My hair is falling out in patches
Dear Dr Campbell-Chambers,
I have been suffering from alopecia areata for the past eight years. A year after I gave birth to my daughter, I noticed a patch the size of a dime. I went to the doctor (GP), he said it was a fungus and gave me a prescription. A few months later, I started noticing other small patches. I went to a dermatologist and she told me it was alopecia. When I started studying at the University of the West Indies, it got really bad. At that time, I was visiting the dermatologist and getting treatment. However, I noticed that as soon as I stopped, the hair started falling out again. I have not been to the dermatologist in two years and it is very bad now. It is really stressing me because the patches are at the front. Please help me.
Response to reader
Alopecia (hair loss) can take a significant emotional toll on affected individuals and families. I, therefore, empathise with you regarding the frustration and emotional stress you are experiencing. Alopecia areata is a non-scarring type of hair loss which can affect any hair bearing part of the body.Treatment may consist of corticosteroid injections, corticosteroid creams, topical minoxidil and/or other creams to alter the skin's immune function. Although oral corticosteroids can be used, we generally prefer not to use them for this condition due to their significant side effects with long-term use. Other options include light therapy where available. Treatments need to be used for some time (for up to 12 weeks) before hair regrowth is noticed.
It usually affects otherwise healthy persons and is not contagious. It is believed to be an autoimmune disorder in which the individual's immune (defence) system attacks their own hair follicles. Your genetic make-up as well as other risk factors, like stress, may trigger the condition. People with alopecia areata may also be affected by atopic dermatitis and additional autoimmune diseases such as thyroid disease, vitiligo and type 1 diabetes mellitus.
In most individuals, the hair loss tends to be in round patches like you described. These patches are usually smooth and free of bumps. Some nail changes like tiny pits, lines, roughness or splitting may be seen. Alopecia areata is often diagnosed based on its clinical appearance. However, a skin biopsy can confirm the diagnosis and other tests can be done to rule out other causes of hair loss.
Unfortunately, alopecia areata can be unpredictable. In some cases, the hair regrows even without treatment and in others it comes and goes despite treatment. For some, the disease goes away for good. In addition to seeking treatment, in the meantime, affected areas can be covered with remaining hair, hats, hairpieces and wigs which are being made more cosmetically acceptable. Alopecia areata support groups (e.g. www.naaf.org) and professional psychological support can help affected individuals and their families. Although it is easier said than done, you should not let this condition stop you from achieving your full potential and enjoying life. All the best!
Dr Arusha Campbell-Chambers is a dermatologist and founder of Dermatology Solutions Skin Clinics & Medi-Spas; email: email@example.com.