Alopecia areata: photos, causes and treatment in adults and children

Focal alopecia, if it is not associated with infectious or tumor processes in the body, is more a cosmetic defect than a serious pathology. Alopecia appears unexpectedly and affects both men and women with the same frequency. Less common alopecia are observed in children. The course of the disease is not predictable, but with a competent approach to treatment, the hair almost always grows back.

Alopecia areata - what is it?

For every hundred people in the world, there are two individuals who somehow encounter a focal form of hair loss. Regardless of the cause of the pathology, the essence of the problem is a violation of the supply of necessary hair follicles, as a result of which they decrease in size, weaken and freely leave the root hole. Alopecia areata can affect not only the head, but also all hairy areas of the body, and the pattern of hair loss will be similar to the classic version of baldness.

With all the variety of classification categories in assessing the nature of baldness, it is customary to adhere to the division of alopecia into benign and malignant. Any of them is divided, in turn, into types that indicate external signs of the disease and the causes that triggered hair loss.

For benign focal alopecia, the following types of local baldness are characteristic:

• boundary - covers the edge of hair growth;
• shearing - the hair roots remain fixed in the nests, but the hair shaft (about 10 mm from the surface of the scalp) becomes thinner and breaks off, forming a kind of clipped area;
• exposing - the area of ​​spread of baldness occupies at least two-thirds of the scalp.

The malignant form of focal alopecia includes the following types:

• subtotal - a gradual and invariably progressive form in which multiple foci of baldness merge into vast hairless zones;
• total - hair loss occurs in full and rapidly, covering not only the head, but also eyebrows, eyelashes;
• universal - characterized by hair loss throughout the body.

With a benign form of the disease, hair restoration is possible in full, in some cases even in the absence of any treatment. The malignant course of the disease is in 80% of cases irreversible. If the hair begins to grow, the process can take many years, and the quality and density of the hair coat will be significantly worse than before the disease.

Causes of baldness

To date, there is no consensus among experts about the truth, the initial cause of focal alopecia, and there is no answer to the question: "Why, in the same circumstances, do some people lose their hair and others do not?" Those internal and external factors that are associated with thinning hair, according to Trichologists, are not the primary source of the problem.

The following provoking circumstances entailing the development of focal alopecia on the head and body are:

• hereditary transmission of a damaged or altered gene;
• constant stress, lack of sufficient time to relax, nervous situation at work or at home;
• head injuries associated with rupture of soft tissues;
• history of infectious diseases;
• fungal lesions;
• autoimmune processes ;
• decrease in general immunity;
• dermatitis;
• the prevalence of testosterone over estrogen (in women);
• an excess of carotenoids (vitamin A) in the body or an acute shortage of calciferol (vitamin D).

A much more rare cause of focal alopecia in women is the frequent use of low-quality hair styling products (varnishes, mousses), as well as frequent washing of the hair with aggressive shampoos.

Symptoms of the disease

Alopecia areata is accompanied by signs, focusing on which, confusing the disease with other damage to the scalp and hair is almost impossible. The first symptom of the pathology is a small (1 to 3 cm) bald spot with a glossy surface and a regular rounded shape. At the borders of the bare area, the hair seems to be broken off and just a few millimeters rise above the skin. If you gently pull them with tweezers, the hairs will leave the nests almost painlessly.

With androgenic focal alopecia in women, a wave development of the disease is observed, alternating with periods of remission. After each pause devoid of dynamics, the pathology will take on more and more noticeable signs: the number of localized bare skin on the head will increase, eyebrows and eyelashes will thin out noticeably. Ten women out of a hundred will begin to deform nails: their fragility will increase, and strong relief will appear.

The male type of focal alopecia is much more complicated and faster (photo below). The most common pattern of hair loss in the stronger sex is the growth of one large lesion on the crown towards the forehead with the simultaneous expansion of the site of baldness to the temporal lobes. At the same time, focal alopecia in men can be found in the facial zone (at the site of beard growth). As a rule, the process cannot be reversed, and the only way to save the hair is a surgical hair transplant.

Competent treatment conditions

Each individual case of focal alopecia in women, men, or children is considered in terms of visual signs and laboratory test results. Be sure to take samples of hair growing near the bald spot, scraping directly from the bald area, a detailed blood test. After receiving the results, options are beginning to be considered how to treat focal alopecia in this manifestation.

Unfortunately, relapse in alopecia is a stable phenomenon, which is unrealistic to predict or prevent. You can only reduce the likelihood of a return of the disease, taking into account some conditions for competent treatment:

• the effect of therapeutic agents only on the foci of baldness will cause the bald spot to move from one place to another, so you need to treat the entire scalp;
• if relapse is observed, antiallergenic drugs must be included in the tactics of treatment of focal alopecia;
• necessarily from the first days, as spontaneous hair loss becomes noticeable, you need to start taking multivitamins;
• regular cosmetic shampoo should be replaced with a medical shampoo containing natural oils and zinc;
• at the time of treatment (and some time after it) will have to abandon hair styling products and sprays that facilitate combing;
• often in the treatment of focal alopecia, the causes of the pathology are found in a simple inability to eat properly: in the daily menu of a person who wants to preserve the volume of hair, there must be foods high in vitamin B7 and zinc;
• daily it is necessary to massage the entire surface of the head, using burdock or castor oil;
• aggressive exposure to ultraviolet radiation can aggravate the situation, therefore, until treatment is over, a visit to the solarium is unacceptable;
• treatment of focal alopecia in women after 45 years of age should be accompanied by examination by an endocrinologist;
• throughout the course of therapy, you need to monitor peace of mind and emotional stability.

If the hair began to fall out during pregnancy or immediately after the birth of the child, treatment with cardinal methods is not required. It is enough to change the usual shampoo to a softer one, more often comb the hair with a brush from the roots and from time to time massage your head using burdock oil. Over time, the hormonal background stabilizes, there will be less stress and the hair will recover.

Drug treatment

Depending on the nature of the disease and the etiology that provoked alopecia, the trichologist prescribes treatment that provides a comprehensive approach to the problem. This will necessarily be the use of local irritating ointments, a drug to stimulate hair follicles in the form of oral tablets and 1-2 names of drugs aimed at eliminating the cause of the pathology.

Hair loss due to weak immunity, vitamin starvation or unbalanced diets is corrected by taking multivitamins, immunomodulators. An approximate menu is drawn up, including products with zinc, group B vitamins and vitamin C. In some cases, hormones such as corticosteroids and the drug Cyclosporin, a powerful polypeptide that includes more than ten amino acids, are prescribed.

Androgenic alopecia involves the use of the drug "Minoxidil" - an external local remedy for long-term use, as well as hormonal contraceptives that regulate the synthesis of testosterone.

Stress leading to nesting baldness, not related to pregnancy and the postpartum period (if breastfeeding is performed), are stopped by antidepressants, psychotropic drugs (anxiolytics) or, much less commonly, antipsychotics. For accelerated hair restoration, glucocorticosteroids are prescribed.

Of the external agents applied directly to the lesion with the capture of nearby space, the most effective are:

• "Fluorocort";
• Ultralan
• Lokacorten
• Lokoid
• "Flucinar."

For men, treatment of focal alopecia is often associated with a difficult choice: either start the situation irreversibly and put up with hair loss, but at the same time maintain high libido and sexual capabilities, or for a while transfer your sexual energy to a sparing regime and save hair. This is due to the need (in most treatment options) to reduce the level of testosterone in the body.

Drugs prescribed for focal alopecia in men:

• Finasteride
• "Carbamazepine";
• “Ketoconazole”;
• "Digoxin".

After treatment, the normal sexual function of a man is immediately restored.

Home remedies

Alternative therapy in the treatment of alopecia has unprecedented experience, so the authority of homemade decoctions, tinctures and ointments is recognized even by official medicine. Medicines prepared according to some recipes can be used immediately as external and internal agents. Such universal drugs include:

• Infusion at the root of the burdock. The crushed dried roots of burdock (1 tablespoon) are poured into a glass of hot water and boiled for 20 minutes in a water bath. The resulting broth is insisted for 45 minutes, filtered and taken for 2 tbsp. tablespoons three times a day half an hour before meals. Diluting the broth with boiled water 1: 1, get a natural hair conditioner.
• Linden blossom. 3 tbsp. tablespoons of dry matter are brewed with a glass of boiling water and kept for 15 minutes on low heat, then cooled and filtered. A third of the resulting broth should be divided into 3 servings and drunk during the day, and rub the remaining liquid before bedtime into the scalp with intensive massage movements.
• Nettle greens. 3 tbsp. tablespoons of fresh nettle leaves, crushed to a mushy state, are poured with 0.5 liters of hot water, brought to a boil, and then simmer for another 10 minutes over low heat under a lid. They drink a cooled and filtered broth in a third of a glass in the morning and in the evening, and rinse their hair every other day, accompanied by a head wash with a massage.

According to numerous reviews, the treatment of focal alopecia is more effective if substances with a strong irritating effect are used for external application. These include onions, mustard, red pepper, garlic, horseradish. Some of these components, such as onions and garlic, simply rub on a grater and intensively massage massage into dry hair until you feel a slight burning sensation. Such aggressive masks should be “worn” for at least half an hour under a warming cap, then rinse with a small amount of neutral shampoo.

Twice a month with oily hair and once with dry hair, it is useful to dilute 1.5 full st. In 2 l of warm water. tablespoons of mustard powder, the resulting liquid is distributed from the roots along the entire length of the hair. After 15 minutes, you must rinse the mustard solution with plenty of water, using 1-2 egg yolks instead of shampoo.

If there are no wounds and rashes on the surface of the head, the tincture of burning pepper will become a life-saving remedy for baldness, effective from the first use. It is better to purchase an alcoholic pungent-smelling composition in a pharmacy ready-made. It is imperative to apply the liquid to dry scalp, trying to distribute the tincture quickly to prevent it from dripping through the hair. Almost immediately after rubbing in, the stove will start to bake. You will have to endure unpleasant sensations for at least 25 minutes, during which the head should bask under a plastic cap. Then the product is washed off with a mild shampoo and dried without a hair dryer.

Masks for baldness

Masks with Dimexidum pharmacy have a very strong effect, therefore, they are often included in the treatment by women who do not want to part with long hair, which complicates local therapy. This remedy has a huge range of advantages over most external drugs, but no less contraindications. So, "Dimexide" is not used during pregnancy and lactation, with some eye diseases and with any cardiovascular pathologies. It does not apply to focal alopecia in children up to 14-16 years.

The best masks with "Dimexidum" for hair growth with alopecia:

• Mix in one glass container 1 ampoule of vitamins A and E, 1 teaspoon of sea buckthorn oil, 2-3 drops of lemongrass essential oil. The mixture must be heated in a water bath to 35 ⁰ C, immediately after that pour 1 teaspoon of Dimexidum. A warm mask is applied to the entire surface of the head and held for 40 minutes, then washed off.
• 3 teaspoons of onion gruel together with juice are combined with vitamins B6 and 12 taken in 1 ampoule, 1 teaspoon of Dimexidum, castor and burdock oil is added. The composition is mixed and distributed over the scalp, and after 40 minutes washed off.
• One and a half tablespoons of good brandy are combined with 1 teaspoon of tocopherol and liquid vitamin B6. Dimexide is poured into the mixture and the mixture is applied, as usual, for 35-45 minutes.

A distinctive feature of the masks with this drug is that after applying them, the head must not be insulated and generally impeded by free ventilation. The frequency of use of the product is also limited: on average 1 time in 7-10 days, and the full course of treatment will be 6-8 masks.

Alopecia in children under 6 years

Alopecia areata in children, if it is not associated with mechanical damage to the scalp and hairline, this is a rather rare case considered by several specialists at once. It happens that multilevel diagnostics do not reveal health disorders, so the question of the etiology of the disease remains open. In this case, the specialists are engaged in a wait-and-see attitude, characterized by placing the child on a special examination and laboratory control.

Specific hair loss on the back of the head in infants does not belong to pathological signs, since this is a natural reaction of the baby's weak hairline to contact with the pillow. If the pediatrician at a regular examination of the child does not find signs of rickets, then no treatment is required.

Kindergarten kids, most of the time in a peer group, can become infected with microsporosis (ringworm), which requires immediate removal. Otherwise, atrophy of the follicles will begin at the site of the lesion, and it will be much more difficult to restore hair growth.

If the tests for the presence of filamentous fungus - the causative agent of the disease - are confirmed, the child can be put in the inpatient unit or prescribed home therapy. After establishing the cause, treatment of focal alopecia in children may involve the use of the following drugs:

1. Oksolinova 3% ointment is applied to the site of the lesion with a capture of the edge of hair growth 2-3 times a day (course from 10 to 21 days);
2. Ointment "Sulfur-tar" is applied in the form of an application to a painful focus every night before bedtime, until the child is completely cured;
3. Lamisil ointment is used from the age of 2 in the morning and evening for 7-10 days.

In some particularly difficult cases, when several foci are found on the baby’s head at once and the disease continues to progress, the doctor has the right to prescribe oral preparations - a suspension or tablets. Among the drugs corresponding to childhood and the required effectiveness, “Terbinafine” and “Griseofulvin” are distinguished.

Alopecia in school children

The most common cause of focal alopecia in primary school children is called by the doctors a neurological reaction of the child to the need to attend school, change the daily schedule and the associated stresses. Therefore, it is very important from the first days of serious changes in the child’s life to provide him with all kinds of moral support, considering the main priority not school success, but a comfortable psychological state of the student.

The second reason for the development of pathology is called the deterioration of the child’s diet with the start of school attendance and a decrease in the quality of food consumed during the day. These are mostly malnutrition snacks, and if a child attends extracurricular activities, often the intervals between meals are six hours or more. All these factors cause serious digestive problems, sometimes manifested by partial hair loss. The situation is being corrected by observing a special diet, including foods rich in zinc, calcium, selenium, as well as vitamins A, F, E and almost all B vitamins (except for B4 and B11, which are successfully synthesized in the body).

Lastly, if a superficial diagnosis does not produce a result, the child is prescribed a test showing hormone levels. You should be aware that therapy using elements that suppress the synthesis of testosterone in the blood of a child is an extreme measure that is used only when there is a risk of irreversible and total hair loss.

What can and cannot be done with alopecia areata in children

The diagnosis of “focal alopecia”, put to the child, means only the localization of one or more areas of bare skin where hair should grow. There can be many reasons for this pathology, most of them are temporary and self-destructive, but many parents, having heard a terrifying term from doctors, begin to go to extremes, expressed in excessive attention to the problem.

Here are clear examples of how you can’t act if a child has foci of alopecia on his head:

• Cut hair “under zero”. A child up to three years of age, the result of such a procedure, may be left unattended, but a child at an older kindergarten or school age is likely to receive the deepest emotional stress associated with the rejection of his changed image.
• Apply oily substances and home remedies based on birch or other tar for massages. Rubbing saturated oils or viscous substances into the baby's scalp can lead to even more serious problems, for example, dermatitis, which appears due to follicles clogged with vegetable fat.
• Give your child medications that indicate childhood restrictions or have too many possible side effects. Exceed the dosages prescribed by the doctor or indicated in the annotations.
• Try to mask low-aesthetic bald patches with lush synthetic bows, bulky hairpins or other decorative elements that can cause irritation or injure the scalp.
• Wash the preschooler's head with adult shampoos or use these products more than twice a week. This also includes the use of specialized (purchased) therapeutic detergent formulations for dandruff, dryness or increased oily scalp.
• Give a child who has a deficiency of certain vitamins and microelements several immediately active drugs designed to make up for the shortage. An excess of certain substances (for example, vitamin A) can lead to a backlash and increase hair loss.
• To do complex, tight hairstyles on the girl’s head or to constantly collect hair in a “tail” using cutting, thin elastic bands.

And what not only can be done, but also actively recommended by doctors? Judging by the reviews, focal alopecia in children stops in development, and the hair begins to grow back better, with regular and frequent combing with a brush with wooden rounded tips. This method is not suitable for fungal or infectious skin lesions, but in all other cases, hair stimulation with massage smooth movements, first from the roots to the tips, and then vice versa, gives a good result.

If a child’s hair is weakened from birth, this is a physiological feature of the body. It’s better to completely refuse to wash your hair with chemicals from the chemical industry, and remember “grandmother's” recipes, replacing “chemistry” with egg yolk, rye bread soaked in water, sourdough, a weak solution of mustard powder. Such recommendations can be addressed to any child who has had a scalp disease and is in the rehabilitation period.