Alopecia's hair loss can be embarrassing

“I’m 16 and I’ve had alopecia since I was in seventh grade. Wow, that’s the absolute worst time to start losing your hair because really, junior high is where they put kids when they’re at their most bitchy and hormonal and judgmental and let them stew and fester for a couple years before releasing them to high school, where everyone is much better,” so wrote a young woman on an alopecia areata support group website.

Alopecia means hair loss. The medical condition called alopecia areata most often makes hair fall out in small round patches on the scalp. Hair loss might also occur on other parts of the body.

“You may first notice clumps of hair on your pillow or in the shower. In rare cases, some people may experience more extensive hair loss. This is usually an indication of another type of alopecia, such as: alopecia totalis, which is the loss of all hair on the scalp or alopecia universalis, which is the loss of all hair on the entire body,” explains Healthline.com.

“The hair loss associated with alopecia areata is unpredictable and random. The hair may grow back at any time and then may fall out again. The extent of hair loss and regrowth varies greatly from person-to-person,” they say.

Not unlike other autoimmune diseases whose symptoms wax and wane, alopecia areata can go into remission for years at a time. The American Academy of Dermatology says that “alopecia is not contagious. It is not due to nerves. What happens is that the immune system attacks the hair follicles (structures that contain the roots of the hair), causing hair loss. This disease most often occurs in otherwise healthy people.”

Most often hair loss occurs mostly on the scalp, but it can also involve eyebrows, eyelashes and beards. Patches can be small or large.

“Often, a few short hairs occur in or at the edges of the bare spots. These hairs get narrower at the bottom, like an exclamation mark,” AAD tells us. “With time, some patients go bald. Some lose all their body hair, too. This is not common. Also uncommon is a band of hair loss at the back of the scalp.

“Alopecia areata also can affect your fingernails and toenails. Nails can have tiny pinpoint dents (pitting). They also can have white spots or lines, be rough, lose their shine, or become thin and split. Rarely nails change shape or fall off. Some-times nail changes are the first sign of alopecia areata,” AAD explains.

Scien-tists suspect that genetics play a part in having a higher risk for alopecia areata. Often people with a family history of other autoimmune diseases, such as type 1 diabetes and rheumatoid arthritis develop the disorder. Healthline.com says that “they also believe that certain factors in the environment are needed to trigger alopecia areata in people who are genetically predisposed to the disease.”

Your primary care provider may be able to diagnose alopecia areata by just looking at the hair loss. Or, he or she may pull out a few hairs to look at under a microscope. Sometimes a skin biopsy is required. In that case your PCP or dermatologist will remove a small piece of skin to be studied under the microscope as well. If the medico thinks you may have another autoimmune disease, blood tests will be ordered.

Without treatment hair might grow back and then fall out again. Unfortunately the same is true if medications are used. But, most likely the clinician will recommend corticosteroids to be either injected or topically applied. There are many other medicines for hair loss that can be used in conjunction with or instead of corticosteroids that have varying success stories depending on the patient.

Our forum patient said that people were mean to her and that she became depressed. Shaving her hair and wearing a wig helped her self-esteem.

“Having this disease really forced me to stop caring what other people think of me. This is my attitude: This is me. I have no hair, take it or leave it,” she said. “And, I think I’m OK.” I think she is too.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at 208-264-4029 or kathyleehubbard@yahoo.com.