When does alopecia occur

Alopecia can occur at any age, with most people developing it between the ages of ten and thirty. Children under the age of ten can also develop alopecia, which tends to be more widespread and advanced in them.

Alopecia:

Hair loss is a very common problem, and alopecia is one of the types of hair loss that occurs as a result of the immune system attacking hair follicles, leading to hair loss. Hair loss can occur anywhere on the body, but alopecia areata primarily affects the face and scalp. Hair falls out in patches, and in some cases, hair loss can occur in larger amounts. Most people with alopecia do not have any other symptoms.

Is alopecia hereditary

If your family members have alopecia, you are more likely to be at higher risk of developing alopecia. However, not having a family history of alopecia does not mean you won’t develop it. Recent studies suggest that genetics play a role in causing alopecia areata, with most of these genes affecting the immune system.

Types of Alopecia:

• Alopecia areata: In this type, which is the most common, hair loss occurs in one or more patches on the scalp or body.
• Alopecia totalis: People lose most or all of their hair on the scalp, and rarely may lose all or nearly all hair on the scalp, face, and rest of the body.

What are the symptoms of alopecia:

Alopecia mainly affects hair but can also have effects on nails. People affected often do not have any other symptoms. Alopecia areata usually starts with sudden oval or round patches of hair loss on the scalp but can occur anywhere on the body, such as the beard in men or eyebrows and eyelashes. There may be short broken hairs in the affected areas without skin rash, redness, or scarring. Hair may regrow in bald patches but may be followed by further episodes of hair loss that are difficult to predict.
As for nail changes: Some people may experience changes like ridges or pitting, especially those experiencing more significant hair loss.

Diagnosis of Alopecia:

Alopecia is diagnosed through clinical examination, with a dermatologist typically using a dermatoscope (a magnifier) to get a better view of the affected area. The doctor may also need to perform a skin biopsy or remove some hairs for microscopic examination. – The doctor may request some tests for thyroid gland levels, iron, and vitamins. Inform your doctor if anyone in your family has had alopecia in the past.
Can hair regrow after alopecia? Hair tends to grow back on its own completely in people who have:

1. Less widespread hair loss
2. No nail changes
3. Developed the disease at a later age
4. No family medical history

Treatment for Alopecia:

It is important to know that there is no one-size-fits-all treatment for alopecia, and it varies depending on the patient’s condition. Your doctor may inform you that your alopecia does not require treatment but should be monitored. The doctor will choose the appropriate treatment for your condition based on factors such as:

1. Onset of hair loss
2. Amount of hair loss
3. Age (treatment varies with age, especially in children)

If you have one or two bald patches that have appeared less than a year ago, the doctor may recommend observation and waiting, especially in children, as hair may regrow without any medical intervention or medication.
Children aged 10 years and under: Hair often regrows spontaneously in these children, but the doctor may prescribe:

1. Topical corticosteroids: Applied once or twice daily to the bald patches, this treatment can be effective on its own for combating bald patches.
2. Minoxidil: A relatively safe option for children with minimal side effects, it helps maintain new hair growth.

For children over 10 years old, treatment is based on the amount of hair loss. If significant hair loss is present, the doctor may prescribe immunomodulatory or topical immunosuppressive treatments for children over 12 years old.

For adults and older children:

1. Corticosteroid injections: Directly injected into the bald patches, multiple doses are needed every 4-6 weeks for effective treatment. This procedure can be slightly painful but is effective, with new hair growth typically visible after the first dose within about 3 months.
2. Topical corticosteroids: Applied once or twice daily to the bald patches, often yielding better results in children than in adults.
3. Anthralin: Applied to the bald patches and left on the skin for a specified duration, it may cause skin irritation. Minoxidil should be used after hair growth for optimal results.
4. Minoxidil: Maintains new hair growth and requires multiple applications per day (2-3 times), often combined with another treatment, providing good results on the scalp, beard, and eyebrows.

Alopecia Totalis:

Sometimes alopecia can progress to cause widespread hair loss rather than just bald patches, resulting in complete hair loss on the scalp or even the body. In such cases, medical treatment is necessary as only a few patients will experience spontaneous regrowth without medical intervention:

1. Topical immunomodulatory treatment: This treatment aims to stop the immune system from attacking hair follicles and requires regular visits for treatment repetition.
2. JAK inhibitors: These medications inhibit the immune system attacking hair follicles and can help treat widespread hair loss. They may aid in regrowing eyelashes and eyebrows, such as Baricitinib (one tablet daily) and Ruxolitinib for children over 12 years old and adults (also one tablet daily). Consult your dermatologist for prescription based on your condition.

There are also many other solutions available such as wigs, hair transplants, and various procedures that may help overcome this issue.

Hair Transplantation:

Hair transplantation is a promising solution for those suffering from permanent hair loss. It provides permanent and consistent results, allowing you to get rid of artificial hair and hairpieces. This technique yields very natural results to the extent that no one will notice that you have done anything.
Hair transplantation is often considered after trying several medications and other routines. During the procedure, a strip containing hair follicles is removed from an area where hair is denser and transplanted to the treatment area. The success rate of the procedure is very high, and there are no long-term side effects.
The results of hair transplantation largely depend on the surgeon you choose, especially concerning the natural appearance desired by patients. Understanding the problem of hair loss is crucial, and then the doctor will inform you if you are a candidate for hair transplantation.

Who is a candidate for hair transplantation:

Anyone, whether male or female, can undergo hair transplantation. It is preferred that the patient has:
1. Sufficient good hair on their scalp to transplant to areas in need of hair (especially on the sides and back of the head as donor areas, considering hair color, thickness, and texture).
2. The ability for hair growth in the thinning area of your scalp.

Your dermatologist will provide you with this information after examining your scalp thoroughly. Some blood tests or scalp biopsies may be required to determine the cause of hair loss.

During the hair transplantation procedure:

The procedure takes about 4-8 hours. If you are having a large amount of hair transplanted, you may need to return for a few hours the next day. Local anesthesia is administered only to the scalp, so patients remain awake during the procedure.
Hair is removed from healthy areas either by cutting a strip of skin with healthy hair from the scalp or by removing individual hairs. Technicians prepare the removed hair, and the surgeon prepares your scalp. One or more surgeons (depending on the amount of hair to be transplanted) then transplant the hair. Once completed, the scalp is bandaged.

Results of hair transplantation:

The results of the surgery start to appear 6-9 months after the procedure and may take up to 12 months to fully show. The transplanted hair may fall out after a few weeks, but new hair growth will begin. Doctors may prescribe medications to treat hair loss for optimal results. Multiple procedures may be needed for desired coverage, with healing between surgeries taking several months.

What should you do before undergoing hair transplantation:

1. Avoid smoking two weeks before surgery.
2. Arrange for someone to drive you home after the procedure (often performed on an outpatient basis).
3. Follow simple post-operative instructions provided by your doctor, including caring for bandages on your scalp, taking pain relievers (as your scalp may become more sensitive), and anti-inflammatory drugs.