Alopecia: all the key facts to know

Alopecia is a chronic skin disorder that affects the hair follicles. It results in loss of hair on the head and sometimes on the body as well. We don't exactly know what causes alopecia, but it is thought to be an autoimmune disease, which is also affected by environment.

Alopecia is not life-threatening, but its treatments options are very limited. As such, it is often associated with a considerable amount of psychological impact, for example anxiety and depression.

4 types of alopecia:

1. Alopecia areata: This is an autoimmune condition that causes patchy hair loss, and can range from a single bald patch to widespread patchy hair loss. Widespread alopecia areata, called alopecia totalis, causes total loss of all hair on the scalp. Alopecia universalis is a type of this form of alopecia which is even more widespread, causing total hair loss on the scalp and all hair on the body, including the eyelashes and eyebrows.

2. Androgenic alopecia: This alopecia type is also known as male pattern (or female pattern) baldness. The baldness is usually associated with aging, is thought to be hereditary and is the most common cause of alopecia. In fact, male pattern baldness affects 50% of men over the age of 50 and interestedly, in women, it affects 50% of females over the age of 65. This form of alopecia causes a receding hairline, and loss of hair from the top and front of the head.

3. Scarring alopecia: Cases of this form of alopecia are rare. But when they occur, they cause permanent hair loss because they destroy hair follicles.

4. Traction alopecia: This alopecia type is caused by tension on hair shafts caused by certain hair styles.

There are also a number of other types of alopecia, including hair loss caused by medication, most commonly, chemotherapy. In these cases, hair usually grows back after treatment is stopped. General thinning of the hair can also occur at times, but in time hair tends to grow back without treatment.

Treatment options
There is no cure for alopecia, but there are some treatments that may help. Please discuss these with your doctor or pharmacist for more information. Treatments include:

  • Steroid creams or lotions , or steroid injections into the local area
  • Finasteride (Propecia®) can be useful in male alopecia
  • Topical minoxidil /Regaine® can be bought over the counter and can slow down hair loss
  • Other specialist prescribed medications include dithranol - a tar like ointment - and tretinoin cream, which is primarily used to treat acne
  • Some say a zinc supplement may be helpful - talk to your pharmacist.
  • If hair loss is more extensive, there are options for more aggressive or systemic treatments, but they can have a lot of side effects and only limited success. They would need to be discussed with a specialist. These options include immunosuppressive drugs, PUVA treatments and UVB treatments and oral steroids.
Wigs and hair replacements

Many people feel more confident if they use a well-fitted wig or hair piece, but, equally others are happier going without. This really is down to the individual. People are also increasingly using semi-permanent hair make-up and hair transplantation to replace the loss of their own hair as well.

Talk to your doctor - and get support
Please don't let hair loss get you down. Talk to your doctor to look at what options are available. For more support and information you can also visit the charity Alopecia UK.

Dr Jennifer Kelly is a GP and founder of the Grace Kelly Ladybird Trust (for awareness and research into childhood cancers).


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