DEFINITION

Alopecia Areata is a disease which affects hair growth on the scalp and may also affect other areas of the body. It is most common in teenagers and young adults although can occur in children and during old age. While uncommon, it is found in 1 to 2% of new patients seen by Dermatologists and occurs in both males and females.

CAUSE

The cause of Alopecia Areata is unknown although it is associated with a higher than normal risk of autoimmune disease (and may in fact be an autoimmune disease itself). The hair falls out because of inflammation around the root, causing the hair root to become inactive and shrink in size. A severe shock may trigger an attack in people prone to this disorder although the role of everyday stress in its development is still unclear.

Alopecia Areata may be confused with tinea (ringworm) although with ringworm the hairs are more likely to be broken not lost, and the area is inflamed. Children prone to severe hair pulling may also have patches of hair loss which may be mistaken for Alopecia Areata. This condition is not infectious and cannot be caught by using someone else's comb or brush or using someone else's towel. Alopecia Areata is likely to run in families, especially those with a history of eczema or autoimmune thyroid disease.

SIGNS AND SYMPTOMS

The first sign is generally a patch of bare scalp, although it may also affect the eyelashes and eyebrows and/or the beard in men. In rare and severe cases body hair may be affected. The patches of baldness are smooth with few remaining hairs in the centre. Round the edge of the patch some stub like hairs can usually be seen (often called "exclamation mark" hairs as they are thicker at the tip than at scalp level). Hair may be lost over wide areas, causing general thinning of the hair. This can cause hair to "turn white overnight" by selectively affecting dark hairs and leaving grey hairs.

The only other structures affected are the nails - people with severe Alopecia may also show dulled and ridged fingernails. Diagnosis is typically made from physical signs and symptoms and rarely requires further tests.

TREATMENT OPTIONS

This is a medical condition and should be under the supervision of a medical practitioner. Your Doctor will advise you on the latest medical treatment for this condition.
The majority of cases settle down and regrow after one or more patches have been present for some months. However, sometimes the condition persists, and new patches can appear while old patches regrow. Sometimes the affected area extends in a ring around the regrowing area. When the condition first appears it is not possible to predict whether it will be mild and recover soon or will become severe.
Many treatments have been used over the years so consult your Doctor on the current approach to this condition. At this time there is no evidence to suggest that particular foods or vitamin deficiencies contribute to the development of this disorder. It does make sense though to make sure that foods which aggravate inflammation in the body are avoided, especially saturated fats and refined sugars. Some studies from Europe have shown that taking zinc over a long period of time may improve the symptoms and mild cases may respond to irritant chemicals prescribed by your Doctor such as dithranol.
The most effective treatment is currently cortisone creams or ointments or injections directly into the patches. Other treatments include D.C.P (dicyclopropylpropenone) which rapidly produces scalp irritation and may not suit all people, ultraviolet light and special photosensitising compounds known as psoralens and minoxidil, a pharmaceutical used in the treatment of male pattern baldness with some success. For those with severe Alopecia Areata wigs may be an option and will not prevent the hair from regrowing or make the condition any worse.
When people are under stress or are very upset about the change in their appearance the Doctor may prescribe a mild sedative.

PHARMACIST'S ADVICE

1) Ask your Pharmacist about stress management programs and techniques.
2) Ask your Pharmacist about vitamins and herbs which may assist with stress control and help control the inflammation.

VITAMINS/MINERALS/HERBS

While there is no definite treatment for Alopecia areata, nutrients and herbs known for their anti-inflammatory activity may assist in decreasing the severity and duration of the condition. These include the antioxidants vitamin E, vitamin C, vitamin A, beta carotene, selenium, quercetin, ginkgo biloba, St Mary's thistle and grape seed extract.

A wide range of antioxidants can be provided from dietary sources which should include a variety of fruit and vegetables, whole grains and a minimum of saturated or heated/cooked fats. Research has shown zinc sulphate may reduce the severity of the attack although this must be taken over a long period of time. High doses of zinc are potentially toxic and must be taken under the supervision of a medical practitioner.

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