ALOPECIA AREATA

I recently saw a young girl with the complaint of small bald patches on the head. The physical examination and relevant tests done revealed that that she had alopecia areata. Alopecia is the condition of falling of hair without any apparent sickness. Given the amount of hair loss, different terms have been coined. Patchy loss of hair is called alopecia areata. Total loss of hair on the scalp is called alopecia totalis. Bald spot in one spot is labelled as alopecia monolocularis, whereas presence of multiple spots is called alopecia multilocularis. Some cases may have loss of hair on the body along with scalp and they are diagnosed to be having alopecia universalis. It is a very disturbing condition for any person, more so for women. The cosmetic disfigurement due to hair loss, coupled with the anxiety of having some big sickness leads to much distress in the affected person. Men usually have hair loss due to hormonal effects around middle age. That is an accepted fact and this mostly runs in families as a hereditary condition. Alopecia areata is different from this natural baldness. Any age or gender can be affected by alopecia areata. There are reports of some babies being affected by this condition. But it is more common in young adults. Mostly it occurs in individuals with history of asthma, allergic rhinitis or similar conditions induced by allergy. Usually more than one member of a family is seen to be suffering from alopecia areata suggesting involvement of hereditary factor. Exact cause of this condition is not known but it is speculated to be an autoimmune condition (state where antibodies produced in the body are directed towards tissue antigens of the body itself). The loss of hair is episodic in some persons. There may be one or 2 episodes of patchy hair loss, then after sometime hair grow back again. There may be another episode of hair loss months or years later. In some individuals, the bald patches become permanent but do not progress. Any kind of stress is known to aggravate the condition. Alopecia progresses to total hair loss in some unfortunate persons. Many people consider alopecia to be a contagious condition due to lack of information about it. But they have to be informed that it is not infectious and they need not fear that they have been infected by someone. Moreover it is an absolutely benign condition and produces no complication in the body, even if of a long duration. It does not also cause any kind of scarring over the scalp. Irrespective of the amount of hair loss it is a distressful condition. Diagnosis is made clinically. Specific tests if needed are done to exclude suspected fungal and bacterial infections of the scalp. There is no specific cure available for alopecia areata. Nothing needs to be done where hair loss occurs in small patches. People try different kinds of shampoos, hair oils, e.t.c., in a bid to stop the hair fall, but nothing seems to work. Corticosteroids have been tried in form of injections, tablets or local applications. But they stop the loss of hair temporarily. After sometime, as their effect wears off, the hair start falling again. There are many adverse effects of use of corticosteroids for a long time hence it is not desirable to use them for long time. Much research is going on to know the precise genetic cause of alopecia areata. In future maybe some genetic modification measures may come up to help in its prevention. Best course for an individual is to accept this condition as it is. If somebody is worried about the cosmetic aspect, he or she can use suitable wigs to mask it. Though it is an uncommon harmless condition, it disturbs the person affected. If people know about it sufficiently there will be no worry regarding alopecia areata. E-mail-rachna212002@yahoo.co.uk