Alopecia areata is an autoimmune mediated inflammatory condition, where the body’s own immune system targets the base (or bulb) of the hair follicle. The word “alopecia” comes from Ancient Greek and roughly translates as “fox disease,” on account of foxes changing their fur twice a year. The word “areata” means “occurring in patches or circumscribed areas.” This will present as smooth, hairless circular patches. Initially, it may start as a single or multiple patches, but it may progress to eventually affect the whole scalp or the entire body. If the entire scalp is affected, this is caused alopecia totalis. If the entire body is affected, this is called alopecia universalis.
What is the cause?
The body’s own immune system, utilizing its T cell, will target the bulb of the hair follicle, likened to a ‘swarm of bees’. We do not know what triggers this attack, but do know that it is most likely from numerous factors including genetics, environmental triggers, and other autoimmune disorders that cause particular patients to be at a higher susceptibility for this disease.
How is it treated?
The good news is that this is considered a non-scarring type of hair loss. This means that the hair follicles are still preserved and can grow back without distortion. However, this does not mean that will definitively happen. Only if the autoimmune system is controlled, can active regrowth be achieved. Every patient’s course is different. Most patient’s respond to intralesional steroid injections directly into the areas of alopecia. Topical minoxidil, anthralin, and squaric acid dibutylester therapy have been used with varying degrees of success. However, some difficult cases may require systemic medications which have their own risks.