What is Alopecia Areata and everything you need to know about it?
Do you remember this tongue twister?
Fuzzy Wuzzy was a bear.
Fuzzy Wuzzy had no hair.
Fuzzy Wuzzy wasn’t really fuzzy, was he?
Let’s stop and think about Mr. Fuzzy Bear for a moment.
Just because his fur wasn’t as thick and robust as it once was, doesn’t mean that he was any less loveable.
Hair loss can take a toll on one’s self-confidence. Our heads are visible to the public eye daily, so when one notices spots of missing hair on their head, it can be easy to panic. But rest assured, we’re here to talk you through this sensitive topic.
So first thing’s first, can you relate to Fuzzy Bear?
Has your hair stopped growing in certain areas where it once did? If you’ve noticed these hairless spots, you might be experiencing alopecia areata (AA).
What is alopecia areata?
According to the National Library of Medicine (NIH), alopecia areata is an autoimmune disorder characterized by non-scarring hair loss. Because it’s non-scarring, there is no permanent damage, explains Dr. Andrew G. Messenger in an article for Wolters Kluwer (a resource for professional data).
An autoimmune disease means that your immune system wrongly attacks your body. So when you have alopecia areata, the cells in your immune system attack your hair follicles. Consequently, this aggression on hair follicles causes the tresses to fall out.
How much hair does this mean you’ll lose? Well, the more hair follicles your immune system bombards, the more hair you’ll lose.
Both men and women can have alopecia areata, which can begin at any age—even in childhood.
It’s essential to note that while this seemingly unfair follicle raid can cause hair loss, the attack usually doesn’t harm the follicles—so often, your hair can regrow.
What does alopecia areata look like?
Usually, alopecia areata begins as a round, smooth bald patch on the scalp. The quarter-sized patch can appear by itself or with others. All the hair on one’s head can eventually disappear, but according to Johns Hopkins Medicine, complete baldness with this condition is uncommon.
To better understand what is alopecia areata, we need to get acquainted with what causes it.
What are alopecia areata causes?
With alopecia areata, the immune system attacks your beloved hair follicles by mistake and causes inflammation and the hair to fall out.
But why does a person’s immune system turn against their own hair follicles?
Well, according to the National Alopecia Areata Foundation (NAAF), research hasn’t definitively shown what causes a person’s system to attack healthy hair follicles.
Scientists don’t know if the trigger first occurs from:
- Inside the body from a bacteria or virus, or if it comes from
- Outside the body from something in the surroundings.
It could even be a combination of both.
But there are a couple of suspected reasons for this adverse reaction.
What are possible alopecia areata causes?
We know that a person’s natural defense system goes on the offense leading to hair loss, but some other possible alopecia areata causes could be:
- Vitamin D deficiency: According to the American Academy of Dermatology Association (AAD), research shows that people with certain autoimmune diseases (such as rheumatoid arthritis) are deficient in vitamin D.
So, because alopecia areata is considered an autoimmune disease, scientists have examined vitamin D levels in people with alopecia areata. The research showed that some people were low in vitamin D while others weren’t.
But more research is necessary before we know if vitamin D deficiency plays a role in causing alopecia areata.
- Genetic disposition: Roughly 20 percent of those with alopecia areata also have a person in their family who’s affected. Based on this percentage, some experts believe a genetic disposition may be at play.
Someone with a close relative with alopecia areata might have a slightly increased chance of developing it. But, according to the NAAF, many factors, including environment and genetics, play a role in developing alopecia areata. Also, most parents won’t pass the autoimmune disease onto their kids.
- Emotional or physical stress: The NIH explains that historically, stress was seen as a likely cause for alopecia areata; however, more conclusive research and findings are needed.
- Infection: Infection has also been historically believed to be a likely cause, but again, more studies are needed.
Quick recap: We know that with alopecia areata, a person’s immune system attacks their hair follicles (rude, much?), causing inflammation and patchy hair loss. But researchers don’t yet fully understand what compels one’s immune defenses to turn on them.
What are alopecia areata symptoms?
Usually, alopecia areata affects someone’s hair, but sometimes, it can also impact nails. However, people with this autoimmune disease usually have no other symptoms and are otherwise healthy.
Alopecia areata symptoms for hair:
Alopecia areata usually begins with sudden hair loss in a circle or oval shape on the scalp. Other symptoms can include:
- Hair loss and regrowth on different parts of the body at the same time.
- Substantial hair loss in a short period.
- Hair loss that’s mainly on one side of the scalp rather than both sides.
- Pointed hairs, known as exclamation points, can appear and are usually found along the edges of growing patches of bald spots. These hairs are short and broken off, becoming narrower at the base and wider at the tip.
Also, other hair-filled spots on the body can be affected, such as eyelashes, eyebrows, or beards.
Right before the hair falls out, it’s reported that some have felt tingling or itching on the spots of the scalp that were about to become hairless.
Alopecia areata symptoms for nails:
With alopecia areata, nail changes such as brittleness, fragility, and pitting (rows of little dents) can occur.
A study published on Karger (a database for academic journals, articles, and books) discusses a man who experienced the above symptoms on his nails. He couldn’t play the guitar anymore because of his nail’s fragility. But after about ten months of drug treatment, his hair grew back, and he gained improved use of his nails.
What are the risk factors for alopecia areata?
According to the AAD, while anyone can get alopecia areata, you’re more likely to get it if:
- You have a blood relative who has the condition. It’s estimated that roughly 15% of people with alopecia areata have a relative who also has it. This percentage may be higher since many people try to hide their missing hair.
- You have asthma, atopic dermatitis, hay fever, thyroid disease, or vitiligo. Research notes that people with one of these conditions can have higher chances of getting alopecia areata.
- You’ve been using a nivolumab to treat cancer. It’s too early to say whether this drug significantly increases your alopecia area risk or not. But, some cancer patients who received nivolumab treatment also developed the autoimmune disease.
The above drug can treat melanoma and lung cancer; hair loss usually starts a few months after treatment. While the loss of locks may seem like a downer, this hair loss is often seen as a positive sign because it shows that the drug is doing its job.
- You’re a certain race. An extensive study found that Hispanic and black healthcare providers were more likely to develop this disease than their non-Hispanic, white counterparts.
Although this study took place over several years, it had many limitations. For example, it only looked at female nurses in the U.S.A. More research is required to determine whether this finding remains true for other people.
What happens after someone gets alopecia areata?
Remember, what will happen next when a bare patch appears on someone’s scalp from alopecia areata isn’t certain. Some possibilities include:
- Regrowth of hair within a few months. It might look gray or white, but it can regain its natural coloring over time.
- More bare patches can appear. Sometimes hair will regrow in the first patch while new bare spots develop.
- Small patches join to form bigger ones. In rare cases, alopecia totalis occurs, meaning all the hair on the scalp is lost.
- All body hair is lost, a type of disease called alopecia universalis. But this scenario is very rare!
In many cases, the hair grows back, but there may be further bouts of hair loss in the future.
In general, the hair tends to grow back for people with:
- Less hair loss.
- Onset at an older age.
- No nail changes.
- No family history of alopecia areata.
Medical alopecia areata treatment
alopecia areata can be treated, and hair can regrow. So, if you have it, there are some medical treatments to try, such as:
- Minoxidil: This treatment is placed on the scalp and is already used for male pattern baldness (MPB). It usually takes about 12 weeks to see the hair growth and requires consistency.
- Corticosteroids: Anti-inflammatory drugs, corticosteroids, can be delivered via scalp injection. They can also be administered as a pill, ointment, or cream.
- Topical immunotherapy: Used when there’s recurring hair loss; this treatment is when chemicals are applied to the scalp. The goal is to provoke an allergic reaction. If it works, this allergic response causes the hair to regrow.
Only use the above treatments under the supervision of a trusted healthcare provider.
Natural alopecia areata treatment
You may be able to reverse or calm some of alopecia areata ‘s symptoms by:
- Adding probiotics to your daily diet.
In an article for Web MD, Dr. St. Surin-Lord (MD and dermatologist) explains that a person may reverse some hair loss or, at the very least, prevent it from worsening by taking probiotics.
Probiotics reduce inflammation by promoting good gut bacteria.
Also, a recent report published in the Journal of Nutritional Medicine and Diet Care emphasized the importance of diet in changing the scalp’s microbiome, which has been shown to impact the progression of alopecia areata.
- Eating healthy fats and protein.
The body needs a certain amount of protein to grow healthy hair, explains St. Surin-Lord. Also, a diet rich in antioxidants and omega oils may reduce the environmental oxidative stress on the hair.
Furthermore, according to St. Surin-Lord, some seafood rich in vitamins and minerals is believed to improve hair growth.
Rather than suffering through an extreme diet, aim for an eating program that promotes anti-inflammation. You might consider the Mediterranean diet ( which is high in fruits, veggies, fish, healthy oils, nuts, and whole grains.
- Eating less inflammatory foods.
Have you heard of the paleo autoimmune protocol (AIP)? This strict diet plan can support you in minimizing inflammation by removing foods that can trigger negative autoimmune symptoms.
On the AIP, you’ll avoid foods such as:
After a few months and under a doctor’s care, you can begin to work the above foods back into your meal plans to understand better which foods trigger inflammation.
- Taking specific supplements.
According to a study published in Dermatology and Therapy in 2018, we require key nutrients to prevent hair loss.
For instance, turmeric with black pepper can help decrease inflammation.
Also, antioxidants, biotin, iron, and vitamin D may boost hair health.
Can alopecia areata treatment cure it?
While treatments can help the hair grow back or prevent hair loss from worsening, currently, there is no permanent cure for alopecia areata.
According to the NAAF, your follicles remain alive with this autoimmune condition that causes hair loss; therefore, hair can grow back anytime!
There’s nothing wrong with seeking treatment. Promising results have shown hair growth, but remember that there’s no permanent solution at this time, so do your best to manage your expectations.
Do you think you have alopecia areata?
If you wish to learn more about this condition, get in touch with a doctor asap.
Our team at Ravkoo Health knows that hair loss is a highly sensitive topic to discuss. With this in mind, we created the Ravkoo Mobile Health App.
Download this app on iOS and Android, and easily book your doctor’s appointment online using Ravkoo MD. When it comes time to talk with your doctor, you can do so from the comfort of your home via audio, video, or text.
According to the NAAF, about 6.8 million American and 147 million people globally are impacted by alopecia areata. While this condition isn’t uncommon, more research is needed to understand it and potential alopecia areata treatment to cure it entirely.