Alopecia Areata

Alopecia Areata; A malady for many

You might have heard of the term alopecia. This means hair loss. However, a type of alopecia called alopecia areata means patchy hair loss with no specific pattern. This is an autoimmune disease that has become a malady for many patients.

Alopecia areata used to be a single or few areas of hair loss that would recover in most cases on its own. The patches would often by found during haircut by barbers/ salon therapists who are good at this. The disease is thought to be due to a change in immune system resulting in an attack on the hair follicles preventing them from growing out of the scalp/ skin. The patch looks clean area with no hair follicle, sometimes showing faint green black dots on surface as a reminder of the follicles underneath.

Regrowth happens when the disease process is reversed. This can happen on its own or with medications that change the immune status. In the recent years this disease is taking on a very stubborn course with recurrence every time the medications are reduced or withdrawn. This causes extreme agony to patients as often it is difficult to hide the bald patches with remaining hair. this gets more difficult when the disease affects facial hairs like beard, moustache and eyebrows.

Medical treatments include application of creams and oral medications only when the disease is extensive and rapidly spreading, Injections are given into the patches if there are few in number. It is not advisable to go for injections of steroids in case of large patch that has positive pull test at periphery. Also in case of multiple patches (more than 3) often the disease is spreading and would not get treated with injections alone

When the disease is extensive and spreading, then oral immunosuppressives like steroids and other drugs have to be administered. Often these are needed for prolonged periods. They have side effects. The dermatologist looks into the pros and cons of each immunosuppressive pertaining to each case and decides the best one.

As the cause of this change in immune system that gives rise to alopecia areata is not known, it is found that a period of stress is common in all patients. Hence it is very important for achieving successful treatment, that there is change to healthy lifestyle. Better lifestyle habits have to be adopted. Of primary importance is the habit of sleeping early at 10pm to sync with nature. This helps in maintaining normal metabolism and hormonal rhythm. Eating food at right times will again ensure proper digestion and nutrient absorption. These help in maintaining better immune health.

Dr Nilesh Goyal is of the firm opinion that a steady decline in responsiveness in alopecia areata with frequent recurrences is due to the massive change in lifestyle brought about by our 24/7 available digital world.

The biggest stress to the human body is the persistent habit of eating and sleeping at odd hours. This has a long-term deleterious effect on immune functioning resulting in autoimmune and allergic diseases and even cancer.