Question 1

How does alopecia start?

Accepted Answer

Alopecia areata is a type of alopecia that typically begins with sudden hair loss in round or oval patches on the scalp, but it can also affect other parts of the body such as the beard area in men or the eyebrows and eyelashes. The hair on these patches falls out very quickly and extremely, and around the edges of the patch, there are often short broken hairs or “exclamation point” hairs that are narrower at their base than their tip. Alopecia areata may occur on the scalp and can also develop slowly and recur after years between. The condition may be caused by the immune system attacking the hair follicles. Alopecia totalis is a more severe form of alopecia areata, where all hair on the scalp is lost. This form of alopecia can begin as alopecia areata, where you may start off with small patches of hair loss. Androgenetic alopecia, commonly known as male or female-pattern baldness, is another type of alopecia that usually occurs gradually and in predictable patterns. In men, it usually results in a receding hairline and bald spots, while in women, hair thinning along the crown of the scalp is common. Hormonal changes and medical conditions can also cause androgenetic alopecia. The causes and the way alopecia starts can vary depending on the type of alopecia. In some cases, alopecia may start with sudden hair loss in round or oval patches on the scalp or other parts of the body, while in other cases, it may occur gradually and in predictable patterns. Understanding the type of alopecia is important to determine the best course of treatment. Dr. Rokhsar is an expert in treating alopecia and he offers several non-surgical treatments to remedy alopecia including PRP injections, steroid injections, and prescription medications. If you are experiencing hair loss, Dr. Rokhsar will discuss your treatment options with you and determine the best course of action.

Question 2

What does alopecia look like?

Accepted Answer

The appearance of alopecia can vary depending on the type and cause of the condition.

Alopecia areata, for example, often starts as a round or oval bald patch on the scalp. This type of alopecia can also affect other parts of the body, such as the eyebrows, eyelashes, and face.

Androgenic alopecia, on the other hand, typically causes gradual hair loss, starting at the temples and crown of the head. This type of alopecia is also known as male-pattern baldness, as it is more common in men, but it can also affect women.

Traction alopecia can cause missing and broken hairs, as well as little bumps on the scalp that look like pimples.

Scarring alopecia, which is a type of hair loss caused by the destruction of hair follicles, usually appears as a bald patch where hair used to be, and the skin in that area may look smooth and shiny.

Question 3

How to know if you have alopecia?

Accepted Answer

Gradual thinning on the top of the head is the most common symptom of hair loss, which usually affects people as they age. On the other hand, alopecia areata usually presents as sudden hair loss in patches on the scalp that can grow larger and eventually merge into a large bald spot. Gray and white hairs often remain where hair loss has occurred, and hair may start to regrow where it fell out. To diagnose alopecia, Dr. Rokhsar examines the areas where hair loss has occurred and looks at your nails, hair, and hair follicle openings using a handheld magnifying device. He may also ask about your medical and family history since other health conditions can cause hair to fall out in the same pattern as alopecia areata. A pull test may be done, where he will gently tug on about 60 hairs to see if more than 6 hairs come out, which may be sent for further testing. He may also recommend you to get blood work done to rule out any systemic causes of hair loss. In some cases, a scalp biopsy may be performed to look at your scalp. Different types of alopecia may require different treatments, and in some cases, medications such as minoxidil and finasteride may be prescribed to promote hair regrowth. If you suspect that you have alopecia, we recommend you to schedule a consultation with our double board-certified Dermatologist and Dermatologic Surgeon, Dr. Rokhsar, to perform a physical examination to check the pattern of hair loss and confirm a diagnosis.

Question 4

How serious is alopecia?

Accepted Answer

While the condition is not usually life-threatening, it can cause a lot of anxiety and sadness for those who experience it. Alopecia areata can occur on the scalp, as well as other parts of the body, and may develop slowly and recur after years between occurrences. There is no cure for alopecia areata, but there are treatments available to help regrow hair. With some conditions, such as patchy hair loss, hair may regrow without treatment within a year. However, in more severe cases, medication and surgery may be necessary. In terms of prevalence, current research suggests that there aren’t any differences in rates of alopecia between men and women, and the mean age of onset is between 25 and 36 years, though it can frequently occur in children and young adults too. While alopecia areata is not usually a serious medical condition, it can cause a significant impact on an individual’s emotional and psychological well-being. Support groups are available to help those dealing with the psychological effects of alopecia areata. Other types of hair loss, such as those caused by chemotherapy or radiation treatment, may also be referred to as alopecia. In these cases, hair loss is often temporary, and regrowth may occur after treatment has ended.

Question 5

What causes alopecia in women?

Accepted Answer

Alopecia in women can be caused by an autoimmune disease known as alopecia areata. This occurs when the immune system mistakenly attacks hair follicles, resulting in hair loss in clumps the size and shape of a quarter. People with certain autoimmune diseases like psoriasis, thyroid disease, or vitiligo, and those with allergic conditions such as hay fever, are more likely to get alopecia areata. Other causes of alopecia in women include genetics, hormonal imbalances, and hair care practices. Additionally, excessive hairstyling, such as tight ponytails, cornrows, or braids, and hot-oil hair treatments can cause a type of hair loss known as traction alopecia. In rare cases, frontal fibrosing alopecia, which causes hair loss on the front and sides of the scalp, may be caused by an autoimmune reaction, genetics, or hormones. It’s worth noting that stress, standing on your head, brushing your hair excessively, wearing hats or wigs, or any other number of myths are not scientifically proven to cause or prevent hair loss in women. If you are experiencing hair loss, we recommend you see Dr. Rokhsar for a proper diagnosis and treatment plan.

Question 6

How to stop alopecia areata from spreading?

Accepted Answer

There are several ways to stop alopecia areata from spreading, including topical treatments, injections, diet changes, stress management, and natural remedies.

Corticosteroid injections and topical treatments remain popular first-line treatments for alopecia areata. These treatments can have side effects like skin thinning and atrophy. Dr. Rokhsar also offers platelet-rich-plasma, or PRP, injections. He can easily perform the procedure in the office. After your blood is drawn, the vial is spun in a centrifuge and the supernatant fluid containing nutrient-rich factors that aid in hair regrowth is injected in the affected areas. Most patients notice significant improvement after 3-6 sessions a month apart. You may also need to continue sessions annually to maintain long-lasting hair growth.

In addition to conventional treatments, there are several alternative ways to stop alopecia areata from spreading. Dietary changes can help prevent alopecia areata from spreading, such as temporarily cutting out certain foods or incorporating foods like yogurt, beetroots, apples, and lemon into the diet. Nutritious diets, including supplements such as phosphorus, protein, and vitamins, can also help prevent the condition from occurring.

Reducing stress, avoiding hair or scalp trauma, and identifying unique triggers can also be helpful in stopping alopecia areata from spreading. Massage, brush, and essential oils, including coconut oil, can help stimulate hair growth and reduce inflammation on the scalp. Natural remedies like probiotics and anthralin can also be beneficial in preventing the condition from spreading.

Question 7

Things to avoid when you have alopecia areata?

Accepted Answer

Nightshade vegetables: Peppers, tomatoes, eggplant, and potatoes should be avoided as they can trigger inflammation. Similarly, inflammatory foods should also be avoided as they can lead to hair loss and worsen alopecia areata. Stress: Try to avoid getting stressed out as it can trigger unexpected hair loss and regrowth. Harsh treatments: Avoid harsh treatments such as hot rollers, curling irons, hot-oil treatments, and permanents. Also, limit the tension on hair from styles that use rubber bands, barrettes, and braids. Certain medications: Some medications can cause hair loss, so it’s important to talk to your doctor about any medications you are taking. In addition to avoiding these things, it is advisable to include antioxidants, probiotics, biotin, zinc, and healthy oils in your diet if you have alopecia areata. Also, consider wearing eyeglasses or sunglasses to protect your eyes from sun and dust if you have lost hair from your eyebrows or eyelashes, and consider cosmetic solutions such as wigs or hairpieces to cover up hair loss. Most importantly make an appointment with dr. Rokhsar to diagnose your specific type of alopecia and to come up with a treatment plan.