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Additional Information
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What Is Alopecia Areata?
Alopecia areata is considered an autoimmune disease, in
which the immune system, which is designed to protect the
body from foreign invaders such as viruses and bacteria,
mistakenly attacks the hair follicles, the tiny cup-shaped
structures from which hairs grow. This can lead to hair loss
on the scalp and elsewhere.
In most cases, hair falls out in small, round patches about
the size of a quarter. In many cases, the disease does not
extend beyond a few bare patches. In some people, hair loss
is more extensive. Although uncommon, the disease can progress
to cause total loss of hair on the head (referred to as alopecia
areata totalis) or complete loss of hair on the head, face,
and body (alopecia areata universalis).
What Causes It?
In alopecia areata, immune system cells called white blood
cells attack the rapidly growing cells in the hair follicles
that make the hair. The affected hair follicles become small
and drastically slow down hair production. Fortunately, the
stem cells that continually supply the follicle with new
cells do not seem to be targeted. So the follicle always
has the potential to regrow hair.
Scientists do not know exactly why the hair follicles undergo
these changes, but they suspect that a combination of genes
may predispose some people to the disease. In those who are
genetically predisposed, some type of trigger--perhaps a
virus or something in the person's environment--brings on
the attack against the hair follicles.
Who Is Most Likely To Get It?
Alopecia areata affects an estimated four million Americans
of both sexes and of all ages and ethnic backgrounds. It
often begins in childhood.
If you have a close family member with the disease, your
risk of developing it is slightly increased. If your family
member lost his or her first patch of hair before age 30,
the risk to other family members is greater. Overall, one
in five people with the disease have a family member who
has it as well.
Is My Hair Loss a Symptom of a Serious Disease?
Alopecia areata is not a life-threatening disease. It does
not cause any physical pain, and people with the condition
are generally healthy otherwise. But for most people, a disease
that unpredictably affects their appearance the way alopecia
areata does is a serious matter.
The effects of alopecia areata are primarily socially and
emotionally disturbing. In alopecia universalis, however,
loss of eyelashes and eyebrows and hair in the nose and ears
can make the person more vulnerable to dust, germs, and foreign
particles entering the eyes, nose, and ears.
Alopecia areata often occurs in people whose family members
have other autoimmune diseases, such as diabetes, rheumatoid
arthritis, thyroid disease, systemic lupus erythematosus,
pernicious anemia, or Addison's disease. People who have
alopecia areata do not usually have other autoimmune diseases,
but they do have a higher occurrence of thyroid disease,
atopic eczema, nasal allergies, and asthma.
Can I Pass It on to My Children?
It is possible, but not likely, for alopecia areata to be
inherited. Most children with alopecia areata do not have
a parent with the disease, and the vast majority of parents
with alopecia areata do not pass it along to their children.
Alopecia areata is not like some genetic diseases in which
a child has a 50-50 chance of developing the disease if one
parent has it. Scientists believe that there may be a number
of genes that predispose certain people to the disease. It
is highly unlikely that a child would inherit all of the
genes needed to predispose him or her to the disease.
Even with the right (or wrong) combination of genes, alopecia
areata is not a certainty. In identical twins, who share
all of the same genes, the concordance rate is only 55 percent.
In other words, if one twin has the disease, there is only
a 55 percent chance that the other twin will have it as well.
This shows that other factors besides genetics are required
to trigger the disease.
To learn more about the genes and other factors involved
in alopecia areata risk, the National Institute of Arthritis
and Musculoskeletal and Skin Diseases (NIAMS) is funding
an alopecia areata registry. The registry is an organized
network of five centers throughout the United States that
will identify and register patients with the disease and
collect data and blood samples (which contain genes). Data,
including genetic information, will be made available to
researchers studying the genetic basis and other aspects
of disease and disease risk.
Will My Hair Ever Grow Back?
There is every chance that your hair will regrow, but it
may also fall out again. No one can predict when it might
regrow or fall out. The course of the disease varies from
person to person. Some people lose just a few patches of
hair, then the hair regrows, and the condition never recurs.
Other people continue to lose and regrow hair for many years.
A few lose all the hair on their head; some lose all the
hair on their head, face, and body. Even in those who lose
all their hair, the possibility for full regrowth remains.
In some, the initial hair regrowth is white, with a gradual
return of the original hair color. In most, the regrown hair
is ultimately the same color and texture as the original
hair.
What Can I Expect Next?
The course of alopecia areata is highly unpredictable, and
the uncertainty of what will happen next is probably the
most difficult and frustrating aspect of the disease. You
may continue to lose hair, or your hair loss may stop. The
hair you have lost may or may not grow back, and you may
or may not continue to develop new bare patches.
To read the rest of this article (including
treatment information) from the National Institute
of Arthritis and Musculoskeletal and Skin Diseases (NIAMS),
please click here: http://www.niams.nih.gov/hi/topics/alopecia/alopecia.htm
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