Alopecia disease

Alopecia disease (Alopecia areata or spot baldness) is a non contagious autoimmune dermatological disease in which abnormal hair thinning and progressive random hair loss often results in balding. This occurs when your own autoimmune cells damage the hair follicle (hair bulb), and hair stem cells that alters the formation of normal keratin, which is attributed to the pathological presence of class I and II Major Histocompatibility Complex antigens (MHC antigens) and Langerhans cells in hair bulbs.

This spontaneous disease occurs in stressed people, usually occurring soon after the death of a loved one (resulting from the death of someone close, losing a father, husband, wife, etc.) or after a divorce. These situations are often associated with grief, which is a self limiting process that can lead to serious personality disorders and mental illnesses.

Most patients with alopecia disease remain worried because of losing hair, and no matter what your age, gender or ethnicity, symptoms can range from mild hair loss in the form of a ring to total baldness. However, regardless of the patient’s condition, the preferred treatment for alopecia is long-term relational psychotherapy, patients are encouraged to accept the disease and have hope, self-acceptance and appropriate treatment has been proven to be effective if the affected area is small, which appear to influence prognosis (disease outcome) in alopecia.

What causes alopecia

Alopecia can occur at any age spontaneously, although there is no question that psychological and environmental factors are thought to play a role in the development of the disease, of these factors:

The immune factors behind alopecia: Alopecia is an autoimmune disease characterized by a dysfunctional immune response, in which the immune system attacks the hair follicles and hair stem cells causing follicles to shrink and hair to thin which slows the growth of hair and leads to hair loss. Although vitamin and mineral imbalances can also cause hair loss. Most people suffering of alopecia experience sadness and depression. Typical signs and symptoms after bereavement include grief, depression, skin and hair issues (hair loss) and digestive issues (painless diarrhea). Scientists have found that grieving the death of a loved one can lead to parts of the immune system being suppressed, which in turn may leave you vulnerable to infections from bacteria.

How grief suppresses immunity

Many of today’s diseases are triggered by psychological stress, which suppresses the immune system, and can impact the whole organism (blood pressure, blood sugar levels, cholesterol levels, hormonal balance, brain chemistry, etc.).  Adrenaline released during a stress response increases the heart rate and raises the blood pressure, as well as it may affect the health of digestive system and cause ulcers.

Older people are more greatly affected by the stress of bereavement, due to a balance of cortisol and DHEA-S (dehydroepiandrosterone sulphate), which respond differently to sorrow with age. In short, while cortisol (a hormone released during stressful situations) is known to suppress the immune system by preventing the production of inflammatory mediators. DHEA-sulfate is a weak male hormone produced by the adrenal cortex in response to stress; however, serum DHEA-S peaks around the age of 30 and then drop with age. DHEA levels may be low in older people between the ages of 70-90, their DHEA levels are only 10 to 20% those in the youngest age group (25-34).

The ability to produce DHEA-S is likely to have greater impact in elderly bereaved in terms of boosting the immune system, so maintaining a relatively balanced ratio helps to keep your immune system functioning properly.

Hereditary factors, it has long been suspected that androgenetic factors are important in causing hair loss. However, male pattern baldness is often caused by a combination of hereditary and hormonal imbalance (androgenetic alopecia), whereas the cause of female pattern hair loss is unclear. At age 50, approximately 70% of men and 10% of women are affected by hereditary pattern baldness, the process starts with thinning of the hair and often progresses to complete baldness.

Infections that cause hair loss: Tinea corporis is a common fungal skin infection caused by dermatophytes that live exclusively on dead body tissue (hair, the outermost layer of the epidermis, and nails). Moreover, male pattern baldness (MPHL) is more likely to develop in people who suffer of two or more autoimmune diseases (alopecia totalis).

Diagnosis of Alopecia disease

History disease, a family history of similar hair loss might suggest the diagnosis of alopecia.

Visual inspection, visual inspection of the scalp and hair can also reveal pattern of hair loss. In addition to a visual inspection, the hair pull test is a common procedure usually performed in diagnosing hair loss conditions.

Thyroid function tests are recommended if the affected is a young adult, as hypothyroidism (an underactive thyroid) can weaken your immune system.

Diagnostic management of alopecia disease

Although there’s no cure for alopecia disease, proper diagnosis and prompt treatment can help the hair regrow more quickly and can prevent further hair loss. To ensure the diagnostic quality and adequacy of information obtained, doctors should evaluate the following negative factors:

If the patient is suffering of atopic dermatitis.

Visual inspection of the hands and legs to seek Ophiasis (hair loss that can affect any hair bearing area).

If the patient is young, as children rarely cure from alopecia.

Total loss of hair.

Treatment of alopecia disease

The preferred treatment for alopecia is long-term relational combination of psychotherapy and drugs, patients are encouraged to accept their conditions and have hope, acceptance and commitment therapy has been proven to be effective in the treatment of localized alopecia areata, which appear to positively influence prognosis in patients with alopecia areata (spot baldness).

Local cortisone injections to treat alopecia areata: an average of 4 to 6 monthly injections of cortisone into bald patches can be used to treat alopecia mainly by suppressing inflammation, coticosteroids are safe treatments for inflammation of hair follicles that usually resume normal hair production whenever the negative autoimmune side-effects are removed.

Oral corticosteroid medications to treat alopecia totalis: long term systemic corticosteroid therapy can be used to treat alopecia totalis, taking 10mg oral prednisone or 10mg oral dexamethasone daily for a period of 3-6 months proven effective for controlling male pattern baldness. The alive follicles usually resume normal hair growth within a period of 6 weeks after removing the negative autoimmune side-effects.

Contact sensitization with topical Dinitrochlorobenzene cream (DNCB) has been used to treat alopecia: DNCB is an organic compound based on diethylaminoethanol derivatives used as a sensitization therapy for alopecia areata. Repeated weekly applications of dinitrochlorobenzene cause contact sensitization and promote hair regrowth.

Minoxidil for alopecia areata: In mild cases of alopecia areata the first choice of treatment would be a long-term application (3-6 months) of 5% and 2% topical minoxidil. Minoxidil is a drug initially created to fight with blood pressure, but after a clinical trial, serious side effects (minoxidil-induced pseudoacromegaly and hair overgrowth) resulted from the long-term use of minoxidil at systemically active doses, so they replaced the oral type of minoxidil with a subcutaneous topical form. Using a topical Minoxidil solution (cream or spray) with a 2% formula for women and 5% formula for men for a period of 2-6 months has been found effective for localized forms of alopecia areata.

UVA

Using other cortisone related creams

Natural remedies for alopecia

The application of garlic extract (Garlic Barrier) onto the affected area: cut a piece of raw garlic, then squeeze it to release some extract, following rub the affected area with this piece of garlic for two minutes, repeat the process twice daily, and keep on this therapy for a period of 1-2 months. This treatment has been found effective for localized forms of alopecia areata, and in most cases cure was achieved after 2-4 weeks of using this remedy.

The application of acetic acid (vinegar acid) onto the affected area: rub the affected area with a dry towel, keep scratching the skin until it bleeds, then apply an amount of acetic acid (or minoxidil solution) onto that area, repeat the process twice per day, and keep on the treatment for 1-2 weeks.

Aromatherapy Massage for Alopecia: an aromatherapy treatment involving a blend of essential oils such as lavender and caffeine oils can be effectively used to treat alopecia through therapeutic massage.

Live your life, baldness is permanent, and in most cases its impossible to regrow your hair naturally after losing it completely; however, reducing the amount of physiological stress can prevent further hair loss.

Wrong believes about alopecia disease

Wearing hats or covering hair with scarves can cause excess hair loss.

Shaving cause hair to grow faster

An oily scalp causes hair loss

Combing your hair regularly causes hair loss; however, combing your hair backwards can cause damage to the scalp. Moreover, excessive combing often causes the hair to break.

Alopecia is contagious, which is true only for the rare infectious forms of alopecia.

Verified by: Dr.Diab (January 7, 2017)

Citation: Dr.Diab. (January 7, 2017). Alopecia disease. Medcoi Journal of Medicine, 22(2). urn:medcoi:article1983.