It's like something out of a bad dream. You step out of the shower, dry your hair, and are startled to discover a glaring patch of baldness on the back or side of your scalp. For the 6.6 million Americans suffering from alopecia areata, this bad dream could become their reality at any time. For such a common disease, there's a lot most people don't know or understand about alopecia areata—starting with its name. "People refer to the disease as simply 'alopecia,' but technically that word refers to any hair loss," says Adam Friedman, MD, an associate professor of dermatology and director of translational research at George Washington University. "Male pattern baldness is a form of alopecia," he adds. "But when we're talking about the disease, we're really talking about alopecia areata. Now that we've got the name down, brush up on your understanding of the disease. 1. It's a "friendly fire" disease. Like all autoimmune diseases, alopecia areata involves your body's immune system mistakenly targeting healthy cells. "Your body's natural defenses don't recognize your hair as one of the good guys, so your immune system attacks it," Friedman says. While experts aren't sure why some people develop autoimmune diseases and others don't, your genes probably play a big role, Friedman says. 2. It could come on at any age. Alopecia areata tends to appear during childhood, but it could surface at any age. It can also disappear for decades, Freidman says. "It's common to have it as a kid, have it go away, and then have it come back 20 years later," he says. 3. It's asymptomatic. Apart from the loss of hair, alopecia areata doesn't cause headaches, irritation, or other symptoms. "If the hair loss occurs on the back of the head, some people don't even realize it's there until someone else points it out for them," Friedman says. 4. It takes many forms. "The classic appearance is a perfect circle of nonscarring hair loss, meaning the bare scalp looks smooth and healthy," Friedman says. But it could also show up as an undulating band of baldness called an "ophiasis," which comes from the Greek word for snake. The disease could also affect your eyebrows, arms, or any other hairy spots on your body, he says. 5. The hair loss isn't permanent. Unlike age-related or natural baldness, alopecia areata does not damage your hair's ability to grow back. "Your immune cells come in and surround hair follicles like a swarm of bees, which stops them from producing hair," Friedman explains. "But once your immune system settles down, hair often grows back just as before." 6. Stress is a major trigger. Stress is like fuel for inflammation. So if you suffer from alopecia areata—or any other autoimmune disease—stress can launch or heighten yourhair loss, Friedman says. For this reason, exercise, meditation, and other stress-relief therapies can calm or prevent hair loss due to alopecia areata, he adds. 7. It's treatable. Treatment often involves injecting steroids into the affected area, which blocks the inflammation. "We'll do this every 3 to 4 weeks for a few months, and a lot of the time the hair will keep growing even when we stop," Friedman says. If the alopecia is more widespread, treatment may involve oral steroids or nonsteroidal immunosuppressant drugs. "These injections or drugs won't cause hair to grow in unnatural places," Friedman says. "They just release the hair follicles from the grip of that inflammation." 8. It's closely related to other conditions. If you have one autoimmune disease, you're at greater risk for others. "The pathways of your immune system are all interconnected and set off by inflammation," Friedman explains. "So if I have a patient with alopecia areata, I check for thyroid disease, lupus, and other autoimmune diseases." 9. Other lifestyle factors can initiate an outbreak. Eating a diet heavy in added sugar, drinking alcohol, and smoking all produce inflammation, and so can instigate an alopecia episode, Friedman says. 10. It could go away and never come back. While a relapse is always possible, sometimes alopecia areata abates and never returns. "It's a very unpredictable disease," Friedman says. "Sometimes it just burns out on its own, but we're not sure why that is." Source
