The recent Will Smith / Chris Rock fiasco at the Oscars has brought alopecia to worldwide attention. Jada Pinkett Smith, who suffers from alopecia areata, attended the event with a shaved head, due to the condition causing her hair to fall out; and Will Smith’s reaction to Chris Rock’s joke about Jada’s hair is now known around the world.
Alopecia often has a profound impact on individuals.
What is alopecia?
Alopecia is a general term for hair loss in medical world. It can be non-scarring where the skin on the scalp looks normal and there is no loss of hair bulbs. Scarring alopecia is where the hair bulbs has disappeared and therefor there is no chance of hair re-growing. There are many causes of both non-scarring and scarring alopecia.
What is alopecia areata?
This type of alopecia is a non-scarring hair loss. It can be patchy or widespread. When it affected the entire scalp it is alopecia totalis. When this condition affected the entire body involving scalp, eyebrows, eyelashes and body hair it is called alopecia universalis. This condition can have a profound impact on the quality of life pf both the affected individual, their family and partners.
What causes alopecia areata?
This is an autoimmune disease where the person’s own white blood cells causes inflammation around the hair bulb leading hair shaft detaches from the hair bulb.
How common is alopecia areata?
The lifetime risk is around 2%.
What treatments are available for alopecia areata?
There is no one size fits all therapy for alopecia areata. The condition is best managed by a dermatologist on a case-based approach. Traditional treatment options include topical and intralesional steroids, oral corticosteroids, topical irritants, oral and topical minoxidil and systemic immunomodulatory therapies. Unfortunately none of these options are always consistently effective particularly in people with extensive hair loss.
More effective treatments may be on the horizon. New emerging therapies such as Janus kinase (JAK) inhibitors represent a promising treatment option in the management of alopecia areata. JAK inhibitors may offer a new perspective in the management of this very troublesome condition.
What are other causes of hair loss?
Androgenetic alopecia or female pattern hair loss is the most common cause of hair loss. This condition also occurs in men but the pattern of hair loss is different.
Chronic telogen effluvium is another common cause of hair loss often seen in females.
Frontal fibrosing alopecia is a scarring process seen in middle-aged alopecia in the frontal area and may be related to use of sunscreens in this area.
Traction alopecia can lead to hair loss due to tight traction of the hair for prolonged period and causing trauma to the hair bulbs.
A dermatologist will help formulate a treatment plan taking into consideration the risk benefit ratios of all practical treatment options as well as diagnosing the type of hair loss present.