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How is Alopecia Areata Treated?

While there is neither a cure for alopecia universalis nor drugs approved for its treatment, some people find that medications approved for other purposes can help hair grow back, at least temporarily. The following are some treatments for alopecia universalis. Keep in mind that while these treatments may promote hair growth, none of them prevent new patches or actually cure the underlying disease. Consult your health care professional about the best option for you.

  • Corticosteroids: Corticosteroids are powerful anti-inflammatory drugs similar to a hormone called cortisol produced in the body. Because these drugs suppress the immune system if given orally, they are often used in the treatment of various autoimmune diseases, including alopecia universalis. Corticosteroids may be administered in three ways for alopecia universalis:
    • Local injections: Injections of steroids directly into hairless patches on the scalp and sometimes the brow and beard areas are effective in increasing hair growth in most people. It usually takes about 4 weeks for new hair growth to become visible. Injections deliver small amounts of cortisone to affected areas, avoiding the more serious side effects encountered with long-term oral use. The main side effects of injections are transient pain, mild swelling, and sometimes changes in pigmentation, as well as small indentations in the skin that go away when injections are stopped. Because injections can be painful, they may not be the preferred treatment for children. After 1 or 2 months, new hair growth usually becomes visible, and the injections usually have to be repeated monthly. The cortisone removes the confused immune cells and allows the hair to grow. Large areas cannot be treated, however, because the discomfort and the amount of medicine become too great and can result in side effects similar to those of the oral regimen.
    • Oral corticosteroids: Corticosteroids taken by mouth are a mainstay of treatment for many autoimmune diseases and may be used in more extensive alopecia areata. But because of the risk of side effects of oral corticosteroids, such as hypertension and cataracts, they are used only occasionally for alopecia areata and for shorter periods of time.
    • Topical ointments: Ointments or creams containing steroids rubbed directly onto the affected area are less traumatic than injections and, therefore, are sometimes preferred for children. However, corticosteroid ointments and creams alone are less effective than injections; they work best when combined with other topical treatments, such as minoxidil or anthralin.
  • Minoxidil (5%): Rogaine: Topical minoxidil solution promotes hair growth in several conditions in which the hair follicle is small and not growing to its full potential. Minoxidil is FDA-approved for treating male and female pattern hair loss. It may also be useful in promoting hair growth in alopecia areata. The solution, applied twice daily, has been shown to promote hair growth in both adults and children, and may be used on the scalp, brow, and beard areas. With regular and proper use of the solution, new hair growth appears in about 12 weeks.
  • Anthralin: Psoriatec: Anthralin, a synthetic tar-like substance that alters immune function in the affected skin, is an approved treatment for psoriasis. Anthralin is also commonly used to treat alopecia areata. Anthralin is applied for 20 to 60 minutes (“short contact therapy”) to avoid skin irritation, which is not needed for the drug to work. When it works, new hair growth is usually evident in 8 to 12 weeks. Anthralin is often used in combination with other treatments, such as corticosteroid injections or minoxidil, for improved results.
  • Sulfasalazine: A sulfa drug, sulfasalazine has been used as a treatment for different autoimmune disorders, including psoriasis. It acts on the immune system and has been used to some effect in patients with severe alopecia areata.
  • Topical sensitizers: Topical sensitizers are medications that, when applied to the scalp, provoke an allergic reaction that leads to itching, scaling, and eventually hair growth. If the medication works, new hair growth is usually established in 3 to 12 months. Two topical sensitizers are used in alopecia areata: squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP). Their safety and consistency of formula are currently under review.
  • Oral cyclosporine: Originally developed to keep people’s immune systems from rejecting transplanted organs, oral cyclosporine is sometimes used to suppress the immune system response in psoriasis and other immune-mediated skin conditions. But suppressing the immune system can also cause problems, including an increased risk of serious infection and possibly skin cancer. Although oral cyclosporine may regrow hair in alopecia areata, it does not turn the disease off. Most doctors feel the dangers of the drug outweigh its benefits for alopecia areata.
  • Photochemotherapy: In photochemotherapy, a treatment used most commonly for psoriasis, a person is given a light-sensitive drug called a psoralen either orally or topically and then exposed to an ultraviolet light source. This combined treatment is called PUVA. In clinical trials, approximately 55 percent of people achieve cosmetically acceptable hair growth using photochemotherapy. However, the relapse rate is high, and patients must go to a treatment center where the equipment is available at least two to three times per week. Furthermore, the treatment carries the risk of developing skin cancer.
  • Alternative therapies: When drug treatments fail to bring sufficient hair regrowth, some people turn to alternative therapies. Alternatives purported to help alopecia areata include acupuncture, aroma therapy, evening primrose oil, zinc and vitamin supplements, and Chinese herbs. Because many alternative therapies are not backed by clinical trials, they may or may not be effective for regrowing hair. In fact, some may actually make hair loss worse. Furthermore, just because these therapies are natural does not mean that they are safe. As with any therapy, it is best to discuss these treatments with your doctor before you try them.

Will My Hair Ever Grow Back?

women's hair loss treatment and cosmetic solutions information

There is every chance that your hair will regrow, but it may also fall out again. No one can predict when it might regrow or fall out. The course of the disease varies from person to person. Some people lose just a few patches of hair, then the hair regrows, and the condition never recurs. Other people continue to lose and regrow hair for many years. A few lose all the hair on their head; some lose all the hair on their head, face, and body. Even in those who lose all their hair, the possibility for full regrowth remains. In some, the initial hair regrowth is white, with a gradual return of the original hair color. In most, the regrown hair is ultimately the same color and texture as the original hair.

Some studies suggest that the percent of patients who develop extensive disease (alopecia areata to either totalis or universalis) is anywhere from 16.7% to 19%. Recurrences are possible even after a 20 year remission. However, the prognosis is worse for those that have experienced loss of hair for over a year.

How Will Alopecia Universalis Affect My Life?

Her Hair Loss Help has an outstanding Discussion Forum specifically for women with alopecia and other forms of hair lossThis is a common question, particularly for children, teens, and young adults who are beginning to form lifelong goals and who may live with the effects of alopecia universalis for many years. The comforting news is that alopecia universalis is not a painful disease and does not make people feel sick physically. It is not contagious, and people who have the disease are generally healthy otherwise. It does not reduce life expectancy and it should not interfere with the ability to achieve such life goals as going to school, working, marrying, raising a family, playing sports, and exercising.

The emotional aspects of living with hair loss, however, can be challenging. Many people cope by learning as much as they can about the disease; speaking with others who are facing the same problem; and, if necessary, seeking counseling to help build a positive self-image. HerHairLossHelp.com offers a wonderful Online Community of women who suffer from alopecia and other hair loss afflictions that can help women who suffer from hair loss cope with their everyday activities. Having a community of women, who are all going through various stages of hair loss, offers other women an empathetic person to turn to when dealing with emotional difficulties because of their hair loss. Visit the HerHairLossHelp.com Forum to learn more!

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Life doesn't end with alopecia - Many women are successful in combating the self esteem issues of not having hair

Angelica Galindez was diagnosed with alopecia when she was 12 years old. But now, seven years later, the 19-year-old from San Francisco is the picture of confidence. She proved that on Saturday when she ditched her wig to compete in the Miss Philippines Earth USA beauty pageant and took home one of six victory crowns.  Read more at Huffington Post

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Hair Loss in Women

Her Hair Loss Help has an outstanding Discussion Forum specifically for women with alopecia and other forms of hair lossWomen experience hair loss because of a number of reasons, such as pregnancy, stress, genetics or an illness. Another cause is Alopecia Areata, an autoimmune disorder which results in hair loss.

Women going through any type of hair loss becomes distraught about their changing appearance. Some are comfortable leading their life as someone without hair, but many seek out hair replacement studios to give them back what they have lost.

Unless you yourself have been through sudden and unexpected hair loss, it is nearly impossible to fully understand the emotions that a person must be experiencing. The process going from someone with hair, to someone losing their hair, to someone seeking hair replacement, is a sensitive and personal journey.

How Can I Cope With the Effects of Alopecia?

Living with hair loss can be hard, especially in a culture that views hair as a sign of youth and good health. Even so, most people with alopecia areata are well-adjusted, contented people living full lives.

The key to coping is valuing yourself for who you are, not for how much hair you have or don’t have. Many people learning to cope with alopecia universalis find it helpful to talk with other people who are dealing with the same problems. More than four million people nationwide have this disease at some point in their lives, so you are not alone. We have a number of women who live with alopecia universalis on a daily basis in our Online Community who can help through message boards and support groups. You can also find others with the disease, the National Alopecia Areata Foundation (NAAF) can help through its pen pal program, message boards, annual conference, and support groups that meet in various locations nationwide.

Wigs and hair extensions are available to help achieve a full head of hair even when you have lost all your hairAnother way to cope with the disease is to minimize its effects on your appearance. If you have total hair loss, a wig or hairpiece can look natural and stylish. For small patches of hair loss, a hair-colored powder, cream, or crayon applied to the scalp can make hair loss less obvious by eliminating the contrast between the hair and the scalp. Skillfully applied eyebrow pencil can mask missing eyebrows.

For women, attractive scarves can hide patchy hair loss; jewelry and clothing can distract attention from patchy hair; and proper makeup can camouflage the effects of lost facial hair. If you would like to learn more about camouflaging the cosmetic aspects of alopecia universalis, visit our online forum for information about your cosmetic options.

I’m 32 and I’ve had 4 battles with Alopecia Areata.

Story from a woman who has battled alopecia areata resulting from severe trauma and/or stress:

I’m 32 and I’ve had 4 battles with Alopecia Areata. Every time something major happens I begin to start loosing a patch of hair. First, when I made a huge move across country and left all my family, a spot started. (pretty scary) since it was the first time. The second time, I was in some financial problems, and again it started. The second times, I had deaths in the family a few years apart, and again, the patches came up. It’s a horrible feeling to have a full head of hair, and then all the sudden a small little patch starts and you start praying that it stops or doesn’t get that big. Currently, I have two huge spots on the back of my head that barely have any fuzz at all. In fact, some of the grey hairs stayed, and the brown didn’t. Weird. I’m not on any medications since the other times it grew back fairly quickly (6-9 months), but I think I’m going to find something this time since their much bigger than before.

Thank you for sharing your story!

AGA – Photo image of onset

Image photo of the onset of Androgenetic Alopecia in a female courtesy of www.aafp.org

Image photo of the onset of Androgenetic Alopecia in a female courtesy of www.aafp.org

Bald Girls Do Lunch: News Clip

Bald Girls Do Lunch on KSTU TV in Salt Lake City, Utah.

What Can I Expect Next?

The course of alopecia universalis is highly unpredictable, and the uncertainty of what will happen next is probably the most difficult and frustrating aspect of the disease. You may continue to lose hair, or your hair loss may stop. The hair you have lost may or may not grow back, and you may or may not continue to develop new bare patches.

Is My Hair Loss a Symptom of a Serious Disease?

Alopecia universalis is not a life-threatening disease. It does not cause any physical pain, and people with the condition are generally healthy otherwise. But for most people, a disease that unpredictably affects their appearance the way alopecia universalis does is a serious matter.

The effects of alopecia universalis are primarily socially and emotionally disturbing. In alopecia universalis, however, loss of eyelashes and eyebrows and hair in the nose and ears can make the person more vulnerable to dust, germs, and foreign particles entering the eyes, nose, and ears.

Alopecia universalis often occurs in people whose family members have other autoimmune diseases, such as diabetes, rheumatoid arthritis, thyroid disease, systemic lupus erythematosus, pernicious anemia, or Addison’s disease. People who have alopecia areata do not usually have other autoimmune diseases, but they do have a higher occurrence of thyroid disease, atopic eczema, nasal allergies, and asthma.

Can I Pass Alopecia on to My Children?

It is possible, but not likely, for alopecia universalis to be inherited. Most children with alopecia universalis do not have a parent with the disease, and the vast majority of parents with alopecia universalis do not pass it along to their children.

Alopecia universalis is not like some genetic diseases in which a child has a 50-50 chance of developing the disease if one parent has it. Scientists believe that there may be a number of genes that predispose certain people to the disease. It is highly unlikely that a child would inherit all of the genes needed to predispose him or her to the disease.

Even with the right (or wrong) combination of genes, alopecia universalis is not a certainty. In identical twins, who share all of the same genes, the concordance rate is only 55 percent. In other words, if one twin has the disease, there is only a 55 percent chance that the other twin will have it as well. This shows that other factors besides genetics are required to trigger the disease.

Who Is Most Likely To Get Alopecia Areata?

Alopecia areata affects an estimated four million Americans of both sexes and of all ages and ethnic backgrounds. It often begins in childhood.

If you have a close family member with the disease, your risk of developing it is slightly increased. If your family member lost his or her first patch of hair before age 30, the risk to other family members is greater. Overall, one in five people with the disease have a family member who has it as well.

What Causes Alopecia Universalis?

In alopecia universalis, immune system cells called white blood cells attack the rapidly growing cells in the hair follicles that make the hair. The affected hair follicles become small and drastically slow down hair production. Fortunately, the stem cells that continually supply the follicle with new cells do not seem to be targeted. So the follicle always has the potential to regrow hair.

Scientists do not know exactly why the hair follicles undergo these changes, but they suspect that a combination of genes may predispose some people to the disease. In those who are genetically predisposed, some type of trigger–perhaps a virus or something in the person’s environment–brings on the attack against the hair follicles.

There are, however, studies that have been done that show a genetic link for those people who are diagnosed as having Alopecia Universalis. According to MedicineNet.com, the “disorder is inherited as an autosomal recessive trait. It is caused by a mutation in a gene dubbed HR in chromosome band 8p21.2 that is the human homolog of the mouse “hairless” gene — the human version of the gene in the mouse that is responsible for hairless mice.” Huh?? Basically they are saying that a good majority of those who develop alopecia universalis have a hereditary gene that could be the possible cause of their hair loss. This is great news since pinpointing a gene may provide scientists a more targeted approach to treating hair growth disorders such as alopecia.

More information concerning studies such as this can be found at:

What Is Alopecia?

Alopecia is considered to be an autoimmune disease, in which the immune system, which is designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks the hair follicles, the tiny cup-shaped structures from which hairs grow. This can lead to hair loss on the scalp and elsewhere.

In most cases, hair falls out in small, round patches about the size of a quarter. In many cases, the disease does not extend beyond a few bare patches. In some people, hair loss is more extensive. Although uncommon, the disease can progress to cause total loss of hair on the head (referred to as alopecia areata totalis) or complete loss of hair on the head, face, and body (alopecia areata universalis).

Alopecia can occur at any age and is not life threatening, however the psychological impact on the person experiencing alopecia can be incredible. Such an impact can affect the person’s social life and may lead to a higher risk of major depression and/or anxiety disorders.

Images of Further Stages of Alopecia

Further stages of alopecia areata

Further stages of alopecia areata

Alopecia with diffuse thinning courtesy of www.meddean.luc.edu

Alopecia with diffuse thinning courtesy of www.meddean.luc.edu

Alopecia Universalis courtesy of www.dermatology.org

Alopecia Universalis courtesy of www.dermatology.org