Understanding Patchy Hair Loss

Dr. Mubashar Mashqoor Mir

Alopecia Areata (AA) is an autoimmune disorder that causes hair loss, typically in patches. This condition affects approximately 2% of the population worldwide including in our UT of Jammu and Kashmir, with both males and females being equally affected.
The exact cause of Alopecia Areata is not fully understood, but it is believed to be caused by a combination of genetic and environmental influences. It is an autoimmune disorder, which means that the immune system itself attacks the hair follicles, leading to hair loss.
Some studies suggest that genetics plays a role in the development of Alopecia Areata. It is more common in individuals who have a family history of the condition or atopic diathesis. Additionally, certain environmental factors, such as stress, may trigger the condition. Some studies have revealed an increased occurrence of alopecia areata in patients having other autoimmune diseases especially autoimmune thyroid disorders.
Symptoms of Alopecia Areata
The most common symptom of Alopecia Areata is sudden asymptomatic hair loss which is often seen in patches. These patches are usually round or oval in shape and may be smooth or have few small lightly pigmented hairs left within the patch. Hair loss can occur on the scalp, face, and other parts of the body, including arms, legs, and pubic area. Most commonly it is seen on the scalp or beard area.
Alopecia Areata can also cause the nails to become ridged, pitted, or brittle. In severe cases, rarely the nails may fall off completely.
Treatment for Alopecia Areata
Various treatment options are available to help manage the condition of alopecia areata. The treatment options vary depending on the severity and extent of the hair loss.
Corticosteroids are a common treatment option for Alopecia Areata. These medications are available in various forms, including topical preparations, intralesional injections, and oral tablets. Corticosteroids work by reducing inflammation and suppressing the auto immune response, which can help to prevent further hair loss. Other emerging treatment options include Topical calcineurin inhibitors, Vitamin D analogues, topical JAK inhibitors etc.
Another treatment option for Alopecia Areata is immunotherapy. This treatment involves using a chemical to create an allergic reaction on the scalp, which can help to stimulate hair growth. This treatment can be instated in some cases and may require multiple sessions. Many other oral and physical treatment options have been used to treat the condition including Narrow band UVB therapy, turban PUVA, Oral JAK inhibitors, methotrexate etc. however treatment of alopecia areata should always be undertaken by a qualified dermatologist and trichologist. It should be noted that the disease can follow a varied course and may recur or expand especially in high risk cases.
Hair transplant surgery is another option for individuals with Alopecia Areata who have burnt out diseases and present late with extensive but stable hair loss from the scalp or beard. During this procedure, hair follicles are taken from a donor area and transplanted to the balding areas.
Coping with Alopecia Areata
Living with Alopecia Areata can be challenging, both emotionally and socially. Hair loss can have a significant impact on an individual’s self-esteem and confidence. It is important to remember that there are support groups and resources available to help cope with the condition.
Wigs and hairpieces are a popular option for individuals with Alopecia Areata. These can provide a temporary solution while waiting for hair to regrow or as a long-term option.
(The author is a Skin and Hair Restoration Specialist and Chief Consultant at Cosmoweave Jammu)