Alopecia Areata (AA) is uneven loss of hair on the scalp or body. It can occur at any age and affects 1% of the population, most commonly children. The reasons for their development not fully understood. Despite not endanger the life, hair loss can be psychologically traumatic.In general, dermatologists diagnose AA careful examination of the scalp, and taking into account, then the elimination of other causes hair loss. AA begins as a typical good bald patch that appears suddenly. Some people feel a tingling sensation or very mild pain in the affected area. The scalp is the most commonly observed area, but AA can form anywhere in the body: the tabs, armpits, legs, hair, etc.
AA spreads across borders, and growing, with hair thinning at the edges of the roots until fall. The stubble left on the thin edge is at the bottom and is said to look like an exclamation point (!). While hair can be easily removed, the AA is activated and increased hair loss should be expected. More hair in the comb means more points.
Not all cases are obvious, and in these the dermatologist should have a small skin biopsy plug (a small piece of skin less than 1 / 4 inch in diameter) for microscopic examination. Usual hair pulling (tricotilomania), scalp fungus (black-dot ringworm) and other skin diseases (lichen Planopilaris, lupus and skin telogen effluvium) are the main cause of confusion.Most cases that begin with a few patches last few months to one year and normal hair growth resumes quickly. If there is more than a few small patches of hair loss, can also grow again or develop into total loss of scalp hair (alopecia totalis) or even complete body hair loss (alopecia universal), although this is rare. Serious illness is less of a tendency to solve alone, especially in children or atopic (prone to allergy).
AA is unpredictable, and repeated episodes are not unusual. Some cases last for many years with some regrowth in an area, while new areas appear. AA can also scroll through expression and remission. When not begin to regrow hair, tends to be very fine "peach fuzz" hair, eventually recover most or all of its normal color and texture.
There is no actual loss of hair follicles (ie the "root"), even hair injuries. The follicles that produce hair because they are not visible from attacking white blood cells that surround the root. Hair follicles are able to make a lot of punishment. Despite the immune cells attack the hair follicles are usually remain capable of re-growth, even after years of attacks. However, in severe cases this becomes increasingly less likely to take years.
Treatment depends on the degree of illness, and patient age. For small irregular disease, intralesional injections of steroids (Kenalog (r)) are the best approach. This is injected with a small needle directly into the patches on the scalp with injections spread over the affected areas. The injections are repeated every 4 to 6 weeks. The amount of steroid use is safe, wherever reasonable limits are not exceeded. Other options include topical minoxidil (Rogaine) and prescription steroid lotions. These cases are better for moderately wide.
For more serious disease, the options include short contact anthralin treatment (Micanol) and contact hypersensitization. The most effective treatment is currently available hypersensitization contact with some studies showing a 40% success rates. That causes a local dermatitis (rash), with swollen lymph nodes. Treatment should continue for months to a year or more to get a good result.
