About Alopecia and Treatments

Alopecia is a hair loss disorder that has a variety of causes. There are many ways to cope with alopecia.

Causes of Alopecia

The two types of alopecia hair loss are alopecia areata and androgenetic alopecia. In the latter, this hair loss is inherited. Hair on the head can thin and fall out, and this is more commonly known as “male pattern hair loss” or “female diffuse hair loss”. This hair loss is permanent, and most of the people affected by this are men. In alopecia areata, the immune system attacks hair follicles, making hair fall out all over the body in patches. Easily removed or broken hairs occur in oval or round patches in this disorder. Alopecia can be caused by aging and genetics, illness, chemotherapy, malnutrition, or an autoimmune disorder. A test for alopecia areata is a “fluorescent antinuclear antibody (FNA) test” which can show if there is an immune system disorder.¹ The hair may grow back normally within a year, in alopecia areata, but it may also grow back “fine and white”. 10% of those suffering from alopecia areata may never regrow their hair. This situation is more likely if there is a family history, if the disorder comes before puberty, if the patient is prone to allergies, if they have an autoimmune disease, if the hair loss is extensive, or if the fingernails and toenails have abnormal thickness, texture, color, or shape (i.e., sandpaper-like, pitted). Hair analysis and blood tests (such as for thyroid performance) may also be ordered.²

Medical and Alternative Treatments

Depending on the type of alopecia, treatments vary. If the alopecia is temporary, hair may grow back on its own. Medications, such as corticosteroids, can reduce hair loss in alopecia areata. With androgenetic alopecia, there are drug options (Minoxidil/Rogaine, Finasteride/Propecia) and surgical treatments, such as scalp reduction, grafts, or hair transplants. There are some nutritional options, such as biotin and zinc aspartate for alopecia areata. For androgenetic alopecia, saw palmetto and beta-sitosterol supplements may be helpful. All supplements should be discussed with a care provider so that they don’t interfere with other medications. One study showed that daily aromatherapy massage in the scalp (with thyme, rosemary, lavender, and cedarwood essential oils) helped to improve hair growth. Massage can increase circulation and reduce stress.³ Alopecia areata may recur; therefore, treatment options are not a cure.⁴

Coping Options

Hair loss could lead to emotional effects in the patient, so “cosmetic camouflage” is an important consideration.⁵ Without hair, the scalp is also more likely to burn in the sun. The nails may also become distorted, since they are also formed from keratin. Hay fever and allergic conditions could also increase, if the hair loss occurs in the nose. Those suffering from alopecia may develop social phobia, anxiety, stress, and depression.⁶ Patients can benefit from counseling and support from their loved ones and/or alopecia support groups. Cosmetics and prostheses are also options for patients wishing to mask their condition. The National Alopecia Areata Foundation website has many informational resources.⁷ Locks of Love is an organization that accepts hair donations to provide “hairpieces to financially disadvantaged children in the United States and Canada under age 21” who have long-term hair loss from medical conditions, such as alopecia areata.⁸