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“Bogie noticed a bare spot on his cheek where his beard was not growing. The one spot increased to several – then he’d wake in the morning and find clumps of hair on the pillow . . . A visit to the doctor was in order. The verdict was that he had a disease known as alopecia areata – in layman’s terms, hair falls out . . . . His next film was going to be The Treasure of the Sierra Madre with John Huston, and he’d have to wear a wig . . .”
– From “Lauren Bacall By Myself”
t goes by the lilting name of alopecia areata, but patchy hair loss – as it’s commonly called – would not be desirable by any name. Still, it can be treated so don’t despair.
Patchy hair loss is pretty much what it says it is – a condition of the scalp and other hairy areas of the body that begins with the sudden appearance of one or more small, round or oval bald patches which gradually enlarge over a period of weeks. It affects all age groups but is more common among children and young adults.
The bald patches appear rather quickly on an otherwise normal, healthy, hairy area. They do not itch, burn, or cause any pain. The scalp is the area most commonly affected, but alopecia areata can affect the beard, eyebrows, eyelashes, and any other hairy region as well. The hairs at the periphery of these balding patches are usually loose and easily pulled out.
In severe cases, patches on the scalp become so large that they merge to produce a total loss of all the scalp hair. This is alopecia totalis. In rare cases, the condition may progress until every hair of the entire body falls out–alopecia universalis. (Queen Elizabeth I of England contracted this condition in 1562 following her severe bout with smallpox. She was completely bald for the remainder of her life and resorted to wigs and other artifices.)
No one knows why the hair root on some people simply stops making hair. I explain to my patients that while the hair growing “equipment” is in no way damaged, the “hair-growth switch” has been turned off. And once the switch has been turned back on, renewed hair growth will take place.
Theories have linked alopecia areata to certain hormonal changes, blows to the head, and severe emotional strain or shock. In some cases it runs in families. The latest theory is that alopecia areata may be an autoimmune disorder–a type of “self- allergy,” where the body rejects its own tissue, in this case the hair follicle.
Fortunately, for many people, alopecia areata is a temporary, self-limiting affliction. Even without treatment, the hairs often begin to grow back slowly after a few weeks or months. At first, the regrowth occurs as fine, downy white hairs. Eventually these hairs develop their normal texture and color. The course is erratic and unpredictable. As a rule, however, the greater the initial hair loss and the earlier in life it begins, the more likely it is to persist or recur.
Is there any treatment for alopecia areata? And can we turn the “switch” back on? Yes.
First of all, stop worrying. Make sure that your general health is good. Only your general physician can correct any deficiencies and give you a “clean bill of health.”
Other treatments include injections of certain cortisone-like drugs directly into the bald patches. These injections are relatively painless and can hasten the regrowth and often prevent further hair loss. In severe cases, applying cortisone-type creams to the patches and covering them tightly with plastic or Saran Wrap may help.
A topical drug, Rogaine (see page 000), also offers some promise in growing new hair in these balding patches, and your dermatologist can give you all the information regarding it.
Other treatments include PUVA (the same type of treatment that is often used to treat patients with psoriasis – see page (000) and applying strong sensitizing agents to stimulate the hair follicle to turn the “switch” back on. One of the latest experimental drugs for alopecia areata is one that is used in kidney transplant patients to prevent organ rejection. Called tacrolimus – Prograf – this medication has been made into an ointment which, when rubbed into the balding patches will, afer several weeks or months, restore the hair. It sounds promising, but the jury is still out . . . .
Massage and hair tonics are worthless. If they do seem to help, it is only because time itself has allowed nature to do its job.
If you have an extensive and persistent case of alopecia areata, you may find that a hairpiece will give you peace of mind.
For further information regarding alopecia areata, get in touch with either of the following:
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National Alopecia areata Foundation 710 “C” Street - Suite 11 P.O. Box 150760 San Rafael, California 94915-0760 415-456-4644; Fax: 415-456-4274 E-mail: info@naaf.org www.alopeciaareata.com HAIR (Help Alopecia International Research) |
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