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What is Alopecia?
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 Tarun, a 23-year-old computer graphics expert, was horrified to find a whole bunch of hair fall out one day. He noticed a smooth bald patch. There had been no history of baldness in his family. He was at a loss and completely worried. On contacting a trichologist he was diagnosed with Alopecia.
What is Alopecia?
Alopecia Areata is a highly unpredictable, autoimmune scalp disease resulting in loss of hair on the scalp and elsewhere on the body. It occurs in males and females of all ages and races and often begins in childhood. Although not life-threatening, it is certainly life altering and naturally has a profound psychological effect, thanks to the pressures of an image-oriented society.
The factors that activate the onset of alopecia areata and the mechanisms of its development are not fully understood. It has been suspected that the cells of one's own immune system prevent hair follicles from producing hair fibers. The affected hair follicles are mistakenly attacked by a person's own immune system (white blood cells) resulting in the arrest of the hair at the growing stage. It isn't known what triggers this off but research suggests that genetic markers increase both the susceptibility to develop the disease and as well as the degree of severity.
What are its causes?
Alopecia Areata has been closely linked with increased levels of stress. Stress causes the sympatric nerves to increase their production of chemicals called neuropeptics in the skin. These neuropeptics increase the autoimmune reaction of the skin causing baldness in patches. For e.g., if you have recently been out of a job, or studying for exams or going through marital problems, this might be a probable cause of alopecia in your case.
Typically, you would first notice the rather sudden development of a smooth bald patch, sometimes even within 24 hours. Some people feel a tingling sensation or pain in the affected area. This patch can progress to total scalp hair loss (alopecia totalis) or complete body hair loss (alopecia universalis) since this disorder is not confined to the hair on our heads. In some people, the nails develop stippling that looks as if a pin has made rows of tiny dents and in a few people the nails are severely distorted
The hair fibre that falls out has been noticed to be unusually shaped, especially at the end closest to the scalp. The cuticle could be missing and there could be longitudinal cracks along the length of the hair. The irregular construction of the hair gives it weak spots where it can readily break off. This gives rise to the stumpy hair fibers (sometimes called exclamation mark hairs).
Alopecia Vs Male pattern baldness
Alopecia Areata can be distinguished from androgenetic alopecia or what is commonly known as male pattern baldness. Generally, the pattern of loss usually starts with a receding hairline, which then advances to thin the top of the head, in a U-shaped formation. The hair follicles shrink with each new growth cycle. The hair shaft narrows, and your hair get finer. This is caused by an increased production of the hormone androgen in post-pubescent boys combining with genetic predisposition.
Unfortunately, there is no conclusive diagnostic test for alopecia areata and it is often diagnosed by a process of elimination of other hair loss causes and close examination of the lesion itself. Hair pull tests are sometimes conducted at the margin of the lesions. If the hair is easily pulled out, it indicated that the lesion is active and that further hair loss should be anticipated.
The most crucial question that you would ask if you were think you are suffering from alopecia areata is whether your hair will ever grow back. The answer is that yes, in most cases it does, though this could be after years of extensive hair loss. There are a number of treatments to prevent this - you would be best advised to rush to the nearest trichologist.
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Dr. Sonal and Apoorva Shah
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