Alopecia areata and its forms

Alopecia areata and its severe forms can be successfully treated

Our medical program for restoring hair growth for alopecia areata/totalis/universalis/ophiasis patients is based on fundamental and clinical research that was launched in late 1970. The results opened the way for the effective treatment of severe forms of alopecia areata. The first patients were cured in 1983, and a specialized independent clinic was established in 1988. Thousands of patients have recovered their hair, got rid of annoying wigs, and are leading a full life.

Everyone who suffers from this disease knows perfectly well, how a small-sized bald patch can lead to total scalp or even bodily hair loss in several months or less.

A single small-sized bald patch readily responds to treatment even though a relapse is possible, while severe forms of alopecia require more patience and prolonged treatment. Severe forms of alopecia areata are rare, and dermatologists usually say that one must simply accept them and wear a wig or hairpiece.

Alopecia areata usually begins as a small patch about an inch (approx. 2.5 cm) in diameter that can be located anywhere on the scalp. However, I have repeatedly observed primary patches of hair loss on the beard, eyebrows, eyelashes, pubis, body, and extremities.

Usually the primary patch widens to a certain size. If the diameter of a patch does not exceed 3-4 inches (approx. 8-10 cm), the prognosis for the disease is favorable, and the hair can regrow without treatment in most cases. If the first patch is followed by additional patches that result in hair loss on two thirds of the scalp’s surface, then the process leads to complete hair loss in 50% of cases. My practice suggests that, the higher the emergence rate of new patches, the more probable the transformation of the disease into alopecia totalis or alopecia universalis.

The disease commonly manifests itself between the ages of 18 and 35. Unfortunately, alopecia areata also occurs among children. The youngest child with alopecia areata that I have seen was 6 months old. Children aged 5-7 and 12-14 years are the most likely to get this disease.

There is a certain genetic predisposition to alopecia areata. In other words, one sometimes sees patients with this disease in different generations of a single family. In most cases, especially among adults, the disease develops as a result of both genetic predisposition and external factors. For example, the development of alopecia areata is often preceded by major long-term stress resulting from difficult life circumstances.

When it develops, alopecia areata may cause profound changes in the patient’s functional status. This is due to the fact that many people are still not familiar with alopecia areata and its severe versions, and those who suffer from it have to deal with coworkers and associates who have no understanding of their condition. Hair loss may block many life opportunities and often destroys families and careers, especially for young people. The disease thus represents a serious challenge to the patient. However, alopecia areata should be understood to be just another common medical condition – in the same way as diabetes, say – and certainly not as a condition that one should be ashamed or embarrassed of.

Alopecia areata is a psychosomatic condition with multiple pathological factors, including autoimmune problems. This explains why there is no generally recognized approach to treating it.

In 1986, we studied keratinocyte mitotic activity and the distribution of epidermal cells throughout the cell cycle by laser flow cytometry. This investigation showed that epidermal cell division is lower in bald patches in comparison with the proliferation rate of cells in neighboring unaffected areas. Thus, the slower division of epidermal cells (keratinocytes or skin cells) forces hair follicles into a dormant (telogen) phase with subsequent hair loss in affected areas. This factor, which is one of the major aspects of the pathology of Alopecia areata, makes it possible to make treatment more efficient, especially for severe forms.

As our twenty-years’ experience shows, complete recovery of hair growth can be attained if the duration of the disease does not exceed 10-12 years. Nevertheless, we have successfully cured many patients who had the disease for up to 20 years.

The treatment program consists of five-day consecutive outpatient or inpatient treatments with an interval of 70-120 days of at-home self-treatment. This program should be repeated at least three times. The number of treatments depends on how long you have had the disease and its severity (usually the program does not need to be repeated more than six times even in the most severe cases). The treatment should not be interrupted between in-patient periods. During this time, patients follow the prescribed therapy and take medicine by themselves. Patients from different countries have been successfully treated.

At first, hair (possibly with colorless ends) appears after the second or third course of the therapy. By the fourth course the length of hair may reach 1-1.5 inches (2.5-4 cm), although the head is not always completely or evenly covered with hair at this stage. The recovery of hair growth on eyebrows and eyelashes needs special procedures.

I must say that everyone who has actively participated in my alopecia areata treatment program made his way out of this distressing condition with a full head of hair and remained a good friend of mine for many years.

Vlad UNDRITS, PhD, MD