Alopecia Areata Treatment in Delhi, India

Alopecia can be categorised based on the extent of hair loss. They can be of the following types:

• Alopecia totalis: It is a type of alopecia where hair loss occurs on the entire scalp.
• Alopecia Universalis: Along with hair loss on the scalp, people suffering from alopecia universalis suffer from hair loss in other areas like their face, eyebrow, eyelashes, etc.
• Ophiasis alopecia: Here, hair loss occurs on the sides and lower back of the scalp.
• Diffuse alopecia areata: Popularly known as alopecia areata incognita, diffuse alopecia areata may seem more like the regular female or male pattern of hair loss. People may notice unexpected hair things occurring all over the scalp, not in one area or patch.
• Patchy Alopecia areata: Patchy variant of the alopecia area's main characteristic is the formation of coin-sized patches of hair loss all over the skin and body. If this condition expands, it may evolve into alopecia totalis or alopecia universalis.

Being an autoimmune condition, alopecia areata is caused when one's immune system mistakenly attacks the hair follicles. The exact cause of this condition remains unknown, but certain factors can increase the risk of contracting alopecia areata. They are:

• Genetics: If a close family member has alopecia areata, the chances of getting it are very high.
• Health conditions: Certain health conditions like Down syndrome, thyroid disease, and vitiligo increase the chances of getting alopecia areata.
• Deficiencies: Vitamin D deficiency also potentially puts one at risk of contracting alopecia areata.

Alopecia areata is characterised mainly by hair loss in patches, at least in the initial stages. Hair loss on the scalp often occurs in chunks. These filaments seldom exceed a few millimetres in length. Hair loss may occur everywhere on the body, including the face. This includes the beard, eyelashes, and eyebrows. Hair loss may be patchy for some individuals. While for others, it may be a sudden and unexpected hair loss from any or all regions of the body.

Candidates may find several strands of hair on the pillow or in the shower. Someone may bring it to their attention if huge patches have lingered on the back of their head. However, hair loss of a similar pattern may also be caused by other medical conditions. Hair loss alone is insufficient for a diagnosis of alopecia areata. Patterns of hair loss and hair growth play a vital role and are best addressed by dermatologists.

Occasionally, individuals may have more severe hair loss. This is indicative of a subtype of alopecia. Experts and clinicians agree that the balding caused by alopecia areata seems random and unprovoked. Candidates may never know whether the hair will grow back if it falls out again. How much hair a person loses and how much comes back varies significantly from person to person.

Several diagnostic tests are conducted to diagnose alopecia areata. The most commonly performed tests are:

• Pull test: Healthcare officials will carefully pick out a large hair sample to see how many strands are removed. 
• Light microscopy: A specific device will be used to check the hairs clipped at their bases. Microscopy helps identify probable abnormalities of the hair shaft.
• Blood Test: This might aid in diagnosing underlying medical disorders that cause balding.
• Scalp biopsy: The doctor scrapes samples from the skin or a few hairs plucked from the scalp to study the hair roots under a microscope.

A physical exam and thorough study of the family medical history may also be conducted to diagnose alopecia areata. The healthcare provider will rely on these tests to determine a treatment plan.

While researchers are yet to find a proper cure for alopecia areata, few treatments can help reduce its intensity. They are: 

• Medication and therapy administered orally: While cortisone pills may be an option for treating alopecia, one should talk to the doctor before using them. Candidates may also try oral immunosuppressants as they help manage the autoimmune response and are effective. However, self-administration for a period more than for which they are prescribed may prove dangerous. Hence it is imperative to take them only under the supervision of a doctor.
• Treatment using Lasers and Light: Photochemotherapy, in which a light sensitiser is used, and phototherapy, in which specific wavelengths of ultraviolet light are used for their therapeutic benefits, can aid those suffering from alopecia areata. To promote new hair growth, laser therapy uses targeted levels of radiation. It is widely agreed that both treatments are effective and safe.
• Alternative treatments: Alternative therapies like aromatherapy can be quite effective in helping one manage the stress associated with this condition. Additionally, lifestyle changes like maintaining a balanced diet can help improve one's condition to some extent.

Ultimately, treatments prescribed are based on a multitude of factors, and there is no single approach superior to others.

It is impossible to prevent the occurrence of alopecia areata, but measures can be taken to stop it from getting worse. They are:

• Don't put the hair or scalp through extra stress: This is a primary method for controlling alopecia and reducing hair loss. The overuse of shampoo, the use of harsh chemicals, the use of colours or perms, and the application of excessive heat may all cause damage to the hair.
• Take extra care: To prevent breaking, one should treat damp hair with extra care. Avoid any head or scalp injuries. The most common causes include using brushes with abrasive bristles or brushing too vigorously. Shampooing is also a contributing factor to damage to the scalp. If candidates wash their hair too often, they risk damaging the scalp. Finally, it would help if one stayed away from haircuts that put unnecessary strain on the head. To control the alopecia and prevent more hair loss, candidates may need to forego ponytails, buns, and braids for the time being.
• Try to de-stress: As unfortunate as it is, stress may play a significant role in hair thinning. Hair loss is more likely to occur during times of increased stress. Alopecia isn't caused by stress per se, but it tends to flare up during times of increased pressure. If candidates are going through a lot of stress, they are suggested to figure out what's causing it so they can get rid of it. In addition, they might make frequent use of stress-relieving practices. Starting a meditation practice and doing some breathing exercises may help them deal with stress and may even help them lessen its effects in the long term.
• Maintain a balanced diet: Nutrient deficiencies have been related to hair loss in certain circumstances. Candidates must ensure they're receiving too much or too little of key nutrients before beginning any supplementation for hair development. Hence, maintaining a balanced diet is crucial.

Conditions like alopecia areata may exacerbate stress and loss of self-esteem; thus, it is crucial to be aware of the treatments available. Contact a doctor to schedule a consultation to learn more about dealing with alopecia areata effectively.

Reviewed by Dr. Prateek Nagrani, Attending Consultant, Dermatology on 02-May-2023.