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DERMATOPATHOLOGICAL INSTITUTE

DR. PABLO UMBERT

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AREATA ALOPECIA

Approximately 1 to 2% of people develop the disease at some point in their lives.In about 60% of cases, the first episode of hair loss occurs before age 20 and is followed by a regrowth of hair.The presence of Alopecia Areata has been linked to infectious factors, endocrine, genetic, psychological, and other causes such as eye or dental irritations, and head trauma.

What is Alopecia Areata?

Alopecia areata is a disease that affects the hair follicles. In most cases, hair falls out in clumps, leaving hairless areas the size of US currency quarters. Although it is rare, the disease can cause total loss of hair around the hair on the face and body.

Why is it produced?

The cause of this disease is probably an autoimmune reaction. This means that the immune system incorrectly attacks the body's own cells. In the case of Alopecia Areata the cells that are attacked are in the hair follicles.

Genetic (hereditary) factors may also play a role. Almost 40% of people under age 30 with Alopecia Areata have at least one family member who has been diagnosed with the same disorder.

The risk of developing this disease is especially high in people who have asthma, allergic rhinitis, thyroid disease, vitiligo, pernicious anemia and down syndrome.

Symptoms

Patients usually present with one or more oval or round plates of 2-5 cm in diameter, located on the scalp, beard or eyebrows. Inside these plates the skin keeps the follicular orifices, but without any hair. On the edge of the plate, short hairs may be seen. (Thin facing up and thick facing down).

One or several outbreaks may develop throughout life, resulting in the re-growth of the hair, initially with white and fine hair, and later pigmented.

What types of Alopecia Areata are there?

When alopecia affects the frontal edge, parietal and occipital hairline, and retains only a strand of hair it is called Ophiasis Alopecia. When all the hair on your head falls out it is called Alopecia Areata Totalis, and when the whole body hair is lost it is called Alopecia Areata Universalis.

Diagnosis

The doctor makes the diagnosis of Alopecia Areata observing the typical appearance of hairless areas. Most of the time there are well-defined points of baldness (round or oval). Sometimes the skin has an ivory color. It may be sometimes difficult to diagnose when it shows up as diffused alopecia.

A diagnosis that differentiates it from ringworms and scarring alopecia must be done. It is important to rule out other diseases that may be associated with this disease such as vitiligo, down syndrome, thyroid disease, pernicious anemia and Addison’s disease.

Examination with a dermatoscope magnifier and also a skin biopsy may be needed.

Treatment for Alopecia Areata

When Alopecia Areata is small, treatment may not be necessary, since it will usually resolve on its own. However due to the negative aesthetic effect, which usually causes an emotional impact, it must be stopped early on to avoid its growth. There are several treatments and due to the unreliability of these we have several options:

  • Topical glucocorticoids.
  • Use of systemic glucocorticoids.
  • Use of Diphencyprone.
  • Use of Minoxidil.
  • Use of Zinc.

The new drugs are very promising. In most cases results are satisfactory for years

Doctor Pablo Umbert

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