What should you know about alopecia?

Alopecia is a common autoimmune disorder that often leads to unpredictable hair loss. In most cases, hair falls in small patches about a quarter size. For most people, hair loss is no more than a few spots, although in some cases it can be more severe.

Sometimes, it can lead to a complete loss of scalp hair (total alopecia) or, in extreme cases, the entire body (comprehensive alopecia)

This condition can affect anyone regardless of age and sex, although most cases occur before the age of 30.


Doctors are usually able to diagnose alopecia fairly easily by examining symptoms. They may look at the degree of hair loss and examine the hair from the affected areas under a microscope.

If, after a preliminary clinical examination, your doctor cannot make a diagnosis, he or she can take a skin biopsy. If they need to rule out other autoimmune diseases, they may perform a blood test. Since alopecia symptoms are very characteristic, the diagnosis is usually rapid and direct.


Alopecia occurs when white blood cells attack cells in hair follicles, leading to their shrinkage and slowing hair production significantly. It is not known exactly what makes the body’s immune system target hair follicles in this way.

While scientists are unsure of the cause of these changes, it appears that genes are involved where alopecia is likely to occur in a person with a close family member. One in five people with the disease is a member of his family who also has alopecia.

Other research has found that many people with a family history of alopecia also have a personal or family history of other autoimmune disorders.

Despite what many people think, there is little scientific evidence to support the view that alopecia is caused by stress. Severe stress can lead to this condition, but recent research suggests a genetic cause.


One of the most prominent symptoms of macular alopecia is incomplete hair loss.

Hair loss can be sudden and develops within a few days or over a few weeks. There may be itching or burning in the area before hair loss. Hair follicles are not damaged and therefore hair can grow again. People with few patches of hair loss often have a full and spontaneous recovery without any form of treatment.

About 30 percent of people with macular alopecia find that their condition either becomes more comprehensive or becomes a continuous cycle of hair loss and regrowth.

Nearly half of patients recover from alopecia within one year, but many will suffer from more than one episode. About 10% of people will develop total alopecia or all alopecia.

Macular degeneration can also affect the toenails and toes, and sometimes these changes are the first sign of the development of the condition. There are a number of small changes that can occur to nails:

  • The appearance of micro scratches
  • White spots and lines
  • Nails become rough and lose their shine
  • Nails become thin and divided


There is currently no treatment for macular alopecia, although there are some forms of treatment that doctors can suggest to help regrow hair more quickly.

The most common form of treatment for alopecia is the use of corticosteroids, a powerful anti-inflammatory drug that can suppress the immune system.

Other prescription drugs that promote hair growth or affect the immune system include Minoxidil, Anthralin, SADBE and DPCP. Although some of them may help regrow hair, it cannot prevent the formation of new bald spots.


Some studies support the use of photochemotherapy and offers a potential alternative to patients who are incapable or unwilling to use systemic or invasive therapies.

In addition to the aesthetic aspect, hair provides a degree of protection against weather factors. People with alopecia who lack protective hair qualities may want to:

  • Apply sunscreen if exposed to sunlight.
  • Wear wrapped glasses to protect the eyes from sunlight and debris that are usually defended by eyebrows and eyelashes.
  • Use headgear such as hats, wigs and scarves to protect the head from sunlight or keep it warm.

Macular alopecia does not directly infect people, nor is it contagious. However, it may be difficult to adapt to them emotionally. For many people, macular alopecia is a painful disease that requires treatment that addresses the emotional side of hair loss, as well as hair loss itself.

Support groups and consultations are available to people to share their thoughts and feelings, and to discuss common psychological reactions to the situation.

Some have compared alopecia to vitreous, a skin disease of autoimmune where the body attacks melanin-producing cells, leading to the appearance of white spots. Research suggests that these two conditions may present in a similar pathogenic process, with similar types of immune cells and cytokines that drive diseases and common genetic risk factors.

As such, any new developments in treatment or prevention of either disease may have consequences for the other.

Home remedies

There are some people who recommend rubbing onions, garlic, rosemary oil, honey or coconut milk in the scalp. While it is unlikely to cause harm, research does not support its effectiveness.

Some people resort to alternative treatments such as acupuncture and aromatherapy, although there is little, if any, evidence to support these treatments.