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ALOPECIA AREATA ALOPECIA AREATA Vanessa Beretta

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Alopecia is a condition affecting humans in which hair is lost from some or all areas of the body. It only affects 1% of the population. Although it is not life threatening, it can be psychologically traumatic.

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Alopecia areata monolocularis: baldness in only one spot on the scalp Alopecia areata multilocularis: baldness in multiple areas throughout the entire body Alopecia totalis: all of the hair on the scalp is lost resulting in a smooth bald head Alopecia universales: loss of all body hair Alopecia areata barbae: affecting the hair of the beard region Reticulated areata barbae: hair loss in irregular patterns, areas of no growth interspersed with areas of normal hair growth Ophiasis alopecia areata: bandlike hair loss in the temporal or occipital regions of the scalp Diffusion alopecia areata: partial hair loss throughout the scalp with no distinct patches Perinevoid alopecia areata: spots of skin are found to have properties different from the surrounding skin. Around these spots of abnormalities are areas where alopecia is noticed Diffues alopecia areata: hair appears to turn white almost overnight, due to psychological trauma

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4 Alopecia is not contagious. There are three main phases of regular hair growth, anagen, catagen, and telogen. Alopecia primarily affects the anagen phase, recent studies have shown that alopecia occurs when premature hair in the anagen phase is precipitated into the telogen phase.. The body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune cells inside of the hair follicles where they are not normally present, the cause of this is unknown. No one has found a reason for the actual cause of Alopecia. However, it is sometimes associated with other autoimmune conditions such as thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. In some cases, alopecia occurs within family members, suggesting it may be caused by genes. It is also more common in patients with chromosomal disorders, such as Down Syndrome.

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1. Psychological long-term chronic stress 2. Shock and sudden extreme stress 3. Physical trauma 4. Local skin injury 5. Genetic predisposition 6. Viral/bacterial infection 7. Pregnancy/hormones 8. Allergies 9. Chemicals 10. Seasonal changes 5 Initiating Factors:

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Alopecia affects between 0.1%-0.2% of humans, occurring in both males and females. It occurs far more for females than males. Alopecia areata occurs in apparently healthy humans with no skin disorders. Alopecia areata tends to occur mostly in children, teens, young adults, and females.

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For females, hormonal changes are often a cause of alopecia. Alopecia can occur after pregnancy or after the discontinuation of the birth control pill. It is estimated that 45% of women suffer major hair loss after the birth of their baby. Most cases of Alopecia start during the later stages during pregnancy. Women who already have alopecia areata can find that they have complete but temporary hair re growth around the time of childbirth. Puberty and menopause have also been suggested as a time of potential alopecia areata onset or remission. It is estimated that 45% of women suffer major hair loss after the birth of their baby. 7

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The diagnosis of Alopecia can be very difficult. It may require a scalp biopsy. The characteristics usually sought for are smooth patches on scalp and weak, thin hair surrounding the bald patches. It sometimes can be identified if there is exclamation point hair left on the scalp. Exclamation point hair is hair that has grown normally but then breaks off at the ends, leaving short stubs

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In about 50% of the people diagnosed with alopecia, hair will re grow within a year without any treatment. There are a variety of treatments that can be used, such as steroid injections, creams, and shampoos. Other medications are also used such as minoxidil, irritants, and other topical immunotherapy. There is no 100% effective treatment or prevention for alopecia, although elimination of stress has proven to be helpful. Injecting cortisone medicine into the area of the hair loss may speed up the re growth of the hair, this treatment is known as interlesional steroid injection. The most successful of all treatments so far has been immunotherapy. Immunotherapy is done by provoking a contact allergic dermatitis in affected areas by applying a concentration of a material that the patient has been made allergic to. Contact allergic dermatitis is and itchy skin condition that is caused by an allergic reaction to the material in contact of the skin. The downside of using immunotherapy is that the resultant dermatitis is irritating. 9