Alopecia: What You Need to Know

Beauty/Skincare, Featured Article, Healthy Living
on March 11, 2013
Alopecia is an auto immune disease.

Bethany Foster, 41, first noticed the signs of hair loss years ago, but it wasn’t until recently that she was diagnosed with alopecia areata. About 10 years ago, Bethany, who lives in Bristol, R.I., started developing the occasional random bald spot. A small patch would open up at the front of her hairline, then fill in again. Two or three years ago, the process started accelerating. She began to lose the hair from her eyebrows, too. She wondered if it was related to stress or perhaps a thyroid condition. But 18 months ago, a dermatologist confirmed that she had alopecia, an autoimmune disorder that causes hair loss.

“I was always the girl with the hair,” she says. “I’m not there yet with ‘this is who I am now.’”

According to the National Institutes of Health, there are three types of alopecia: Alopecia areata, or patches of hair loss; alopecia totalis, the complete loss of hair on the scalp; and alopecia universalis, the total loss of all body hair.

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The National Alopecia Areata Foundation (NAAF) reports that approximately 5 million people in the United States are affected by alopecia. It crosses all racial and ethnic lines and affects both children and adults, although it seems to affect younger people most often.

“If you get your first patch before you’re 10 years old, you’re more likely to get it again in your adult life,” says NAAF president and CEO Vicki Kalabokes.

No one is sure of the precise cause, but the relevant gene has been identified, says Kalabokes. And according to a 2010 New England Journal of Medicine study, alopecia also seems to be linked with an increased overall risk of other autoimmune disorders.

Alopecia can start with small round patches and progress to more extensive hair loss, but it doesn’t always progress this way. Many people who have alopecia areata even experience the regrowth of the lost hair, only to lose it and regrow it again later. Alopecia areata is often diagnosed by a skin biopsy, although the American Academy of Dermatology notes that some dermatologists may be able to diagnose the disease by looking at the site of the hair loss.

There’s no real “cure” for alopecia areata. But new treatments are evolving every day. Dermatologists often prescribe corticosteroids—either as injections or applied as a topical lotion—to suppress the immune system in the hopes that the hair will start to grow. Some patients choose to apply a hair regrowth medicine like Minoxidil to their bald areas, although they may use this treatment in partnership with an additional one. Another option, according to the AAD, is diphencyprone (DPCP), which is applied to the bald skin. It can take several months to see any effect.

The good news? The NAAF notes that hair regrowth happens for many people regardless of whether they undergo any type of treatment—and it can even happen after many years.

But in the meantime, it can be psychologically challenging for people to lose their hair, particularly women, which is why experts often refer people to support groups or to counselors.

“It is your outside image,” says Kalabokes. “The image you see in the mirror is a totally different person, and I think that’s what’s very hard for people.”

While Bethany hasn’t had much luck with treatments, and her dermatologist says she’s unlikely to experience regrowth, she’s determined to find a solution, even if it’s only cosmetic. She’s taken to parting her hair in a deep side part, and she’s even considered trying to wear a hat.

“I’m still finding ways to camouflage it,” she says.