Alopecia areata is a form of hair loss from areas of the body, usually from the scalp . Because it causes bald spots on the head, especially in the first stages, it is sometimes called spot baldness. Alopecia areata affects both males and females. This type of hair loss is different than male pattern baldness, an inherited condition. Alopecia areata is one type of hair loss. The exact number of people affected by alopecia areata is not known. Estimates vary between 1 in 1000 to 2 in 100 people being affected at some point in their life. Alopecia areata can occur at any age but most cases first develop in teenagers and children. In about 6 in 10 cases the first patch of hair loss develops before the age of 20 years.

Causes

Alopecia is not contagious. It is an autoimmune disease in which the body’s immune system attacks itself, in this case, the hair follicles. Alopecia areata may occur in more than one member of the family, and such families may develop other autoimmune diseases such as pernicious anaemia and vitiligo. It is also more common in patients with chromosomal disorders such as Down syndrome.

Symptoms of Alopecia

The primary symptom of alopecia areata is roundish patches of hair loss on the head, with smooth, hairless scalp in the affected areas. Alopecia totalis involves the complete loss of all scalp hair, and alopecia universalis is characterized by the complete loss of all scalp and body hair.

Treatment

Topical Minoxidil Topically applied rninoxidil 5% solution is helpful in reducing the rate of hair loss or in partially restoring lost hair in some patients; in large clinical trials, moderate growth has been noted at 4 and 12 months in 40% of males. The efficacy of minoxidil in females is not yet known from large clinical trials. Combinations of higher concentrations of minoxidil with topical retinoic acid are promising improvements.
Immunotherapy using chemicals such as diphenylcyclopropenone or squaric acid dibutyl ester on the scalp that can produce an allergic reaction, which may neutralize the turned-on immune cells.

Antiandrogens Spironolactone, cyproterone acetate, flutamide, and cimetidine, which bind to androgen receptors and block the action of dihydrotestosterone, have been reported to be effective in treating women with AGA who have elevated adrenal androgens; these must not be used in men.

There are several available treatments for Alopecia. Two relatively new drugsminoxidil (Rogaine) and finasteride (Proscar)promote hair growth in a significant minority of patents. UVB is generally used to treat skin conditions but is also used for people with severe hair loss.Steroid injections are commonly used in sites where there are small areas of hair loss on the head or especially where eyebrow hair has been lost. Anti-inflammatory drugs that are prescribed for autoimmune diseases. Corticosteroids can be given as an injection into the scalp or other areas, orally (as a pill), or applied topically (rubbed into the skin) as an ointment, cream, or foam. Hair transplantation is completed by taking tiny plugs of skin, each containing one to several hairs, from the back side of the scalp.

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