Alopecia areata treatment
Alopecia areata is a condition that causes hair to fall out in small patches, which can be unnoticeable. These patches may connect, however, and then become noticeable. Alopecia areata occurs when the immune system attacks hair follicles and may be brought on by severe stress, resulting in hair loss. Sudden hair loss that starts with one or more circular bald patches that may overlap. Treatment may address any underlying conditions and includes topical scalp medication.
Depending on which type of alopecia areata you have, your age and the extent of hair loss, there are a variety of treatment options available. The main goals of treatment are to block the immune system attack and/or stimulate the regrowth of hair. This can be effective, especially for people with milder forms of the disease (less than 50% hair loss).
It’s important to know that while these therapies may offer benefits to some people with alopecia areata, there is no single option that will work for everyone. Even if your hair is regrown, there is no guarantee that it won’t fall out again once treatment is stopped.
If there is no cure for alopecia areata, what good are treatments?
There are a variety of treatments for both mild and severe alopecia areata — it’s important to stay informed, so you and your doctor can choose the best course for yours. Goals of therapy include stopping active hair loss and regrown hair.
Treatments for mild alopecia areata
INTRALESIONAL CORTICOSTEROID INJECTIONS
This method of treatment — the most common form of treatment for alopecia areata — uses corticosteroids that are injected into bare patches of skin with a tiny needle. These injections are repeated about every four to six weeks and are usually given by a dermatologist.
Benefits
If new hair growth occurs from corticosteroid injections it is usually visible within four weeks. There are few known side effects related to this kind of treatment.
Drawbacks
Corticosteroid injections, like all treatments for alopecia areata, do not prevent new hair loss from developing. While there are few reported side effects related to this kind of treatment, temporary depressions (called “dells”) in the skin may result from the injections. However, these usually improve with time. People may experience slight discomfort from the needle pricks and tingling from the medication, but usually there is no other pain or discomfort after leaving the dermatologist’s office.
TOPICAL MINOXIDIL
With this form of treatment, a 5% topical minoxidil solution is applied once or twice a day to help stimulate hair on the scalp, eyebrows and beard to regrow. 2% and 5% topical minoxidil solutions are available but aren’t usually effective for alopecia areata when used alone, but when applied in combination with topical corticosteroid medications, some people see improved results.
Benefits
If a person’s hair grows back completely with topical minoxidil, treatment can be stopped. This medication is considered easy to use and has minimal side effects.
Drawbacks
Topical minoxidil is not considered effective on its own in treating patients with extensive hair loss.
TOPICAL CORTICOSTEROIDS
In alopecia areata, corticosteroids are thought to decrease the inflammation around the hair follicle. Topical steroids can come in different brands, strengths and preparations, such as solutions, lotions, foams, creams, or ointments.
Benefits
Studies have shown that there is a reduction of hair loss when using topical steroids. In addition, improved regrowth of approximately 25% has been observed with the use of highly potent topical corticosteroids. They can be good adjunct medications especially when treating children with alopecia areata.
Drawbacks
The effectiveness of topical corticosteroids is limited by their absorption in the scalp.
ORAL CORTICOSTEROIDS
Corticosteroids taken in the form of a pill are sometimes prescribed for extensive scalp hair loss to try to suppress disease activity and regrow hair.
Benefits
Some patients may experience hair regrowth during the short period of time they are able to tolerate using this medication.
Drawbacks
Healthy, young adults can usually tolerate corticosteroid pills with few side effects. However, doctors do not prescribe corticosteroid pills as often as other treatments for alopecia areata, because of the health risks and side effects associated with using them for a long period of time. It’s important to talk to your doctor about your goals for treatment and possible side effects of the medication, to be sure the benefits of using corticosteroid pills in your case are greater than the risks. As with other options, hair regrown with corticosteroid use may fall back out once treatment is stopped.
Alopecia Areata – Frequently Asked Questions
Alopecia areata is often diagnosed simply by the physician examining the scalp and obtaining a medical history. Often, your primary care provider or dermatologist will order blood work to assess you for other conditions that can contribute to alopecia areata, such as hormonal abnormalities or vitamin deficiencies. In rare circumstances where the diagnosis is unclear, your dermatologist may perform a scalp biopsy to determine the cause of your hair loss.
Alopecia areata can affect any hair-bearing part of the body. It primarily affects the scalp, eyebrows, eyelashes, and body hair. People can also lose their nose hairs, which leaves them susceptible to dryness and subsequent increased runny nose and heightened sensitivity to environmental allergens and pollutants. Nasal rinses, lubricating gels and sprays can help with the dryness and runny nose, and antihistamine sprays can help mitigate the allergic rhinitis, also known as hay fever. Some individuals that have lost their eyelashes report increased sensitivity and eye irritation. This can be relieved with lubricating eyedrops and the use of sunglasses while outside to prevent dust and other particles from getting into the eyes. Please speak to your primary care provider if you have concerns about alopecia areata and your health.
There may be a hereditary component to alopecia areata. However, some patients are the only people in their families to have the disease. Some people with alopecia areata will have children that do not develop the disease, and for some people the disease runs across several generations. Simply put, further research is required to fully determine the role of genetics in the disease susceptibility and progression.
Sun protection is recommended for all individuals – hair or not. However, individuals with hair loss on the scalp are more susceptible to sunburns on the head and other harmful effects of ultraviolet (UV) radiation. Hair helps to block UV radiation from reaching the surface of our skin, thus, when an individual loses their hair, they also lose some of that protection. Even people with hair are encouraged to wear a hat or spray their scalp with sunscreen if they’re going to be out in the sun for long periods of time.
In general, alopecia areata is unpredictable. There is no way to tell when the hair will fall out, when it will grow back, how much will grow back, and how long the hair growth will last. Medical treatments such as corticosteroids and immunosuppressants are able to suppress the autoimmune response and give the body a better chance at growing and retaining hair. People with more advanced forms of alopecia areata, such as Totalis, Universalis, Ophiasis, etc., tend to be more resistant to meaningful hair growth, but this does not mean that they cannot regrow hair. This lack of understanding underpins the need to fund biomedical research for alopecia areata.
Typically, the hair loss caused by alopecia areata is not associated with any symptoms. However, some people have reported mild itching and tingling in the areas of hair loss.