In the present world, all of us have experienced hair fall at one time or the other. It is normal to lose 50- 100 hair/day. The medical term for hair fall is Alopecia.But imagine, losing coin shaped patches of hair or all your hair suddenly overnight. This hair condition is called Alopecia areata. 

What is Alopecia areata?

It is an autoimmune condition where the body’s immune system goes rogue and attacks body’s own healthy hair follicles. This results in patchy hair loss from any part of the body, especially the scalp, eyebrows, beard,etc.This is a common condition seen by dermatologists everyday. 

Who can get alopecia areata?

Alopecia areata can affect anyone. However, the likelihood of developing it is higher if:

You’re a child.

There is a family history of alopecia areata.

You or close relatives have autoimmune conditions, such as diabetes, lupus, or thyroid disorders.

History of stress, smoking, nutrient disorders

It nearly affects around 2% of the population and can occur in any age group – children to adults. At times, this condition can progress from patches and may progress to involve the entire scalp. It is called as Alopecia Totalis.If a person loses hair from his scalp and body, it is termed as Alopecia Universalis. This is a severe condition and is very difficult to treat.Alopecia areata is a hair condition that can be extremely worrisome. But there is no need to to panic. With proper treatment, your doctor can regulate your immune system which can result in the regrowth of your lost hair.

How long does it take for the hair to grow back?

The duration of the treatment and the hair growth may vary in individuals as it depends on the severity of the condition. There are many effective treatment options available. They range from lotions, tinctures, injectables and oral medications. These various modalities of treatment depend on the age of the patient, nature of disease, severity, size and number of patches.One must always consult a dermatologist, even if it is for a single patch because a single patch may also progress to Alopecia totalis or Universalis.

What are the treatment options available?

The first line of treatment is usually immunosuppressives like corticosteroids. These agents suppress the immune response that is damaging the hair follicles. They can either be applied as a lotion over the patch or can be given in the form of injectables. Small doses of steroids are useful and one should not be scared to use steroids. One can expect results as early as 3 to 4 weeks.

In extensive cases or if there is no response to steroids, one can be started on topical immunotherapy like DPCP (Diphencyprone) , SADBE (squaric acid dibutyl esterase) where chemical irritants are applied over the patches to modify the immune response and stimulate hair growth.Topical minoxidil and contact irritants like anthralin are other good options. They show very good cosmetic response.

Oral medications in the form of corticosteroid can be used if the condition is severe that is if one has alopecia totalis or if there is rapid spreading of patches all over the body as in a case of Alopecia universalis. They show excellent results in some patients.Oral steroids can be used for a short period of time and one is usually prescribed in pulses. As there will be steroid free intervals in between the doses, it usually negates the side effects of steroids.

Other forms of oral medications like Tofacitinib, Azathioprine, cyclosporine, methotrexate (immunosuppressives) can be used to suppress the immune cells.

Sometimes growth factors derived from our own blood are delivered to the patches of alopecia Areata in the form of Platelet Rich Plasma Therapy. It helps in stimulating the hair to start to grow again.

Another method which gives consistent results is photo therapy. It has shown good results in 60-65% patients.In some difficult to treat cases, one can use combination treatments such as PUVA (Psoralens with Ultra violet A rays) with corticosteroids.

Another excellent option these days is LASERs. Infrared diode laser, 308nm Excimer lasers or fraction photothermolysis laser works well in Alopecia Areata. They usually work by inducing the death of rouge immune cells and also stimulate hair growth. You can expect good improvement within few weeks to few months.

Apart from all these, we do have immunomodulators like Alefacept can be used. But they are not as effective as the above mentioned treatment modalities.

Any supportive medications work?

Some supportive medications that are effective in this condition are oral anti oxidants, vitamin supplements mainly vitamin D and zinc.If none of these treatment options work, we still have other options like hair wigs, hair weaving, scalp micropigmentation, etc which also give excellent cosmetic results in AA.

So, if anyone of you has this particular condition, then one need not worry or get stressed. One just has to visit your nearby dermatologist and get the necessary treatment as Alopecia areata is usually reversible.

Research and development in dermatology along with safe effective medicines has made it easy to treat this condition and we can expect very good results and maybe even cure.

But remember, Consistency, Compliance and Commitment is also needed from the patient's end to get results.

Disclaimer: These treatment medications are mentioned to make one understand what all options are availble. Please don't self medicate as they are immunosuppressant medications and need to be taken only with the prescription of a dermatologist!