Inflammation-Induced Hair Loss

The impact of certain skin diseases on the lives of those affected tends to be underestimated or even dismissed as simply a "cosmetic problem." Alopecia areata exemplifies such a condition, owing to its substantial disease burden and its often devastating effects on the patient's quality of life and self-esteem. Although alopecia is one of the most common autoimmune diseases, the pathobiology of this chronic, relapsing hair-loss disorder is not fully understood.
Alopecia is the most frequent cause of inflammation-induced hair loss, affecting an estimated 4.5 million people in the United States. Depending on ethnic background and area of the world, the prevalence of alopecia is 0.1 to 0.2%, with a calculated lifetime risk of 2%. Alopecia areata affects both children and adults and hair of all colors. Although the disorder is uncommon in children under 3 years of age, most patients are relatively young: up to 66% are younger than 30 years of age, and only 20% are older than 40 years of age. There is generally no gender predilection, but more men were found to be affected in one study involving a group of subjects who were 21 to 30 years of age. In a study of 226 Chinese patients with alopecia areata who were 16 years of age, the median age at onset was 10 years, and the male: female ratio was 1.4:1; the disorder was more severe in boys and in those with an onset in early childhood.
Although diagnosing alopecia areata is usually easy, treating it is not. Curative therapy does not exist, and there is a paucity of well-conducted, long-term, controlled trials evaluating therapy for alopecia areata and its effect on the quality of life. Given the often unsatisfactory results of current therapy, some clinicians rely on the high rate of spontaneous remission and will recommend a wig if remission does not occur. Still, limited but often helpful therapeutic options do exist for both acute and chronic, relapsing alopecia areata.
Like most other autoimmune diseases, alopecia areata is a chronically relapsing inflammatory disorder, which suggests a cyclic recurrence of disease-promoting events. Also, in the absence of a perifollicular infiltrate, there is no hair loss. The main therapeutic challenge is to reduce the already established inflammatory infiltrates and to prevent both recurrence and spread to previously unaffected hair follicles. Unfortunately, currently available therapies do not predictably and satisfactorily meet this challenge.
There are many hair loss treatments on the market, conventional and unconventional. It's important not to choose the treatment yourself, but to ask for professional help and advice from your doctor, who will give you the best one for you, just be sure to follow the instructions he gives you.
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