Typically, a diagnosis of alopecia areata can be made based on the pattern of hair loss and the patient's medical history. In some cases, a biopsy is needed to confirm the diagnosis. “When we do a biopsy, we're looking for immune cells around the base of the hair follicle in order to make the diagnosis,” says Dr. King.
Patchy hair loss (alopecia areata)
In the type of patchy hair loss known as alopecia areata, hair loss occurs suddenly and usually starts with one or more circular bald patches that may overlap.
Your dermatologist will examine the area(s) with hair loss carefully and look at your nails. Your dermatologist will also ask some questions. This may be enough to diagnose you. Because there are so many reasons for hair loss, testing is sometimes necessary to make sure alopecia areata is the cause of your hair loss.
Alopecia areata is a disease that causes the hair to fall out in small patches. When the immune system attacks the hair follicles, the results are hair loss. Some blood tests used to test for alopecia is the ANA test, Anemia #1 Baseline Blood Test Panel, and the CRP.
The only sign of alopecia areata is often sudden hair loss. The patches of hair loss can grow larger. Sometimes, the patches grow larger and become one large bald spot.
Alopecia areata (AA) occurs when the immune system attacks the hair follicle. Studies have shown a relationship between AA and low vitamin D levels. Vitamin D should be supplemented if levels are low.
Causes of Alopecia Areata
In alopecia areata, the immune system mistakenly attacks hair follicles, causing inflammation. Researchers do not fully understand what causes the immune attack on hair follicles, but they believe that both genetic and environmental (non-genetic) factors play a role.
Blood Tests and Androgenetic Alopecia (AGA)
Blood tests should typically be ordered in patients with suspected androgenetic alopecia. Testing for blood hemoglobin levels, iron, thyroid, B12, vitamin D should at least be considered in all patients.
The extent of alopecia (how much hair has fallen out) varies and links to the different subtypes. Some said their hair loss involved one small patch about the size of a 1p coin which regrew after a few weeks or months. Others developed more patches which sometimes joined up into bigger bald areas over time.
Everyone is born with hundreds of thousands of hair on the head. The hair cycle consists of three phases: the growth phase, which is called anagen, the resting phase, which is called catagen, and the shedding phase, which is the telogen phase.
The condition can develop at any age, although most people develop alopecia areata for the first time before the age of 30.
Alopecia occurs for many different reasons and presents in various ways. It can occur suddenly or develop gradually over time. Sudden-onset causes include illness, diet, medications, and childbirth. Alopecia that has a gradual onset more likely has a genetic component.
Alopecia areata frequently presents as the sudden onset of smooth, round, hairless patches on the scalp. The affected areas are usually skin-colored but may have a peach color. Occasionally, there are scattered short colored or white hairs within the hairless patch.
During a pull test, a dermatologist grasps small sections of hair, about 40 strands, from different parts of the scalp and gently tugs. If six or more strands fall out, you have what's known as active hair loss.
Alopecia areata is more common among African Americans but less common among Asians, compared with whites, according to a new study involving registry data for more than 11,000 individuals.
On the AIP elimination diet, you will avoid grains, legumes, nightshades (such as potatoes and peppers), dairy, eggs, coffee, alcohol, sugar, oil and food additives. After a few months, you can work the excluded foods back in one at a time to figure out which foods trigger an inflammatory reaction.
Calcipotriol, a vitamin D analog, has been reported to be topically used in treating alopecia areata with promising results. Combination therapy of vitamin D analogs with corticosteroids might also be used in treating alopecia areata.
Alopecia areata is sometimes triggered by viral infections such as influenza that causes excess production of interferons (IFN). IFN- γ is one of the key factors that lead to the collapse of immune privilege.
“Both vitamin D deficiency, as well as vitamin D excess, may cause hair loss,” Chacon explains. A 2020 study in the International Journal of Dermatology found that vitamin D deficiency may also play a role in the development and severity of androgenetic alopecia, also known as male pattern baldness.
A variety of factors are thought to cause alopecia areata (al-o-PEE-she-uh ar-e-A-tuh), possibly including severe stress. With alopecia areata, the body's immune system attacks the hair follicles — causing hair loss.
A few people who develop alopecia areata will progress to total scalp baldness (alopecia totalis). Even fewer people will lose all scalp and body hair (alopecia universalis).
There is no cure for alopecia areata. If you have a few, small patches of hair loss on your head, it's likely your hair will grow back within a few months. Your doctor may not prescribe treatment in those cases. For larger areas of hair loss, your doctor may prescribe steroid injections under your scalp.
Hair usually falls out in patches on the scalp. These patches are often several centimeters or less. Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places.
Ways to Stop Alopecia Areata from Spreading or Worsening
Avoiding unnecessary hair or scalp trauma, reducing stress and analyzing your diet are all worthwhile endeavors when attempting to prevent alopecia areata from spreading.