DEAR DR. GOTT: I don’t think I have ever seen my problem addressed in your articles before, so here goes. My granddaughter has alopecia. All her hair fell out when she was seven. She has no eyelashes or eyebrows either. What causes this and what can be done about it?
DEAR READER: Alopecia areata is an autoimmune disorder that causes a person’s body and or scalp hair to fall out. The extent of the condition varies from person to person. Some people lose clumps the size of a quarter and maintain the balance of their hair, while others can experience total loss. When alopecia occurs on the head, it is referred to as alopecia areata totalis. When the entire body is involved, the condition becomes alopecia areata universalis.
No one is immune; however, the risk for alopecia is greater for those with a family history. It also occurs more frequently in families that have a history of autoimmune disorders such as thyroid disease, lupus and diabetes. Other causes to be considered are damage to the hair shaft or follicles, fungal infections, malnutrition, medications to include chemotherapy and others and the aging process. While stress is sometimes thought to be to blame, there is no evidence to document a direct relation.
Most cases of alopecia areata resolve within a year but some are permanent. Treatment is available with drugs commonly prescribed for other conditions. Some drugs designed for psoriasis might be prescribed, as they have side effects of hair growth that may not be desired by some individuals but which is welcomed for alopecia patients. Corticosteroids are available in pill, topical or injectible forms; Rogaine (minoxidil) and Propecia (finasteride) are two medications prescribed for both men and women. On the downside, Rogaine must be used indefinitely. The process can take about three months for results and, as indicated, once discontinued, a person’s hair will fall out, negating any progress that had been made up to that point. Propecia is used for prevention of male pattern hair loss on the vertex and anterior mid-scalp area. There don’t appear to be any common side effects with Propecia but any chest tightness, breast enlargement, depression or pain should be reported to the prescribing physician promptly.
On the home front, therapeutic massage will increase blood circulation to the scalp, while reducing stress. Massage using essential oils of cedarwood, thyme, rosemary, lavender and others might be considered.
There is no effective prevention known but promoters of products continue to endorse items that will likely have no benefit in the long run. A great deal of research remains before more is understood about this very complex condition that can be devastating for those so diagnosed. Alopecia is not a serious medical condition, nor is it contagious; however, it can have an enormous psychological impact on those afflicted. While not ideal, wigs or hair pieces are always an option. Surgical options to combat baldness might include hair transplants and grafts — effective but extremely expensive and often painful procedures.
Without knowing how old your granddaughter is now and how long the alopecia has persited, I cannot offer a prognosis. If it has lasted a year or more, she’ll likely have to learn to deal with the condition and make the most of it. Support is available through the group Bald Girls Do Lunch at www.BaldGirlsDoLunch.org.