Alopecia: The secret behind the patchy and total hair loss

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Alopecia or pathological hair loss is different than the normal hair loss or hair fall that everybody has to a certain degree, specially as aging. The illness Alopecia if it is limited to a small patch or patches, mostly on scalp that can happen in other areas of the body as well, is called “Alopecia areata”. Alopecia that often is areata or localized as a small patch or patches and most often self-limited and improves, could also rarely lead to the total hair loss of the scalp that is called “Alopecia totalis”, or the total hair loss of the body, called “Alopecia universalis. (1)

Alopecia in its three types is an autoimmune disease, where the body immune system by mistake attacks its own hair follicles for wrongly being recognized as foreign. If there is no inflammation, scars or fibrosis at the site of alopecia areata, the condition is mostly reversible and self-limited, specially in children and adolescents. Alopecia like any other autoimmune diseases could be partly hereditary and runs more in the families with such history or other immune disorders. But like any other immune disorders or any so called “genetic disorders”, Alopecia can occur in anyone for the first time with no hereditary background history of any autoimmune disorders. So what would be the primary cause or trigger of “T cell lymphocytes” as the defenders of the body or our immune system to attack its own?! (2)


The secret behind Alopecia:

As it has been discussed in detail in other articles on autoimmune disorders such as MS (Multiple Sclerosis) and Diabetes Melitus Type 1 on this site, the trigger to the autoimmune disorders are external and caused by microbial invasions. Metabolic defects in the endogenous retinoids, a chemical compound that are vitamers of vitamin A and important in immune function and activation of tumor suppressor genes have been shown to play a key part in the pathogenesis of the alopecia areata. This defect is not only seen in alopecia but also in skin cancers as well. (3) Moreover other than the T lymphocytes, specially the interferon gamma (IFNG) and other T helper cells, cytokines and substance p, all important members of our immune system are involved in alopecia. (4-5)

While there is a well consensus among the experts in the autoimmune pathogenesis of Alopecia, the research has rarely gone behind the scene to identify the primary cause or enemy of our immune system that defects it so it attacks itself! This is despite many evidential reports since late 1940’s and 1950’s, confirming the link between different focal infections from parasitic Tineas to syphilis and fungal infections. (6-9) There have also been surprisingly early reports in 1950’s and 70’s of the reversal of alopecia areata with antibiotics. (10-11) 


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