Hair loss is often discovered by a hairdresser, as there are usually no symptoms. The hair stops growing and then falls out from the roots. The cause is a mystery. It is considered to be one of the autoimmune disorders - the immune system starts to reject the hair for unknown reasons. It may occur in more than one member of the family, and such families may develop other autoimmune diseases such as pernicious anaemia and vitiligo.

Alopecia areata is not contagious and is not caused by any food. It sometimes starts after a stressful event, but this is not usually the case.

Alopecia areata has three stages. First there is sudden loss of hair, then enlargement of the patches of hair loss. Lastly new hair grows back. This may take months and sometimes years.

Up to 5% of affected individuals lose all the hair on their scalp. This is known as alopecia totalis and can be very long lasting.

In less than 1% of cases, the hair on the body is also completely lost, which is known as alopecia universalis.

The more severe forms of alopecia areata arise unpredictably. They are more likely if the hair loss starts very young, if the initial hair loss is very severe, and in individuals who also suffer from eczema or asthma.

Alopecia areata does not result in physical disability, but it can be emotionally very distressing.



TREATMENT

If you have alopecia areata, obtain specific advice from your dermatologist or doctor. The hair usually grows back slowly by itself. Sometimes the new hair may regrow grey or white, but after a while the original colour usually returns.

The natural regrowth of hair may be sped up by injecting a cortisone medicine into the area of hair loss. The regrowth occurs only in the area that has been injected. Unfortunately, there is no way of preventing new areas of hair loss. However if they appear, regrowth can be helped by further injections.

Many other treatments have been introduced for alopecia areata, but the results are variable - no one has yet devised anything that works for everyone! Some lotions applied to the scalp do seem to result in temporary improvement in some people, but the hair falls out again as soon as they stop. Medicines which are often tried include topical steroids, irritants such as dithranol, and minoxidil.

For extensive hair loss, there is no reliable treatment. Steroid pills, or a special form of ultraviolet light treatment (PUVA), are sometimes worthwhile, but may result in side effects.

An attractive wig is often the best solution. Some people need professional counselling to come to terms with the disorder, regain self confidence and live full, productive lives.

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