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Hirsutism, excess facial hair can sometimes occur simultaneously with some forms of AA
Disorders that may be associated with alopecia areata
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Alopecia Areata, Alopecia Totalis, Alopecia Unversalis
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What is Alopecia Areata (AA)?
Also, see "Hirsutism," excess facial hair. Hirsutism and AA are not related, however, sometimes occurs simultaneously in carbohydrate metabolic disorders.
What is Alopecia Areata (AA)?
AA is a chronic type of hair loss that can evidence in any area where hair is present, especially on the scalp. It is a benign condition (causes no harm to the body) but it can be psychologically distressing to persons suffering hair loss from AA.
Suspected Causes of Alopecia Areata
Currently, the causes of AA are not understood but the most commonly accepted explanation is that it s a T-cell autoimmune disorder that seems likely to have some genetic predisposition involved. It has also been discovered that many persons with AA also have an increase in antibodies to hair follicles. This means the body sees hair follicles as foreign invaders and follicles are attacked by white blood cells because they must be eliminated from the body. This disrupts the normal hair formation and cycle and follicles become very small; not re-growing hair for months or even years (however, the follicles do not die). Studies show about 90% of persons with AA have these antibodies as compared to only approximately 37% in the general population.
The antibody response affects the anagen phase hair follicles but it is not known if this a cause or side effect of AA but clinical evidence does show that AA is associated with other autoimmune disorders especially those of the thyroid and vitiligo. That fact that AA affects one in five (according to the NAAF) seems to indicate some genetic issues at play. In fact, AA is most common in families that have other autoimmune disorders including allergies, thyroid disease, lupus, early-onset diabetes and rheumatoid arthritis.
Biopsies of skin in the area affected by AA show the presence of lymphocytes (one of the body's immune system cells) inside the hair follicles. Since lymphocytes normally are not normally present in hair follicles, this is again, another indication of AA being some sort of autoimmune related disorder.
Persons with AA may have a family history of other persons being affected. The rate is estimated to be approximately 10-20% familial affectation, compared to 1.7% in control subjects. The degree of AA symptoms do not show any pattern in relation to how other family members are affected, but the more severe the problem of AA is, the more common it seems to be in families.
Several genetic studies have been focused on the leukocyte antigen, and specifically leukocyte antigen DQ3 (DQB1*03) has been found in over 80% of those with AA. Other genes are also being studied and the high association of AA in persons with Down syndrome may be an indication that part of the genetic clues like on chromosome 21.
It appears that AA is probably the result of polygenetic (more than one gene) defects and the role of environmental factors in causing or triggering AA has not been determined.
Some persons with AA complain of itching or pain on the affected areas. This may indicate there is an underlying problem or aggravation to perifollicular nerves. One study has also shown evidence of a lower basal blood flow and greater vasodilatation but more studies are needed to understand the significance of these findings.
Symptoms of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis
AA results in loss of scalp hair in smooth, circular patches typically about the size of a coin, which cause bald spots. With alopecia totalis, the entire scalp hair is lost, and alopecia universalis refers to the entire loss of body hair. There is also a form of AA in which there is a general overall thinning of hair. Although hair loss is usually temporary, it can reoccur.
There are varying degrees of affectation in different persons with AA an there is no way to predict how large, or substantial the balding will be, or, how long it will last before normal re-growth can be expected, and, if and when additional episodes of AA will occur.
Alopecia Areata related statistics:
Treatment Options for Alopecia
In approximately 50% of persons with AA hair will regrow without any treatment within a one year period. It is important to note that the longer the hair loss persists, the less likely it is that hair will re-grow. It is best to see a dermatologist for treatment options early on.
No cure is available for AA or one size fits all treatment approach, but there are treatments that may prove to be effective for individual patients. Treatment options include:
Coping with Alopecia
Hair loss can be traumatic for men and women, and especially to young children. Counseling and support groups may be needed to help a person cope with lose of scalp hair in particular. Persons with AA may feel as if they are alone, or helpless, and the uncertainty as to whether hair will re-grow and when can be very stressful.
Page Updated 03/27/2006