good sunscreen can do the trick. For the head, opt for wearing a hat, a headband or a wig.
  • Wearing eyeglasses (or sunglasses) helps protect the eyes from the sun and dust for people who no longer have eyebrows and eyelashes.

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