Q I am a 53-year-old man. Last
year, I discovered a patch
of baldness on my head.
Doctors at the National Skin
Centre identified the condition
as alopecia areata. Injections
were administered and the hair
grew back about two months later.
However,new and bigger patches
have appeared on my scalp. What is
the cause and how can I prevent the
development of more patches?
A While there are many causes of
localised hair loss, the description
of your symptoms does suggest
alopecia areata.
Alopecia areata is a common
cause of hair loss that can occur at
any age. It usually causes small
patches of baldness on the scalp.
Most people get a few patches but
some people may lose more hair. In
rare cases, it may cause total loss of
hair on the scalp or on the entire
body.
In alopecia areata, the body’s
immune system mistakenly attacks
the hair follicles, for reasons that
are not entirely understood,
resulting in inflammation and
damage to the hair.
Up to 20 per cent of those
afflicted with alopecia areata have
family members with the same
condition, suggesting that genes
may play a role.
Some of these genes have a link to
other autoimmune diseases. In
some cases, stress appears to be a
trigger. Fortunately, the affected
hair follicles usually retain the
ability to regrow hair and, in most
cases, the hair loss is not permanent.
However, hair regrowth may take
months, sometimes years.
Unfortunately, there is no permanent
cure or way to prevent this
condition. A relapse is common.
Many people experience more than
one episode during their lifetime.
The condition usually has no
direct impact on your health and is
not contagious, but it can be distressing.
It is advisable to seek early treatment.
But none of the treatments
can alter the course of the disease.
Common treatment options
include steroid creams, scalp applications
and local steroid injections.
In very mild cases, no treatment
is required as spontaneous hair
regrowth is expected.
In more severe cases, contact
immunotherapy – an application of
a medicine that causes a mild
allergic reaction on the skin to
stimulate hair growth – may be
required, as well as steroid tablets
or immuno-suppressants.
You may want to see a dermatologist
to check if resuming the
local steroid injections is beneficial.
You may also want to consider
some measures to reduce the
effects of the condition on your
looks. For example, you could wear
a cap, scarf or wig.
Sprays containing artificial hair
fibres may be used to cover up the
bald areas temporarily.
You can also join patient-support
groups and discuss your concerns
with your doctor.
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