Alopecia areata is a common cause of hair loss that can affect individuals at any age. In many instances it is first noticed at the hairdresser’s, causing many to resort to traditional or “Arabic medicine” remedies before seeking a doctor’s advice.
Alopecia areata usually presents as round or oval patches of hair loss on different areas of the scalp. While some develop only single areas of hair loss, others may get numerous ones or even complete baldness. In extreme cases, it may lead to hair loss of the eyebrows, eyelashes, and body hair. Alopecia of the beard/moustache is a common presentation in men. Although in most cases alopecia areata develops gradually over months from a small area that expands, some suffer a more sudden onset where they lose most of their hair acutely. This is especially common after a stressful event and may be quite alarming. Interestingly, white hairs are usually the most resistant to falling. Some patients with diffuse acute hair loss wake up to find sudden graying of their hair.
Alopecia areata is thought to be an autoimmune condition where the body’s own immune cells attack the hair follicle, leading to hair loss. It is non-contagious contrary to what many think but it has a genetic susceptibility, so more often than not, other family members have a similar history of the condition. It may be triggered by stress, but stress alone is not a cause of the disease.
The chronic, recurrent nature of this disease makes it distressing to many affected people. Spontaneous recovery, without any treatment may sometimes occur. First line treatments include steroid creams and injections under the skin of the affected area, which are usually sufficient to obtain re-growth. Minoxidil spray can be combined with this for better results. Some doctors choose to give steroid tablets by mouth. This is not recommended as it does lead to hair growth, but all new hair is lost once the steroids are stopped.
PRP (platelet rich plasma) is a new procedure in dermatology that involves removing an amount of blood from the patient, separating it and re-injecting the platelets and growth factors. This approach boosts the skin with essential nutrients and has been found effective in facial rejuvenation and treating acne scars. The role of PRP in promoting hair growth has been investigated. A recent study demonstrated PRP to be even more effective than steroid injections for alopecia areata. At The Skin Clinic, we combine PRP with the other more classical treatments for resistant cases when needed.