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Alopecia areata | Everything you need to know

Table of Contents

What is alopecia areata?

Many people use the term alopecia to describe male or female pattern hair loss, however alopecia is a broad and general term just meaning hair loss.

Alopecia areata is a specific type of non-scarring hair loss, meaning it does not scar the hair follicles, that is caused when the body attacks its own hair follicles. This can occur anywhere in the body and in males present in the beard as well.

How does alopecia areata present?

Alopecia areata presents as “bald patches” seen throughout the scalp, beard or other parts of the body. There can also be ridges in the nails.

What causes alopecia areata?

The exact cause of alopecia areata is unknown, or idiopathic, however the main theory is that it is a type of autoimmune condition where the body causes its immune cells to attack the hair follicles and the resulting inflammation causes the hair to fall out. 

What are the types of alopecia areata:

  1. Alopecia areata: Patchy baldness that can develop anywhere on the body including scalp, beard, eyebrows, eyelashes and armpits.
  2. Alopecia totalis: this is complete loss of hair on the entire scalp.
  3. Alopecia universalis: this is when the hair loss occurs all over the body, leaving the entire body hairless.

Is stress causing my alopecia areata?

Stress can definitely worsen the condition however is not a direct cause.

Does having alopecia areata mean I am sick?

Alopecia areata is not correlated with any underlying disease or condition. A small portion of people do have other autoimmune conditions such as thyroid disease but most people have no other illness. 

 

Other important issues in alopecia areata

Will I pass on alopecia areata to my children?

There is a chance of passing on alopecia to your children, however the chance is quite low. 

 

Can my alopecia areata happen again?

 

It is important to know this condition can definitely recur in different areas of the scalp or body.

 

Can I treat my alopecia areata?

 

Alopecia areata is definitely a treatable condition. Sometimes the hair may grow back itself, however the main treatment is calming down the inflammation. 

 

The most effective treatment is a combination of Injectable corticosteroids along with Platelet Rich Plasma injections. The combination of the two therapies aids in reducing the surrounding inflammation as well as improving the blood supply and nutrients to the area. 

collagen to improve elasticity in the skin  reducing scars, wrinkles, lines and sagging appearance. 

Case Study: Alopecia Areata

Here we present a case study of a middle aged female (55 years old), presenting with a history of rapid hair loss confined to specific spots on the scalp.

 

Patient History:

 

A 55 year old female patient presented to Monarch MD for our hair analysis experiencing  bald patches throughout the scalp. There was no family history of hair loss in her family. She hadn’t tried any other treatments or supplements. The hair loss was not related to any menopausal symptoms.

 

Examination:

 

Scalp Examination: Bald patches seen throughout the scalp.(see photos below)

Trichoscopy findings

Trichoscopy showed vellus and Miniaturization of hairs throughout along with single hair follicles. The yellow dots seen indicate follicular inflammation. The presence of exclamation point hairs are classic findings in alopecia areata. (See images below)

Assessment, diangosis and treatment

Assessment: 

In any patient with random bald patches that are round or oval in shape, sharply demarcated and have no scarring, alopecia areata is the likely diagnosis. This condition can also extend into the beard for male patients. 

Diagnosis: 

Alopecia Areata. 

Treatment Plan:

  1. Steroid Injections: 4 sessions of intralesional (into the affected areas) steroid injections once per month were recommended. 
  2. Platelet Rich Plasma (PRP): 4 sessions of PRP were recommended staggered with the steroid injections.
  3. Topical Minoxidil: Topical Minoxidil during the treatment course was recommended to improve blood supply and hasten hair regrowth. 

The photos below were taken 4 months apart. The patient’s condition will continue to improve and she will have a successive PRP in one month.

 

Below is a repeat of the trichoscopy 4 months after the first PRP treatment and corticosteroid treatment. As seen in the image, the density of hair has improved. In addition, there is less follicular inflammation indicated by the yellow dots.

Frequently asked questions about microneedling

  • What Areas Can Be Treated?

Morpheus8 is usually used to treat the face and neck area and can be employed to treat nasolabial folds, jowling, wrinkles and lines, a loss of facial fat volume in the midface, aging in the neck and acne and acne scarring.

  • How Many Microneedling Treatments Are Needed To See Results?

Generally anywhere from 3-4 treatments are recommended however, accurate estimates of number of treatments and treatment frequency depend on your skin texture, tone and laxity. During our free consultation, we will provide a full assessment and be able to provide you with the number of treatments to optimize your results.

  • How Soon After A Morpheus8 Treatment Can I Wear Makeup?

It may be suitable to apply makeup 1-2 days after treatment.

  • What Kind of Post Procedure Care Is Required?

After treatment, patients should minimize sun exposure and apply a broad spectrum sunscreen everyday. In addition, daily moisturizing is important.

  • Are There Any Side Effects After Treatment With Microneedling?

Our team will discuss the side effects you might experience during your consultation and decision regarding the extent of your treatment plan. However, side effects of Morpheus8 may include: Transient redness and swelling – It is possible that some patients may experience temporary bruising. The microneedling aspect of treatment may leave tiny points on the skin that crust and flake off. Mild tenderness or soreness may result from the absorption of RF energy and can be managed with over-the-counter pain medication.

  • Can Microneedling be combined with Platelet Rich Plasma (PRP)?

To enhance your results, microneedling can be used in combination with PRP, using your own plasma.

  • What Is the Benefit of Fractionated Energy?

Fractionated Radiofrequency (RF) energy is a scientifically proven method to reduce wrinkles and rebuild collagen and fat.

  • What Is The Benefit of Radiofrequency (RF) Energy?

RF energy improves skin complexion and texture through heating the deep layers of the skin to promote collagen production.

 

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