What Is Alopecia Areata, and Can It Be Treated?

Alopecia Areata Awareness Month falls in September. Professor Caitriona Ryan, Consultant Dermatologist and Co-founder of the Institute of Dermatologists, discussed the condition on Newstalk's Pat Kenny Show.

Alopecia areata is an autoimmune condition where the immune system mistakenly attacks the hair follicles, causing sudden, round or oval patches of hair loss, most commonly on the scalp.

It can affect children and adults, and in more severe cases can involve the eyebrows, eyelashes and body hair. There is no single treatment that guarantees full regrowth, but several topical and systemic options can help.

What Is Alopecia Areata?

Alopecia means hair loss, and in alopecia areata, one or more round patches of hair loss appear, usually without warning. It can affect males and females at any age, starts in childhood in around half of cases, and carries a lifetime risk of roughly 1 to 2%.

As Professor Ryan explained: "[Alopecia Areata] that's the type that is your own immune system attacking your hair follicles. You'll see round or oval shaped patches gone. Sometimes in more severe cases, every bit of hair on the body is gone, scalp, eyebrows, eyelashes, and body hair. This is something that can affect young children, but it can happen all the way through life, and it can be devastating."

What Causes Alopecia Areata?

It is more common in people with a family history of alopecia areata or other autoimmune conditions such as vitiligo or thyroid disease, and it is also seen more often in those with atopic dermatitis (eczema).

Triggers linked to its onset include physical trauma, hormonal change, and emotional or physical stress.

What Are the Stages of Alopecia Areata?

It typically develops in three stages: sudden loss of hair in a patch, enlargement of that patch, and then regrowth of fine, downy hair within it.

How Is Alopecia Areata Treated?

Treatment depends on the person's age, where the hair loss is, and how much of the scalp or body is affected.

• Topical potent or ultra-potent steroids, and minoxidil foam, as first line treatments

• Intralesional steroid injections directly into each patch, usually repeated every 6 to 8 weeks

• Topical immunotherapy for suitable adults (not generally recommended for young children)

• Oral steroids, sometimes given in pulsed doses, though long term use is avoided due to side effects

• Oral systemic therapies such as ciclosporin or methotrexate for severe cases that haven't responded to other treatment

• Newer JAK inhibitors such as tofacitinib, an oral therapy now being considered for severe cases

Living With Alopecia Areata

Hair loss can take a real emotional toll. Counselling can help those significantly affected, and camouflage options such as hair fibres or hairpieces are worth discussing with your dermatologist as part of a treatment plan.

Frequently Asked Questions

Is alopecia areata permanent?

Not always. Many people regrow hair, sometimes without treatment, though the condition can also recur.

Can children get alopecia areata?

Yes, it starts in childhood in about half of all cases.

Is alopecia areata caused by stress?

Stress is one possible trigger, alongside trauma and hormonal change, but it isn't the only cause.

How is alopecia areata different from other types of hair loss?

Alopecia areata is autoimmune and causes patchy loss, unlike genetic pattern hair loss or stress related shedding. See our guide to the four types of hair loss for the full picture.

Get in Touch

If you're noticing patches of hair loss, a consultation with your GP or dermatologist is the right first step to explore treatment options suited to you.

Source: Professor Caitriona Ryan discussed hair loss with Ivan Yates on The Pat Kenny Show, Newstalk.