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In this form of hair loss normal hair growth is interspersed with totally bald patches which have well defined margins, the patch or patches are usually round or oval. This is called Alopecia Areata. The patches may spread and increase until the entire scalp may be totally bald causing Alopecia Totalis. In extreme cases the eyebrows, eyelashes, beard and axillae hair as well as the downy hair of the body may all be lost in Alopecia Universalis. Alopecia Areata This fairly common scalp condition has no special cause. A number of theories exist as to why it occurs. The main theories as to its causes are:- Trophoneurotic Relating to nerve damage or change. Genetic Influences Sometimes occurring in families, a genetic influence has been suggested. Atopic States Alopecia Areata does seem to be more common in those people prone to eczema, asthma and allergies. Autoimmune Reactions The autoimmune system protects the body from external and internal attack by viruses, bacteria and foreign tissue. Antibodies are formed in the blood to destroy the invading organisms. These may be formed unduly and attack hair follicles causing cessation of hair growth. Emotional Stress This plays a large part in Alopecia Areata and its influence has long been underestimated by the medical professions. The probable cause of Alopecia Areata lies in a variable mixture of all the theories given, different people being more 'reactive' to varying causes. Emotional Stress Relating to nerve damage or change. Sometimes occurring in families, a genetic influence has been suggested. Alopecia Areata does seem to be more common in those people prone to eczema, asthma and allergies. The autoimmune system protects the body from external and internal attack by viruses, bacteria and foreign tissue. Antibodies are formed in the blood to destroy the invading organisms. These may be formed unduly and attack hair follicles causing cessation of hair growth. This plays a large part in Alopecia Areata and its influence has long been underestimated by the medical professions. The probable cause of Alopecia Areata lies in a variable mixture of all the theories given, different people being more 'reactive' to varying causes. Usually with Alopecia Areata the nails of the fingers and toes are affected, they may show longitudinal ridges or more usually pitting of the nail plate. Rarely severe damage of the nail may be seen. Eye disorders may be more common, also Vitiligo, a skin condition in which pigment is absent in patches. Alopecia Areata may affect men and women more or less equally and at any age, becoming rarer in the elderly. Sometimes it starts during childhood and may recur at various intervals. The bald patches form very rapidly and are often first noticed by a relation or hairdresser. As the patches spread, the hair bulbs (papillae) fail to produce normal hair before they cease working. This causes the hair to be finer just above the scalp at which point the hair breaks off. Under the microscope the shape looks like an exclamation mark and these shaped hairs are often seen around the perimeter of a rapidly growing patch and are a clear indication that the patch is still growing. Where these exclamation mark hairs are not seen usually indicates that the patch has reached its full size. This form of Alopecia predominantly attacks dark pigmented hairs, white hairs are usually not affected. Some people notice that their scalp becomes itchy just before a new patch begins to form. The long hair continuing to grow around a bald patch may become looser than normal so the scalp should be treated gently and vigorous brushing avoided. If the degree of hair loss is not too great and the patches are fairly small, hair growth will often start in the centre of the patch within about three months and spread so that the hair growth eventually covers the whole patch so it becomes more difficult to find. Frequently the hair will begin to grow in white but normally regains its usual colour within a few weeks. If the problem is continuing, old patches will re-grow as new patches form. In about 4-6% of cases the patches continue to spread and multiply until they merge into each other eventually leading to total loss of hair on the scalp. Alopecia Totalis and Alopecia Universalis Loss of scalp and body hair is obviously the most serious manifestation of this form of hair loss. |
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