indexWHAT IS IT?

Alopecia areata is a dermatological condition that can affect the hair, hair, nails. It is relatively common as it affects 1.7% of people in their lives. This is not a serious disease: it “hides nothing” there is no underlying pathology that could be responsible and who would want to find.

HOW DOES THIS?

Alopecia areata may appear in the form of plate (s) without hair, usually round (s) or oval (s) (formerly known as sclerosis Alopecia areata alopecia areata and alopecia areata in English) and it is the form the more common. Sometimes it beginning at the occiput and gradually extends to the sides going up above the ears (areata ophiasique). It can rarely affect the entire skull (total décalvante alopecia). If body hair are also affected one speaks of universal alopecia areata. The nails may especially have small pits giving the appearance thimble (punctate depressions) or more widely damaged, rough as if they had been shredded in the lengthwise (trachyonychia). All hairy structures can be individually with: eyebrows, eyelashes beard in humans, certain areas of body hair in patches or diffusely.

Edge of plate you can see hair exclamation point are small broken hair of a few millimeters and poorly adherent.

HOW IS areata?

So very temperamental …

Indeed, the evolution is episodic; a person may have only one episode in his life, or have multiple, be “quiet” years and then present a new episode for no reason. The episodes can be intensity, extent and duration variable. Little evidence for judging the evolution of alopecia areata which is in fact a surprising and unsettling disease. It seems accepted that extent against alopecia areata appears that early childhood is more likely to worsen or recur so severe surface. This is however only statistically but not in a single value. There are many intermediate and clinical and progressive forms between alopecia areata occurring in one plate pushes spontaneously in two months and many more exceptionally universal alopecia that does not change for many years.

A REPORT IS NEEDED?

Generally not. The balance sheet: what is the clinical examination the doctor. But sometimes your doctor may consider a blood test would be useful in terms of clinical signs, to check if there is no other autoimmune disease associated: indeed as alopecia areata is an autoimmune disease, it represents a little more to other autoimmune diseases are also common in the population, such as those affecting the thyroid. If it turns out that thyroid malfunctioning, the situation would soon be restored by a simple treatment (unfortunately no effect on alopecia areata itself …).

Furthermore, the persons who have a areata greater susceptibility to have a “allergic” tendency, that is to say a predisposition to eczema, asthma, allergic rhinitis – which are otherwise common in generally. population These diseases have generally no specific effect on alopecia areata.

Contrary to what was sometimes performed there many years radiographs of teeth, teeth interventions have no interest as regards alopecia areata.

STRESS IS CONCERNED?

Not particularly: psychological factors and more specifically a “stress” are often implicated by patients and their families, even by some doctors as a cause of alopecia areata (and a bit too general for skin problems). We all know that exist interconnections between the mind and the immune system (as we have seen alopecia areata is an autoimmune disease) and that stress is sometimes written neatly in the days or weeks before the trigger a first episode of alopecia areata. However, this phenomenon has no statistical value and rigorous studies show no significant correlation between a stressful event and a first episode. Psychological disorders that may have find in association with alopecia areata are varied and can sometimes be the result of … alopecia areata itself.

SHOULD WE SEE A “PSY”?

There are no rules. The goal here is not to seek a psychological cause alopecia areata, we have seen, but feel their best despite this pathology can be destabilizing. The consequences of alopecia areata on mood, social and vocational or academic, emotional, what is called “Quality of Life” are some life and variable depending on the type of alopecia areata and the affected person’s age, gender, origins and his personal history. Specialist advice psychotherapist can sometimes be useful, but not systematic, it can be discussed with the doctor who supports areata.

IS THAT I WILL SEND TO MY CHILDREN areata?

The risk of developing alopecia areata in a family history of alopecia areata where there is very variable, depending on the genetic heritage passed. The situation is of course different when several people close within the same family have alopecia (eg a parent and a grandparent, and uncles or aunts, …) or if it is a phenomenon isolated. Considering that on average if one parent is suffering from severe alopecia areata (décalvante universal), the risk for children to develop alopecia areata during his life would be 6% and to develop a severe alopecia 2%. By cons with regard monozygotic twins (“twins”), if one of the two has alopecia areata, the risk to the second twin would be 55%.

Alopecia areata IS AN AUTOIMMUNE DISEASE?

Yes: some white blood cells, including lymphocytes of individuals do not recognize the bottom root of the hair, that is to say, the bulb, as a “normal” of the body member. They will attack and surround the bulb like bees around a hive [Figure 0]. Hair or hair and attacked stops working, it breaks (the hair says “exclamation point”) then falls and leaves a smooth skin without hair shaft apparent. There is just one block without destroying the follicle and when lymphocytes leave spontaneously or under the effect of a treatment, the hair or the hair works normally again. The problem is that these cells are sometimes stubborn and numerous, and they obey rules that are not yet clear for physicians and researchers.

IT CAN PUSH ALL ALONE?

Yes, and often even for alopecia sclerosis (60% of alopecia which cover less than 40% of the scalp); but also less likely to décalvantes and universal alopecia. Of course alopecia areata is more ancient and rebellious, the more chances to push spontaneously decrease, and the risk of recurrence increases. Again these data are statistics, but do not have a systematic individual value. Do not treat alopecia areata does not increase the risk of not seeing push in the future. We are therefore not required to quickly and push “at all costs.”

WHAT ARE THE EXISTING TREATMENT?

Most currently used treatments are intended to disappear white blood cells that attack the hair follicles. At the moment we have treatments have a suspensive effect as other white blood cells may appear in this episode or during other episodes. We will not develop each treatment and will not expose their specific advantages against indications, side effects and potential risks will be to consider with your doctor. He alone can judge you with the best treatment to be undertaken. Treatments are generally used:

Cortisone, which is a basic treatment of inflammatory and autoimmune diseases.

Local application (topical steroids), it is a simple and safe treatment using the recommended doses by your doctor. His interest is shown and can act on many forms of alopecia areata in adults or in children.

In local injections (injections made by the physician in the skin) in adults in areas and limited quantity. They allow regrowth “clumps” in a few weeks on the injected areas.

Systemically, in particular cases of limited duration, which otherwise is posed by the specialist

Preparations based on derivatives of tar (anthralin or dioxyanthranol) applied brief contact to the affected areas of the scalp. This treatment is irritating.

Minoxidil regrowth can thicken, it has no effect on the mechanism which regulates the areata.

Phototherapy (PUVA most often, that is to say a combination drug called psoralen and ultraviolet A rays) is used on a limited and quantified by the dermatologist in a cabin for the treatment period. The indication of this treatment is posed by the specialist, because it is not suitable for all. UVB lamp or excimer laser 308 nm are variations of phototherapy, the effect seems less than PUVA.

Contact Immunotherapy is a treatment performed in specialized centers is to make patients allergic to a chemical substance (usually diphencyprone) which is then applied to the areas of alopecia areata. Eczema created can promote regrowth. It is recommended in particular cases.

Immunosuppressive: methotrexate tablet taken or injected intramuscularly is also sometimes suggested by the dermatologist for severe alopecia and rebels.

There are other treatments whose effect is discussed or has not been validated in studies.

AND MEANS OF CAMOUFLAGE?

A hair or wig or hairpiece prosthesis can accommodate for a person with extensive alopecia areata. A prescription written by the doctor makes a partial refund (based on € 125) by social security, more or less completed by mutuals. Prices vary depending on quality, type of hair (synthetic or natural), support and user hairline on the support. Considering where this is justified as Social Security supports the reimbursement of two wigs per year.

Tattoo eyebrows or the free edge of the eyelids, especially in women, can be done by competent persons. We will, where possible, prior to alopecia areata pictures to appreciate the shape of the eyebrows. The tattoo does not hinder growth.

AND RESEARCH IT FORWARD?

Many teams and work on this topic around the world: the pathophysiology (mechanisms of appearance) and therapeutic means. Every year many articles are published on alopecia areata in scientific journals. They did not of course always quick impact on the treatment of alopecia areata your concern, but can advance in small or large step in the understanding and management of this disease.

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