Every month we try to highlight a monthly observance and raise awareness for a cause in the medical field. July is women with alopecia month in the US, and we’re giving you the ins and outs of this condition, covering what is known about the types and causes of alopecia.
Simply put, alopecia, synonymous with the term balding, is a lack of hair in an area that would usually have it. It can be in patches or affect the entire area, and it can be permanent or temporary. There are many different types of alopecia, but they all involve either partial or complete hair loss to one or more areas of the body.
This condition is the one you’ll recognise the most, as it’s the one people have if they lose the hair on their scalp as they get older. In some people and over time, the hair follicles become more sensitive to a hormone called dihydrotestosterone, which is converted from testosterone. This is why many more men than women suffer from baldness; the levels of testosterone are much lower in women than men and therefore, there is less chance of increased sensitivity towards it.
Not to be confused with the above age-related balding, alopecia areata is in fact an autoimmune condition. The exact cause is unknown, but it is thought the body sees the hair follicles as a threat and begins to attack them, meaning hair stops growing in the area. This common condition is often only temporary, and the small coin sized patches of no hair begin to regrow within a year. Sometimes the areas can be bigger than this, and there’s no way of knowing when regrowth will occur. In a few cases, the whole scalp may suffer, which is called alopecia totalis, or even the entire body, known as alopecia universalis. There is no cure for the condition, but if there is only a small amount of hair loss early on, many people get complete regrowth with time. If there is extensive hair loss early on in the process, or if it occurs in children, then regrowth is less likely.
This rarer group of conditions refers to alopecia types that actually destroy the hair follicles and replace them with scar tissue. Accompanying symptoms may be itchiness and burning, which further exasperates the condition. However, sometimes there are no accompanying symptoms and the condition may not be noticed for some time. You can’t actually see any scarring on the scalp, as it is within the hair follicle. Once a hair follicle has become affected the stem cell and sebaceous gland is destroyed, meaning the change is permanent and the follicle will not produce another hair. However, there are some treatments available to try and prevent further follicles from becoming damaged and therefore stop the alopecia in its tracks.
Sometimes alopecia occurs as a result of other conditions or treatments, the most well known being during cancer treatments. Radiotherapy and chemotherapy can sometimes attack the cells in the hair follicles and cause hair loss all over the body, but this is temporary and usually the hair grows back once treatment is over. Other conditions that may cause alopecia include iron deficiencies and mental health conditions such as stress.
Little is known about the causes of alopecia beyond the reasons mentioned above. We do know there is a hereditary element and hair loss can run in families for most types. For example, about 20% of people with alopecia areata have some family history of the condition. Age plays a large factor in androgenetic alopecia, with 50% of men over 50 experiencing it, and 50% of women over 65. More research is always being done into the causes of these conditions, with the hope that a cure could be found.
Unfortunately, there are not many treatments available for alopecia, that have been proven to work, at present. If the baldness is temporary, the hair will usually grow back of its own accord, and if permanent, often the follicle is damaged and unable to be repaired. There are steroid creams and ointments available for mild cases or to stimulate regrowth in temporary conditions, which sometimes helps. Hair transplants have become popular in recent years, where healthy hair follicles themselves are moved to areas with alopecia. Anywhere between 10-80% of the transplanted hair follicles can successfully grow in their new location, so results vary greatly. This method is also not a cure as the moved hair follicles are still susceptible to the alopecia suffered by the previous, damaged follicles.
There is a lot of support out there for those suffering with alopecia. Although almost all forms of alopecia have no other adverse effects on health, it can greatly affect our mental health and state of mind. For many, their hair is their identity and losing it, either temporarily or permanently, can have a big impact. Alopecia UK have a lot of information on getting used to a lifestyle without hair, and in the US there is the National Alopecia Areata Foundation (NAAF) with lots of advice and tips.
If you're concerned about any symptoms you're experiencing, place them into the Isabel Symptom Checker and discuss the results with your doctor:
Mandy has worked for Isabel Healthcare since 2000. Prior to this, she was a Senior Staff Nurse on the Pediatric Infectious disease ward and high dependency unit at one of London's top hospitals, St Mary’s in Paddington which is part of Imperial College Healthcare NHS Trust. Her experience in the healthcare industry for the past 28 years in both the UK and USA means she's a vital resource for our organization. Mandy currently lives and works in Scottsdale, Arizona.