Alopecia Areata (Hair Loss)

What is Alopecia Areata?

Alopecia Areata is a patchy non-scarring hair loss condition that a person develops coin-sized round baldness over the scalp. It is postulated that the body’s immune system attacks the growing hair leading to hair loss.

What causes Alopecia Areata?

There are increasing evidence to suggest Alopecia Areata is due to underlying immune system reacting onto hair follicles, resulting in inflammation and hair loss. Hair follicle immune response can also be triggered by environmental factors such as infections, drugs, vaccinations or even stress.

What are the symptoms of Alopecia Areata?

Alopecia Areata typically presents with a well-circumscribed discrete smooth bald patch over the scalp. Sometimes, this condition can affect other parts of the body such as the beard, eyebrows, eyelashes, body and limbs. You may notice roughening of the nails or developing of little pits over the nail surface.

Is Alopecia Areata painful?

No, Alopecia Areata does not cause pain. However, Alopecia Areata can be a devastating condition. The loss of hair has a negative psychological impact and can be associated with low self-esteem. Patients with Alopecia Areata can be vulnerable to exploitation and should be cautioned against spending unnecessary money on remedies that are unproven.

Who is at risk of Alopecia Areata in Singapore?

Both female and male are equally at risk of developing Alopecia Areata. The age demographics tends to occur between adolescence to mid adulthood. Uncommonly, it can also affect children less than 10 years old.

The following increase an individual’s risk of developing this condition:

  • A past history of Alopecia Areata
  • Autoimmune conditions
  • Thyroid disease
  • Family history of similar condition

How is Alopecia Areata diagnosed?

Alopecia Areata is diagnosed based on history and clinical examination findings. However, depending on individual cases, your doctor may consider to run some blood tests to screen for other causes of hair loss.

Can Alopecia Areata be cured?

Due to the association of autoimmune response, treatment of Alopecia Areata involves use of steroid. The most effective treatment for small areas of patchy Alopecia Areata is intralesional steroid (triamcinolone) injection. Depending on individual cases, your doctor may pair the injection treatment with topical/cream based steroid. You are advised to discuss with your doctor on the treatment alternatives for Alopecia Areata.

FAQS

First line treatment for Alopecia Areata which is fast and effective is intralesional steroid injection.

Your doctor will take a detailed relevant history regarding your scalp, and hair over other parts of your body. Your doctor will use a dermatoscope to review your scalp as well. In cases when the diagnosis is uncertain, your doctor may offer blood tests, a skin sample procedure (known as skin scalp biopsy) to obtain tissue scalp sample to review it in under microscope.

The good news is: Hair loss secondary to Alopecia Areata usually do recover as the hair follicles are intact. Once the body’s immune system settles, the hair will regrow. You can discuss with your doctor on ways to treat and recover sooner from Alopecia Areata.

Some patients may only experience an episode of Alopecia Areata. Unfortunately, there are patients may have a few episodes or recurring Alopecia Areata. Thankfully, most patients recover well despite the recurrence! You are advised to discuss with your doctor on ways to manage the condition and lifestyle measures to avoid triggers that can cause relapse of Alopecia Areata.

Alopecia Areata is not a life threatening condition and the general prognosis of the condition is favourable. Nonetheless, Alopecia Areata hair loss can be a frustrating condition and can cause significant psychosocial distress. One can also be susceptible to scams or various street remedies that may not be cost effective. Speak to the professionals if you develop Alopecia Areata as there are clinically effective treatment to manage the condition.

No, Alopecia Areata is not an infectious disease. It will not be transmitted through contact, touching, or sexual intercourse.

You should keep your hair short, avoid braiding or pulling of the existing hair. Repeated chemical hair treatment should be avoided to reduce further scalp injury leading to hair fall.
Discuss with your doctor on treatment options to manage and recover from Alopecia Areata.

You may notice overtime, there are small soft ‘baby’ hairs growing out the bald patch areas, and making the appearance of the bald patch less conspicuous and smaller. The ‘new’ regrowing hair may appear grey/white in some patients, and eventually revert back to its original color over months.

The risks of developing Alopecia Areata among both genders are equal.

Vitamin D deficiency has been shown in clinical studies as a risk factor for development of alopecia areata. You are advised to replenish the level if your level are low. Discuss with your doctor on replacing vitamin D levels, and avoiding over-replenishing of the vitamin!

Yes, you can. In fact, sun is the natural source of vitamin D which will stimulate hair follicle and encourages new hair regrowing in Alopecia Areata.

You are advised for a balance, well nutrition daily meals. In particular, you can aim for a diet rich in anti-inflamamtory antioxidant properties. This includes fruits and vegetables, berries, cherries, broccoli, spinach and many more!

Processed food, food additives, MSGs, diary, eggs, caffeinated drinks, sugar, alcohol are common food that promotes inflammation in the body and should be avoided. You can discuss your dietary intake with your doctor to tailor a suitable meal to aid the symptoms of Alopecia Areata.

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