When there is a noticeable hair fall in patches, it is known as alopecia areata. This disease is caused by the immune system attacking the hair follicles by mistake resulting in hair loss. It could occur in the scalp, eyebrows, eyelashes, face and other parts of the body as well. The extent of hair loss differs from person to person.

Though there is no cure as of now for this disease, there are treatments that help in quick re-growth of hair, preventing future hair loss and also to cover up the loss of hair. There are resources to manage the stress caused by the disease too. Hair is perceived to be an important part of one’s personality and loss of it could cause emotional stress.

The immune system normally defends the body against invaders such as viruses and bacteria. Sometimes, the immune system themselves attack the healthy cells causing an auto-immune disease. When the hair follicles are attacked, they become smaller and stop producing hair, leading to hair loss.

It is still a mystery as to why the immune system attacks the hair follicles but research proves that people with a family history of auto-immune disease like type – 1 diabetes or rheumatoid arthritis are more prone to alopecia. People who are genetically predisposed to the disease can also be affected by environmental factors that trigger the disease.

Patchy hair loss is the most prominent symptom of alopecia. Patches of hair fall out mainly from the scalp but it can also affect the beard, eyelashes and other parts of the body. Clinical symptoms of alopecia would include:

• Hair that look like exclamatory marks
  When short hairs become narrower at the bottom and grow around the edges of bald spots, such exclamatory marks occur.
• Cadaver hairs
  When the hair strands break even before they reach the surface of the skin, they are known as cadaver hairs.
• White hair
  In areas that have been affected by hair loss, there may be regrowth of white hair.

Fingernails and toenails can also be affected by alopecia. 30% of individuals who suffer from alopecia usually suffer from extensive or continuous hair loss and re-growth.

It is fairly easy to diagnose alopecia by examining the symptoms. The symptoms of alopecia are classic and straight forward. The degree of hair loss and examination of hair from the affected areas under a microscope helps in quick diagnosis.

In rare cases, when a diagnosis cannot be made after the initial clinical examination, usually a skin biopsy is done. During a scalp biopsy, a small piece of skin from the scalp is removed and sent for further analysis. It is to rule out another possibility of hair loss which could include fungal infection like tinea capitis. A blood test is performed to rule out the possibility of other auto-immune diseases also.

Specific blood tests are performed based on the suspicion of the physician regarding a particular disorder. In the presence of one or more abnormal antibodies in the blood, it is considered an auto-immune disorder. Some blood tests that rule out other conditions are:

• C-reactive protein erythrocyte sedimentation rate
• An anti-nuclear antibody test
• Free and total testosterone
• Thyroid hormones
• Follicle stimulating and luteinizing hormone
• Iron levels