Alopecia areata can affect any hair-bearing part of the body. It primarily affects the scalp, eyebrows, eyelashes, and body hair. People can also lose their nose hairs, which leaves them susceptible to dryness and subsequent increased runny nose and heightened sensitivity to environmental allergens and pollutants. Nasal rinses, lubricating gels and sprays can help with the dryness and runny nose, and antihistamine sprays can help mitigate the allergic rhinitis, also known as hay fever. Some individuals that have lost their eyelashes report increased sensitivity and eye irritation. This can be relieved with lubricating eyedrops and the use of sunglasses while outside to prevent dust and other particles from getting into the eyes. Please speak to your primary care provider if you have concerns about alopecia areata and your health.
It is very uncommon for two or more siblings to have alopecia areata – particularly if their parents don’t have it. In terms of twin siblings, Jackow et al. (1998) reported that the concordance rate of alopecia areata in monozygotic twins was 55%, and 0% for fraternal twins.
There may be a hereditary component to alopecia areata. However, some patients are the only people in their families to have the disease. Some people with alopecia areata will have children that do not develop the disease, and for some people the disease runs across several generations. Simply put, further research is required to fully determine the role of genetics in the disease susceptibility and progression. Having said that, the chances of a person developing alopecia areata in their lifetime is approximately 2% (Villasante Fricke & Miteva, 2015).
It is normal to experience grief after developing alopecia areata. We associate much of our identity with how we look, so it is common to feel like you have lost a part of who you are. The grieving process is different for everyone.
People newly diagnosed with alopecia areata can experience a variety of emotions including sadness, hopelessness, guilt, fear, isolation, loneliness, anger, and frustration. In some cases, individuals may experience more significant feelings of anxiety and depression. If these feelings are affecting your ability to function at home and at work/school, etc., please seek help from your primary care provider.
You may never truly feel exactly like your “old self” again, as you didn’t have alopecia at that time. What is important is that you get to a place in your life where you can be happy and live life the way you used to without alopecia getting in the way. For some people it takes a few weeks, others a few months, and some require support from medical and mental health professionals. CANAAF is here to support all Canadians with alopecia areata and provide them with the insight and awareness of resources they need to be the best they can be.
In general, alopecia areata is unpredictable. There is no way to tell when the hair will fall out, when it will grow back, how much will grow back, and how long the hair growth will last. Medical treatments such as corticosteroids and immunosuppressants are able to suppress the autoimmune response and give the body a better chance at growing and retaining hair.
People with more advanced forms of alopecia areata, such as Totalis, Universalis, Ophiasis, etc., tend to be more resistant to meaningful hair growth, but this does not mean that they cannot regrow hair. This lack of understanding underpins the need to fund biomedical research for alopecia areata.
Sun protection is recommended for all individuals – hair or not. However, individuals with hair loss on the scalp are more susceptible to sunburns on the head and other harmful effects of ultraviolet (UV) radiation.
Hair helps to block UV radiation from reaching the surface of our skin, thus, when an individual loses their hair, they also lose some of that protection. Prolonged, unprotected (not using sunscreen or physical barriers) exposure to the sun increases one’s risk of developing skin cancer. Even people with hair are encouraged to wear a hat or spray their scalp with sunscreen if they’re going to be out in the sun for long periods of time.
Therefore, people with alopecia areata are encouraged to use sunscreen on their scalp or cover it with a hat, bandanna, scarf, or wig when out in the sun for long periods of time.
Alopecia areata is often diagnosed simply by the physician examining the scalp and obtaining a medical history. Often, your primary care provider or dermatologist will order blood work to assess you for other conditions that can contribute to alopecia areata, such as hormonal abnormalities or vitamin deficiencies. In rare circumstances where the diagnosis is unclear, your dermatologist may perform a scalp biopsy to determine the cause of your hair loss.
If they don’t, direct them to our website! They can learn more about supporting you and other people with alopecia areata.
Typically, the hair loss caused by alopecia areata is not associated with any symptoms. However, some people have reported mild itching and tingling in the areas of hair loss.
It is not common for alopecia areata to be passed on from parents to children – but it is still possible. A study from Blaumeiser et al. (2006) found that the chance of a child developing alopecia areata in their lifetime was only 5.7% if their parent had it. This is slightly higher than the lifetime incidence risk of 2% for individuals who do not have parents with alopecia areata.