Alopecia areata (alopecia) and alopecia areata treatment for men, women and children, the reasons

Very often, round bald spot on my head is a godsend in scratching, especially for those with long hair, as the hair falls out without any subjective sensations.

What is alopecia areata and what can you do if you found such a rounded hearth in themselves or their loved ones, read our article.

In children

Children alopecia alopecia is quite rare compared to other types of alopecia, and the first symptoms develop most often after 3 years.

Development theory

To date, the causes of disease are not found, because scientists developed a theory that starts focal alopecia as a symptom of one of the diseases or conditions of the body.

Parasitic theory

Hair loss due to worm infestation or presence in the body other parasites which can cause local hair loss directly its presence in the skin or indirectly via the blood (toxins) or immune system (antibodies and immune complexes).

It should be noted that the parasitic theory currently has more evidence against than for. Because most researchers and practitioners do not recognize it.

Hereditary theory

There are observations for which alopecia areata is often found in those parents, who in childhood was also marked by episodes of local hair loss.

Animals found in similar manifestations of a genetic component fixation which descendants received the bald breed of cat (Sphynx), dogs, rats, and more recently, and Guinea pigs. People the accuracy of the hereditary theory of the development of alopecia areata is discussed.

Endocrine theory

According to this theory the development of focal alopecia is associated with thyroid diseases.

The neuroendocrine theory

The disease develops as a reaction of the child on the psychological and mental trauma. In favor of this theory is the fact that alopecia areata often develop simultaneously with vitiligo.

It is believed that the nervous shock and emotional stress can cause disorders in the immune system, when immune cells or immune complexes damage the skin and hair follicles in it.

Also discusses the likelihood of developing persistent local spasm of the blood vessels of the skin under the influence of stress factors, which leads to impaired growth and hair loss.

The theory of the influence of local infection

It is seen that alopecia areata often occurs in those children who have in the body there are pockets of chronic infection: often recurrent purulent otitis, purulent inflammation of the tonsils (tonsillitis), dental caries (there is also the reproduction of pathogenic bacteria), osteomyelitis and others.

How does

Usually the first manifestation become rounded foci of the skin of the scalp in which hair completely falls out. Such foci may be single but may be multiple foci. The edge of the hearth clear. In diameter the area of baldness can be from 1 to 10 centimeters. Lesions grow on the periphery and gradually merge.

The hair on the border with foci of alopecia is easily pulled out. This so-called «zone of loosened hair.» The skin in the area of baldness is not changed. She was a regular color, maybe a little redness, no peeling and crusts, the hair follicles are dilated.

To loss of hair change in a certain way. Hair breaks off at a distance of about 3 mm above the skin. Part of the hair shaft just above the skin becomes thinner and loses pigment. In the end, lost hair has a normal root, the thinned portion at the base of the hair shaft and the normal structure of the rest of the rod.

Externally this hair resembles an exclamation point «!». Often at the same time with hair loss or a little earlier the change in the shape and structure of nails. The nail plate becomes thin, krohkie, easily stratified, on their surface there are longitudinal furrows, sunken areas.

In particular, oficinas form of the disease, the hair begins to fall out of the back of the head towards the temples or around the entire circumference of the head with the border of hair growth.

This form of alopecia areata, and nail involvement were considered to be inauspicious signs, indicative of the intensity of the process and a high likelihood of a malignant (universal) alopecia, when the hair falls out all over the body. Malignant alopecia practically cured.

Poor prognosis for those children that have:

  • the disease began in early childhood;
  • episodes of alopecia was accompanied by the emergence of a large number of pockets of large area or complete loss of hair on the head;
  • marked nail involvement began long before the appearance of foci of baldness;
  • alopecia areata is combined with atopic dermatitis.
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Diagnosis

The disease has almost no other symptoms besides the appearance of foci of hair loss. Sometimes there may be a slight tingling or itch just before the hair loss.

The most common complaint is discomfort from changes in your own appearance. Diagnosis is about finding hair in the form of an exclamation mark and the exclusion of any other diseases in which hair can fall out in limited areas of the skin. For this perform:

Trichogramma

On the border areas of alopecia pull 25-50 hairs and examine them under a microscope to determine the structure of the hair, stages of their growth.

A skin biopsy of the scalp

A sample of the skin and histological examination allows to exclude cicatricial alopecia in lupus or planus and violent pulling of hair with this mental illness as trichotillomania (irresistible desire to pull out own hair and, quite often, to eat them), skin atrophy in this disease as pseudopelade of Brock.

Scraping of the skin

Usually scrapings taken exception fungal diseases of the skin, which may cause local hair loss. This happens when microsporia and trichophytosis. First, skin cells are examined under a microscope to find them in the cells of the mycelium.

Microscopically if nothing is found, shall then be sowing on fertile ground, where the fungus, if present in the sample, gives rise to manifest herself.

General clinical examination

Appointed General and biochemical blood tests, feces analysis on helminth eggs and other to rule out the presence of anemia, diseases of the endocrine and nervous systems, helminth infection, local foci of chronic infection in the body.

All of these studies is assigned to the patient at the discretion of the physician only in cases where the diagnosis is unclear. In most cases a characteristic appearance of the lesions, the absence of complaints and change the shape of the hair allows to make a diagnosis during the first visit to the trichologist.

Basic principles of treatment

In children with first episode of alopecia hair loss treatment is not assigned in cases when the child himself is not very concerned about changing their appearance. A waiting game is justified because more than half of the patients with a single lesion in the course of the year the growth of hair is resumed spontaneously without any treatment.

This period may be assigned to restorative therapy: iron supplements, vitamins a, E, C, PP, group or ready vitamin-mineral complexes, amino acid methionine, phytin, Riboflavin.

If hair loss is traumatic for the child, at the same time there are several sources or baldness captures the entire scalp, the treatment begins immediately, without a period of waiting and observation.

For this prescribed:

  • Glucocorticosteroid locally

Usually corticosteroid hormones administered in the form of lotion or ointment for topical application. Usually start with a lotion that is applied on areas of hair loss 1 time per day in the evening. If the lotion is very dry skin, you can begin to apply the ointment. The course of treatment is three weeks, followed by a week break. Usually, to obtain a stable effect it is necessary to undergo 3-4 courses of treatment korticosteroidami.

A more rapid effect can be obtained by intradermal injection of corticosteroids. But this method of administration is only available in a medical establishment in children older than 10-12 years, who are willing to endure the pain from injections. The injection is repeated once in 4-6 weeks to obtain a stable effect. For intradermal injections can be used diprospan or triamcinolone acetonide.

  • Anthralin

Anthralin is usually used as a local effect means that causes contact dermatitis and blocks the activity of immune cells in the affected area. Treatment antralnom is a laborious method and requires the supervision of parents and close cooperation with their physician, but it is good for those who prefer treatment at home.

  • Diaminocyclohexane

This drug belongs to the group of immunomodulators, therefore can be used only in those children who have reached the age 12letnego, the area of baldness which is more than 30% of the area of the skin of the scalp and who do not help other treatments. Diaminocyclohexane applies only in the hospital environment, where doctors have enough experience with this drug.

  • Systemic use of corticosteroids

In children taking drugs of corticosteroid hormones for the treatment of alopecia areata is ineffective and gives a great number of side effects. Against the use of these drugs can lead such a fact that after discontinuation of corticosteroids may develop recurrence of alopecia areata.

  • Local phototherapy
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Usually phototherapy is used in combination with drugs for local use, which increase skin sensitivity to UV light. But the effectiveness of this method for the treatment of low. Phototherapy is better to use to maintain the effect of treatment after recovery.

  • Minoxidil

This drug proved to be effective in the treatment of androgenetic alopecia in men and women. But clinically significant results of treatment of alopecia areata in children Minoxidil does not.
Prolonged use of the drug may be a small increased hair growth in areas of baldness, but full recovery of hair does not occur. In Germany Minoxidil is generally prohibited for the treatment of alopecia areata in children as ineffective.

  • Physical therapy

On the stage of treatment gives good results with only one method – local cryotherapy. Usually, the course requires 20-25 sessions that are held every other day or every day.

Sometimes a course has to be repeated. Other methods of physiotherapy can be applied only after clinical recovery, as maintenance procedures. Usually at home you can apply darsonval or the laser comb.

Alopecia areata in women

In women alopecia areata occurs at age 20-50 years, the peak of the first appearance of the disease occurs at the age of 25. If to speak about the reasons, the women according to frequency is dominated by the neuroendocrine mechanism for the development of alopecia areata.

Manifestations of the disease are identical with those in children. In adults, alopecia areata has its own classification.

In the area affected:

  • focal;
  • Subtotal: foci grow and merge with each other, but between plots and a complete absence of hair there are Islands or strips separating their hair;
  • total: total absence of hair on the head;
  • universal: loss of hair on the head, eyelashes, eyebrows, pubic hair and armpits.

In appearance of the affected area:

  • ofias: hair loss from the hairline to the occipital region and temples with the spread to the top;
  • psevdomatematicheskoe: occurs at the same time many small lesions a few mm in diameter, which often durg in contact with each other;
  • ringworm: the hair in this form of the disease in the foci do not fall out and break off at a short distance from the skin.

Separately in classification is diffuse alopecia areata, in which hair falls out not in individual lesions with clear boundaries, and uniformly throughout the head without the formation of visible bald spots.

Video: Female hair loss: causes and solutions

At the stage of the disease:

  • stage progression: there may be slight redness and burning in the hearth, especially at its periphery, there is a zone of loose hair, broken hair in the form of an exclamation mark;
  • stationary phase: skin normal color or pale, there is no area of the loose hair;
  • stage regression: across the surface of the lesion first appear vellus hair lacking pigment, which are then replaced by normal pigmented hair.

To confirm the diagnosis in addition to the listed methods of examination is added to the blood test for syphilis to exclude syphilitic nature of the lesions.

Signs of an unfavorable course of the disease.

  • the presence of the disease from a parent or other close blood relatives;
  • accompanying atopic dermatitis;
  • the presence of autoimmune disease;
  • frequent relapses of the disease;
  • ofias, total or universal form of the disease;
  • the heavy defeat of the nail plate;
  • hair loss re-growing vellus hair.

What to do if you happen to notice circular bald spots:

  • if the focus is only one, and in diameter it reaches three inches, then behind it to watch: if the area of hair loss does not expand, unless there are new centers, a hotbed of self-heals within three to four months without treatment;

Foci multiple foci grow and merge with each other:

  • not to look for answers and recommendations for treatment on the forums (except that the recommendations on the choice of a specialist, which is trust the treatment of your hair), you should immediately consult a trichologist;
  • to take in addition to General clinical analysis of blood from a vein in cytomegalovirus, Epstein-Barr, Mycoplasma, Toxoplasma;
  • to donate blood from a vein on hormones, thyroid, adrenal and pituitary;
  • to go to a therapist and the detection of chronic anxiety (acute you and the therapist determine), signs of depression, get the necessary psychotherapy and medication.
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The treatment is carried out about as well as in children. Corticosteroids applied topically and intradermally, local irritating and immunomodulatory drugs. But a large role in the treatment of women have folk remedies that have a local irritating effect, due to their availability and lack of side effects.

Local irritating effect: onion juice, mustard, red hot pepper, cognac and alcohol tinctures of medicinal fruits and herbs. These funds can be used as a mask before shampooing, and can be applied daily in the evening or twice a day at the hair roots in the form of medicinal tinctures.

Also from the popular media can be used acupuncture, and acupuncture, aromatherapy, evening primrose oil (both independently and as part of masks for the hair) zinc.

In hospitals at home can be used a variety of physiotherapeutic procedures, including cryotherapy, ozone therapy, d’arsonval, low-intensity laser irradiation.

You should consider the fact that in some women alopecia alopecia does not just fail to cure, can not even stop its progression up to the loss of all hair on the head and on the body.

Male pattern baldness

The only difference between alopecia areata in men is the probability of occurrence of foci of baldness in the field of mustache and beard. Particularly unpleasant is the presence of such lesions men with dark hair, who even after shaving dark hair bursting through his skin and make bald spots visible.

The treatment described above, pharmaceutical preparations, folk remedies and methods of physiotherapy. Patches of baldness on the beard can be treated to restore hair growth, and can be done laser hair removal of the cheeks, moustache area and chin so that the bristles do not remind you of the presence of bald spots.

Video: Alopecia baldness

How to treat alopecia alopecia on the beard:

  • treatment of any disease that the patient is back to health or clinically significant remission, prevention of relapse;
  • corticosteroids and immunomodulators on the face to apply undesirable, as it increases the risk of side effects;
  • photochemotherapy: the use of ultraviolet radiation after application of special drugs that increase skin sensitivity to UV radiation;
  • the use of biogenic stimulators: hirudotherapy, the use of products containing extract of saliva of leeches;
  • the use of preparations of zinc and silicon, which enhance growth and structure of hair;
  • locally irritating drugs: turpentine ointment, Naftalan alcohol, tincture of red hot pepper, chilibuhi;
  • means for stimulation of hair growth on the basis of placental extract;
  • massage and cryomassage of the face and scalp;
  • ozone therapy, laser therapy, d’arsonval;
  • electrophoresis of solutions of reserpine, aminophylline;
  • in any case should not self-medicate, it is better to consult a doctor.

If the treatment of alopecia areata inefficient:

  • always remind yourself that even if hair loss you feel good and can do the usual things: work, meet people, play sports;
  • alopecia areata does not affect lifespan;
  • there are many other people who live with this problem;
  • to value yourself, not only for the number of hairs on head and body;
  • wear sunscreen;
  • use goggles to protect eyes from sun and dust, if absent eyebrows and eyelashes;
  • apply the ointment with antimicrobial and antiviral effect, if hair falls out in the nostrils;
  • pick up a wig or a stylish headpiece to reduce the impact of hair loss on appearance;
  • to disguise the lack of eyelashes and will help permanent makeup, which in this case can be used in men;
  • to mask lesions on the beard you can use the same tattoo, which is used by women to correct the shape of eyebrows;
  • if foci of baldness is small, they can be masking a special spray or a mascara for the hair, matching the hair.