Alopecia areata is a disease in which rounded foci of baldness form on the head. Pathology is found not only in men, but also in women, and even in children. This type of hair loss is also called focal alopecia. This is one of the most complex and difficult to treat forms of baldness. A person does not feel any discomfort during hair loss. Only when combing on the head a bald spot of a round shape is found. The affected areas are similar to nests, hence the name of the disease.
Causes of the disease
The causes of alopecia areata are not exactly established. It is assumed that the pathology is of an autoimmune nature. The human body begins to perceive the hair follicles as a foreign substance, and rejects them. First, a small round area of baldness appears on the head, which then increases.
The following factors can provoke the development of the disease:
- Heredity. Often focal alopecia is noted in parents and immediate relatives of patients.
- Chronic respiratory infections. Untreated dental caries, acute respiratory viral infections and influenza cause bacteria and viruses to enter the bloodstream. These microorganisms settle in the hair follicles. When a person’s immunity fights infection, not only the destruction of microbes occurs, but also the destruction of hair follicles.
- Stress and neurotic disorders. In depressive conditions, the blood supply to the hair worsens, which leads to their loss. In addition, under stress, the functioning of the immune system is disrupted, and the body begins to struggle with its own hair follicles.
- Endocrine diseases. Pathologies of the thyroid gland, adrenal glands and pituitary gland also affect the condition of the hair.
- Hormonal imbalance. Alopecia areata in women often appears during pregnancy, menopause or when taking hormonal contraceptives. During the bearing of the fetus, treatment of baldness is not carried out, usually the condition of the hair normalizes after childbirth. In other cases, you must visit a doctor.
- Helminthic invasion. Nest alopecia sometimes occurs against the background of helminthiases. The immune system fights against parasites and at the same time the hair follicles are affected.
The hereditary factor plays the main role in the occurrence of the disease, which is why the disease is difficult to cure. All other causes of baldness can be eliminated.
Alopecia areata occurs in several forms. In medicine, the following varieties of this disease are distinguished:
- Local On the head there is one or two rounded bald spots.
- Subtotal. The foci of baldness merge and form large areas. About half of the hair is missing on the head.
- Total. Hair on the head is missing. Eyebrows and eyelashes often fall out.
- Universal. Hair falls not only on the head, but throughout the body. Sometimes the hairline grows back, but it lasts for a very short period.
- Ophiasis of Celsus. With this form of the disease, a bald spot in the form of a strip can be seen. The baldness zone ranges from the temples to the back of the head. This kind of alopecia is characteristic of children.
- Diffuse. There is baldness only in the upper part of the head.
- Focal alopecia with dystrophy of nails. This is the most severe form of the disease that is difficult to treat. When it affects not only the hair follicles, but also the nails. Deformation and delamination of the nail plate occurs.
Different forms of baldness can pass one into another. If at the beginning of the disease local alopecia is noted, then in the future, if untreated, a subtotal and total variety of the disease may develop. As a result, a person loses more and more hair.
Stages of the disease
In its development, alopecia areata passes through several stages:
- Progression. At this stage, hair follicles lose strength in humans. Sections of baldness with inflamed skin appear on the head. Sometimes a slight itch appears. The hair looks thinned and is easily removed from the bulb when sipped.
- Stationary stage. Baldness stops progressing. Skin inflammation disappears. Hair stops falling out.
- Stage of regression. On affected areas, bushy blond hair grows. Under favorable conditions, they become stronger, pigmented and turn into a normal hairline. But with an exacerbation of the disease, baldness can begin again.
The first sign of the disease is the appearance of areas of baldness. They usually have a round shape and a size of 1 cm to 10 cm. The lesion focus has clear boundaries. Usually a single site of alopecia is noted, but in some cases there may be several. Zones of baldness can merge with each other.
The skin in the affected areas is slightly changed. Sometimes slight redness is noted. Crusts and peeling are not observed. Hair near the alopecia zone does not hold well in the follicles and is easily pulled out.
Increased fragility of hair is noted. They have a normal root, but a very thin stem base. Often hair breaks at a length of about 3 mm.
There is a special kind of disease (ofiasis) in which bald spots are not round, but longitudinal in the form of a strip. Nails can also be involved in the pathological process, their condition significantly worsens. Such types of alopecia are considered the most malignant and poorly respond to therapy.
Alopecia areata in women usually occurs between the ages of 15 and 35 years. More often this disease affects patients with dark hair. Pathology usually proceeds more favorably than in men. Estrogens predominate in the body of a woman, this prevents severe hair loss. However, if the patient has hormonal disruptions, then baldness can be significant. Due to alopecia, women often experience stress and depression, which in turn enhances hair loss.
Alopecia areata in men begins most often with the crown. In the upper part of the head, a lesion is formed. If no action is taken, the area of hair loss grows over time. In advanced cases, the patient completely loses hair.
Features of baldness in children
Alopecia areata in children is a fairly rare occurrence. Very often skin ailments join the disease: atopic dermatitis, allergic rashes, vitiligo. With alopecia, the child often loses not only the hair on his head, but also the eyebrows with eyelashes.
Most often, this disease affects children older than 3 years. A bad prognostic sign is the attachment of atopic dermatitis, nail damage and the onset of the disease at an early age. In these cases, the pathology is cured with great difficulty. However, malignant forms of the disease are rarely seen in children. In most cases, hair can be completely restored.
When the first signs of alopecia appear, you should consult a trichologist. Typically, an external examination of the patient is sufficient for diagnosis. In some cases, additional laboratory tests are necessary:
- Trichograms. Several hairs are pulled out from the patient near the affected area and their structure is examined under a microscope.
- Biopsies. From the affected area, particles of skin are taken for examination. This allows you to separate focal alopecia from damage to the scalp with lupus and lichen lesions.
- Research with a dermatoscope. We study the structure of hair follicles and the condition of the skin.
- A smear from the affected areas for a fungal infection. This study helps distinguish focal alopecia from ringworm.
Sometimes alopecia is a manifestation of vitamin deficiency, as well as endocrine and infectious diseases. In order to identify such pathologies, serological studies, a blood test for biochemistry and hormones are prescribed.
If there is a small area of baldness on the head (not more than 3 cm), then dynamic observation is necessary for 3 months. If during this time the site is not covered with cannon hair, then a course of treatment for alopecia areata is required.
Locally prescribed corticosteroid ointments and creams: "Celestoderm", "Dermoveyt", "Clobetasol", "Fluorocort". They are applied to areas of baldness. Also used are the corticosteroid drug Diprospan in the form of a solution. It is administered subcutaneously in the affected areas. This treatment helps with hair loss of not more than 50%.
In the treatment of alopecia areata in women, the drug "Cimetidine" gives good results. It has an antiandrogenic effect and normalizes the hormonal background in the patient’s body. It is released in the form of tablets, capsules and a solution for injections. Men should not take this medicine, since it can adversely affect the production of androgens.
In the treatment of alopecia areata in men, the drug Finasteride is used. It prevents the accumulation of the hormone dihydrotestosterone in the bulb area and prevents hair loss. This tool is not recommended for children and pregnant women. A medicine can cause genetic abnormalities in the fetus.
In the treatment of male and female patients, Ditranol ointment is used. It has a locally irritating effect. At the site of the drug, a slight reddening of the skin occurs. Immune cells are activated to fight inflammation and distracted from the hair follicles. The drug Antralin, tincture of red pepper, lemongrass, burdock oil also have irritating properties. Such funds can be used in the stationary stage of the disease when hair loss has stopped.
A good result is given by the drug "Minoxidil". This is a solution that is rubbed into the skin in areas of baldness. It stimulates hair growth.
In addition to local drugs, prescribe medications for oral administration:
- vitamin complexes "Perfect", "Pantovigar", "Nutricap".
- sedatives: Persen, Novopassit.
- blood circulation improving drugs: Nootropil, Actovegin.
In severe cases, immunosuppressants are used: Cyclosporin A, Timopentin, Groprinosin. They are able to affect the autoimmune nature of the disease. You can take such potent drugs only on prescription. These drugs have many side effects.
Physiotherapy complements the medical treatment of baldness. To improve the condition of the hair, the following procedures are prescribed:
- Electrophoresis with nicotinic acid. The medicine is injected into the skin using galvanic current. This helps improve blood microcirculation and metabolism in the dermis. The drug penetrates the bulbs and stimulates hair growth.
- Microcurrents. The affected areas are affected by electric waves. As a result of this treatment, nutrition of the hair follicles improves.
- Laser treatment. Rays penetrate the bulb and stimulate hair growth.
- Darsonvalization. Using a special apparatus, small impulse currents are supplied to the affected areas. As a result, blood supply to the follicles and hair growth improves.
To achieve the result, 10 to 15 physiotherapy procedures are needed.
In advanced cases of the disease, conservative treatment does not help. Have to resort to a hair transplant. However, not all experts consider this treatment method effective. Transplanted hair may not take root if the body has a pathology that provoked baldness.
Before a hair transplant, it is necessary to accurately identify and eliminate the cause of alopecia. Only in this case, a new hairline can take root.
The prognosis of the disease largely depends on the cause of alopecia. If you can identify and eliminate the factor that triggered baldness, you can completely get rid of hair loss. With the genetic form of alopecia, the prognosis becomes more serious. Achieving complete hair restoration is far from always possible.
You can find many positive reviews about the treatment of alopecia areata by darsonvalization. Patients stopped hair loss after 7-10 procedures. After some time, a new hairline appeared in the bald areas. This method helped many women with postpartum alopecia associated with hormonal imbalance.
There are also reports of the good efficacy of Minoxidil. It helps even with severe forms of alopecia areata. In the reviews, it is reported that after the course of treatment, patients began to gradually overgrow areas of baldness, both on the head and on the body. This tool was effective even with a loss of hair more than 60%.
In some cases, locally irritating agents have helped stop hair loss. If good reviews about the use of burdock oil and tincture of hot pepper. However, such remedies help while stabilizing the process of hair loss. With an active focus with a loose hair, locally irritating agents can aggravate baldness.
If a person has a tendency to hair loss, then it is necessary to take measures to strengthen them. To do this, regularly wash your hair with special shampoos with vitamin supplements, as well as use herbal rinses for rinsing and medical masks. You should not wear tight hairstyles and pull your hair tight. It is necessary to resort to staining as little as possible.
It is also important to eat right and avoid stress whenever possible. At the first sign of increased hair loss, you need to visit a trichologist. This will help prevent the development of alopecia.