What is Alopecia Areata, and Why Does It Occur?
Alopecia areata is an autoimmune disease that occurs when the immune system mistakenly identifies and attacks its own hair follicles as foreign invaders. This leads to hair loss, characterized by round patches of baldness, and can occur anywhere on the body, including the scalp, eyebrows, and beard. While the exact cause is not yet known, genetic factors, stress, and associations with other autoimmune diseases are believed to play complex roles.
Main Symptoms and Types of Alopecia Areata
Alopecia areata can manifest in various forms. The most common form is the appearance of one or more coin-sized, round patches of hair loss on the scalp. However, if symptoms worsen, it can progress to the following forms:
- Single-patch Alopecia Areata: The most common form, characterized by a single patch of hair loss.
- Multi-patch Alopecia Areata: Multiple patches of hair loss appear simultaneously or sequentially.
- Ophiasis: Hair loss patches appear connected in a serpentine (snake-like) pattern.
- Alopecia Totalis: A severe form where all hair on the scalp is lost.
- Alopecia Universalis: The most severe form, involving the loss of all hair on the entire body, including scalp hair, eyebrows, eyelashes, and body hair.
When hair around the bald patches is pulled, it may come out easily, and 'exclamation mark hairs' (hairs that are narrower at the base) may be observed. Additionally, changes such as small pits or horizontal ridges on the fingernails may accompany the condition.
Diagnosis Process for Alopecia Areata
Alopecia areata is primarily diagnosed through visual examination and medical history taking. The doctor assesses the size, shape, and number of bald patches, and comprehensively considers the patient's medical history, family history, and stress factors. In some cases, additional tests may be required:
- Hair Pull Test: Gently pulling hair around the bald patch to assess the degree of hair shedding.
- Dermoscopy: Magnified observation of the scalp and hair condition.
- Biopsy: When the diagnosis is uncertain or differentiation from other conditions is needed, a skin tissue sample from the bald area is taken and examined under a microscope.
- Blood Tests: May be performed to check for other autoimmune diseases or underlying conditions that may be associated with alopecia areata, such as thyroid disease or anemia.
It is crucial to consult with a dermatologist for an accurate diagnosis.
Various Treatment Methods for Alopecia Areata
Treatment for alopecia areata is customized based on the patient's age, size and number of bald patches, and progression of the condition. The goal of treatment is to suppress the immune response and promote hair regrowth. Generally, the following treatment methods may be used:
- Topical Corticosteroids: Primarily used for mild alopecia areata, applied directly to the bald patches or injected to suppress inflammatory reactions and aid hair growth.
- Corticosteroid Injections (Intralesional Injections): Effective when bald patches are not large or few in number. Steroid medication is injected directly into the affected area to locally modulate the immune response. Repeat treatments may be necessary, typically at 4-6 week intervals.
- Topical Immunotherapy (e.g., DPCP, SADBE): Considered for extensive alopecia areata or when there is no response to steroid treatment. Specific chemical substances are applied to the scalp to artificially induce contact dermatitis, thereby suppressing the activity of immune cells that attack hair follicles.
- Oral Corticosteroids: In cases of extensive and rapidly progressing alopecia totalis or universalis, short-term oral administration can powerfully suppress the immune response. However, long-term use can cause side effects, so it must be taken under the direction of a specialist.
- JAK Inhibitors: Recently developed oral medications that help hair regrowth by blocking specific signaling pathways involved in the immune response. They are gaining attention as an effective treatment option for severe alopecia areata patients and can be prescribed after consultation with a specialist.
- Phototherapy: Treatment using ultraviolet A or B light, which can help modulate the immune response.
Treatment efficacy varies among individuals, and recurrence is possible, so consistent management and regular consultations with a specialist are important. Lifestyle improvements, such as stress management and a balanced diet, can also positively influence treatment.
This article provides general medical information and does not substitute for individual diagnosis and treatment. If alopecia areata is suspected or treatment is deemed necessary, it is crucial to consult with a dermatologist for an accurate diagnosis and appropriate treatment plan.
Clinics with Registered Related Procedures
- Gangnam Laren Clinic (Gangnam-gu) — Registered Procedure: Hair Loss Injection
- Hosu Clinic (Hanam-si) — Registered Procedure: Hair Loss Injection
Listed in alphabetical order and not a ranking or medical recommendation. Procedure information is based on content registered by each clinic. (Source: Keudeomjip)