What is Alopecia Areata (AA)?
Alopecia Areata is an autoimmune disease characterized by hair loss on the scalp, face, and/or body. Immune cells infiltrate in and around the hair bulb causing inflammation around the hair follicles, which can lead to hair loss. Because AA is a chronic condition, hair loss can ebb and flow. Patients might experience periods of hair loss as well as dormant periods or periods of hair re-growth. Patients also experience different degrees of hair loss.
What are the different types of Alopecia Areata?
- Patchy Alopecia is characterized by one or multiple, separate or conjoined, patches of hair loss.
- Alopecia Totalis is characterized by total or near-total hair loss of the scalp.
- Alopecia Universalis is characterized by total or near-total hair loss on the entire surface of the body.
Who does Alopecia affect?
Approximately 2% of the population is affected by alopecia in their lifetime. Alopecia occurs in men, women and all ethnic groups. While the initial presentation of alopecia can occur at any age, the most common initial presentation occurs during a patient’s 20’s and 30’s.
What are some of the physical impacts of Alopecia beyond hair loss?
- Patients who experience hair loss are at increased risk for sunburn and sensitivity to temperature.
- Patients who experience loss of eyebrows, eyelashes and/or nasal hair may experience eye and nasal irritation.
- Patients often experience nail abnormalities including pitting, splitting and pain.
- Patients often have comorbidities for other autoimmune disorders (ie: thyroid) and atopic diseases like eczema and asthma.
What are some of the social impacts of Alopecia?
As you can imagine, losing your hair can have a big impact on your overall self esteem. A large percentage of Alopecia patients report withdrawing from social activities and an increase in time missed from work. Patients also report experiencing depression and anxiety. Younger patients often experience bullying; as a results there is an increased risk for suicidal idealation amongst this population.
What treatments are available for Alopecia Areata?
The treatment options available to patients depend on their age, the type of alopecia they have and the extent of their hair loss. The main goal of treatment is to block the immune system attack and stimulate the regrowth of hair. Many treatments for Alopecia are not approved by the FDA specifically to treat Alopecia but they are approved to treat other diseases. Treatment options include:
- Phototherpy or light treatments
- Topical Steroids (often injection of steroids to localized patches of hair loss)
- JAK inhibitors– Olumiant (Approved by FDA for treatment of AA in June 2022, previously used to treat rheumatoid arthritis)
There have been significant advances in the treatment of AA over the past several years as well and an increase in support and resources for patients experiencing emotional and physiological pain as a result of the disease. At Siperstein Dermatology group we are proud to have Dr. Julian Mackay-Wiggan on our team, a world renowned hair loss specialist from Columbia University. If you are experiencing hair loss, we are here to help. Please contact us to set up an appointment.
