Hair Transplant

Circular Hair Loss (Alopecia Areata): Symptoms, Therapy

Circular Hair Loss, an immune attack on the hair root occurs. Circular Hair Loss, the result: Mostly round, bald spots on the head, on the eyebrows, or in the beard. Often this happens already in childhood or young adulthood

Circular hair loss (alopecia areata): immune attack on the hair root

Circular Hair Loss, The exact causes of this disease are unknown. Doctors assume that it is a misreaction of the body’s immune system. Instead of fighting dangerous viruses and bacteria, the defense cells are suddenly directed against the body’s own hair. There, more precisely: at the roots of the hair, they trigger inflammation. The process corresponds to an autoimmune disease (auto-, gr. = itself). As a result, the hair no longer grows properly and falls out.

Circular hair loss occurs more often than average together with other autoimmune diseases, for example, white spot disease (vitiligo) or thyroid diseases such as Graves’ disease and Hashimoto’s thyroiditis.

Circular Hair Loss, Alopecia areata mainly affects children and young adults. According to a survey in the USA, girls could be affected even more often than boys. In some families, alopecia areata is typical, which makes a hereditary predisposition likely. This is currently being intensively investigated.

Circular Hair Loss
Circular Hair Loss

Symptoms of alopecia areata: Mostly round, bald spots

In the case of circular hair loss, individual, round, hairless spots usually form relatively quickly or in batches: in the hair of the head, less often in the beard, on the face, or in the body hair. On the edge of the hairless spots there are usually short, broken hairs, so-called “exclamation marks”, “comma” or “piston” hairs. Towards the pore on the skin, they are thinner.

In many cases, the hair grows back on its own within about six to twelve months. However, a recurrence of the disease is possible. Sometimes only the colored (pigmented) hair falls out, already existing, but so far hardly noticed gray hair remains. This gives the impression that the person concerned is graying within a very short time.

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The hairless areas can also merge and affect the whole head (alopecia areata totalis) or even the whole body (alopecia areata Universalis). This is rather unfavorable since hair loss often persists.

Circular Hair Loss, The ophiasis type is called an alopecia areata, in which the hair falls out in the neck and further in a ribbon shape along the hairline on the sides and forward. This, too, can be associated with a chronic course.

And although it sounds contradictory: a diffuse form of alopecia areata without single bald spots (alopecia areata diffuse or incognita) is also possible, albeit rarely.

Circular hair loss: diagnosis

Circular Hair Loss
Circular Hair Loss

The hair-clearing pattern and the information of those affected about the symptoms are usually already informative. But the doctor examines the body hair as a whole, the skin, and nails. Because with alopecia areata, nail changes such as so-called spot or grooved nails are also more common.

Circular Hair Loss, When looking at the scalp, for example with a dermatoscope, the tiny pores of the hair follicles can be seen on the bald spots. The fact that they are still visible is a sign that the hair can grow back in principle. For the short, broken hairs on the edge of the bald patches, see the section “Symptoms” above.

At the edges next to the bald spots, the hair is often easy to pluck out. Sometimes the doctor also notes swollen lymph nodes behind the ears. The dermatologist excludes possible concomitant diseases in cooperation with the general practitioner, if necessary also with other specialists.

Therapy of circular hair loss

Circular Hair Loss
Circular Hair Loss

Circular Hair Loss, Often the disease recovers on its own after a few months, so therapy is not required. If this is not the case, therapy with cortisone for application to the bald areas, which are then covered, can be started if the findings are pronounced. Cortisone suppresses immune reactions. In addition, there is the possibility of injecting cortisone under the skin of the hairless areas, if there are only a few of them.

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With the strong activity of hair loss, cortisone can be used in individual cases, for example, as shock therapy (in tablet form for oral use) in decreasing dosage over a short period of time. Although cortisone slows down the inflammatory response, it can occur again after discontinuation. Regrown hair then often falls out again. In addition, the side effects must be taken into account. In this regard, the doctor will weigh such therapy very carefully.

If no new growth of the hair can be detected in the hairless areas with pronounced and persistent courses, for example even after therapy experiments with cortisone, there is the possibility of treatment with the so-called contact allergen diphenylcyclopropenone (DCP). It causes an allergy to the scalp. The immune system should be stimulated and “distracted”, which ideally stops hair loss.

This external immunotherapy is not an approved therapy or DCP is not an approved drug. Treatment is provided only in individual specialized centers and at university clinics. Patients should definitely contact such a center, where one is well versed in the means. Therapy with DCP is not suitable for pregnant women or women who wish to have children.

Circular Hair Loss, Other therapeutic approaches, for example with dithranol, psoralen-UVA turban (the hairy head, especially the hairless areas, is wrapped for minutes with a cloth soaked in a special solution to make the skin more sensitive to light on contact; then the head without a turban is irradiated with long-wave ultraviolet rays), then with conventional immune-suppressing drugs or lasers are not sufficiently occupied.

Treatment of children

Circular Hair Loss
Circular Hair Loss

In children, the decision on therapy will have to be made especially carefully. First of all, other diseases must be excluded. Spontaneous regression is expected in up to 40 percent of cases. In adults, this percentage is even higher; this makes it so difficult to assess the effectiveness of a therapy!

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Circular Hair Loss, Especially in the case of mild hair loss and other favorable signs, for example, inconspicuous nails or the absence of typical concomitant diseases, a wait-and-see behavior is considered justified. Parents of affected children and adolescents should get detailed advice in the special consultation hour of a skin clinic. There you will also learn more about the possibilities of psychosocial support.

Taking zinc tablets in higher doses can also have a supportive effect on alopecia areata. This is especially worth considering for children.

Parents should explore the pros and cons of any therapy together with the doctor.

From research

Circular Hair Loss
Circular Hair Loss

The hopes of many patients and doctors now rest on so-called janus kinase inhibitors (JAK inhibitors). Janus kinases mediate certain inflammatory signals. At the hair roots, the signals can block the entry into the growth phase (anagen).

Circular Hair Loss, JAK inhibitors, which are already used for some serious rheumatic diseases and malignant diseases of the bone marrow, can interrupt the signal chain, so that the hair roots begin to grow again after local treatment. However, after weaning, they stopped growth again. There is still a lot of need for clarification, for example, on dosage and safety during use.

Circular Hair Loss information. Do not forget to share your thoughts on this subject with us. Be sure to do more research and consult your doctor about your health issues. You can search through the Google search engine.

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