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Alopecia Areata
Alopecia Areata (AA) is a unique hair disorder, characterized by round or oval patches which are symptom-less and appear spontaneously. The hair is easily pulled out from the margins of such patches. These bald patches can occur anywhere on your body, including hair from the eyebrows and eyelashes. It affects 0.1-0.2% of the general population, with an average life time risk of 1.7%. It generally begins in childhood or early adulthood. Very rarely, it may progress to complete hair loss over the scalp and/or body (AA universalis).
AA is an autoimmune disorder. This is a condition where our immune system becomes misguided against its own cells due to certain triggers like stress, medication, infection or hormonal imbalances. The immune system then begins to attack and eliminate the hair follicles WITHOUT destroying them. Hence, the hair in these patches can always grow back as the follicle itself is intact and unscarred. This process can be set-off by environmental factors like genetics, atopy and stress.
AA can also be seen in conjunction with other autoimmune diseases like thyroid disorders, vitiligo, pernicious anemia, Rheumatoid Arthritis, Diabetes Mellitus, Myasthenia Gravis and ulcerative colitis.
Most people get 1-3 patches. Hair regrowth during the first attack takes place within 6 months in 30% of cases, within 1 year in 50% and within 5 years in 75%; complete recovery occurs in approximately 30%; in up to 33%, the hair never regrows. It is generally symptom-less, though occasionally itching or burning sensation may occur.
Young age at onset of illness, extensive disease, nail changes and association with other autoimmune diseases are poor prognostic factors. When spontaneous regrowth does not occur within 3 months, your dermatologist can successfully treat you with medicated creams, solutions and injections. The regrowing hair may be grey in color initially, but quickly re-pigments in a month or two.
