What are the Types of Alopecia Areata?
Depending upon the extend of involvement, alopecia areata is divided into:
1. Localized alopecia areata
2. Alopecia totalis: involve the whole scalp, eyebrows, beard
3. Alopecia universalis: Total loss of body hair
At times, alopecia areata can be quite stubborn in its response to treatment. Many patients continue to get recurrences despite the therapeutic interventions. This definitely calls for further investigations to rule out or confirm causes like unmanaged stress, direct pressure or untreated caries teeth.
Tips on dealing with Alopecia Areata
1. In many cases hair growth occurs spontaneously in a few months without any medical treatment. A wait and watch approach is indeed a non expensive, safer alternative for a limited number of patients.
But if the patches are getting wider and the hair pulling test is positive, it is wiser to consult your dermatologist.
Hair pulling test: Try pulling out the hairs at the periphery of the patches. If they come out very easily without any resistance, the test is positive. Also these hairs will look like “exclamation marks” with loss of pigment and thinning just above the hair roots
2. The first hair re growth after treatment or spontaneous regrowth will show fine, non pigmented or grey hairs. There is no need to worry as normal, pigmented hair will come out sooner or later.
3. Do not apply contact irritants from “helpful” friendly advices or home remedy tips! This may cause further worsening of the lesions and sometimes even cause permanent scarring if the irritant reaction is severe. It is to be noted that mild counter irritant effect does actually produce hair growth in some patients of alopecia areata. Possibly new inflammatory cells attracted to the area may be flushing out the auto antibodies and releasing the hair roots from their inhibitory effects.
4. Intradermal injection with corticosteroids is a very effective treatment for alopecia areata. This procedure should only be done by an experienced dermatologist as proper dilution, quantity and depth are necessary to produce optimum results. I have come across quite a number of patients scarred for life with skin atrophy and leucoderma following undiluted steroid injections given by pharmacists and non dermatologists. This is very unfortunate and should be avoided by all means.
5. Like wise, application of topical steroids should be done only under medical supervision. Super potent steroids applied on face can cause permanent damage to the facial skin.
6. If you are getting new patches of hair loss despite treatment, look for hidden infections in the teeth. Get a dental consultation.
7. Review whether you are causing undue pressure on the area with tight fitting helmets or scarves, improper shaving techniques etc. Also correct your posture while sleeping or watching TV.
8. Use hands free sets or blue tooth for your cell phones. This will reduce the damaging effects of the radio waves emitted by the sets.
9. Take a stress test. If your stress level is high, learn how to manage the stress. A sense of perceived loss of affection from the near and dear may be the underlying problem in the causation of patchy loss of hair. I have seen young children of 2-5 years age getting alopecia areata within a few months after their younger siblings are born. It is clearly the imagined or real loss of attention and affection from the parents that is the culprit in such cases. Parents have to take extra care to convey the message that the newcomer in no way interferes with their affection for the elder one.
10. Once the hair loss has stopped and new patches stop appearing, you can boost the hair growth with medications like minoxidil and vitamin supplements. This will hasten the growth and also provide additional nourishment for the newly sprouting hair roots.