Alopecia areata | Dermatologists’ Insights: Can Stress Cause Premature Balding?

What are Alopecia areata?

Alopecia areata are caused by an autoimmune disorder where the body’s immune system mistakenly attacks hair follicles, leading to their shrinking and eventual disappearance. This attack can occur rapidly, within a matter of days, and without proper treatment, the hair loss can worsen, potentially spreading to the entire scalp and, in severe cases, affecting eyebrows and eyelashes.

The Mechanism of the Autoimmune Disorder

An imbalance in the immune system is the primary culprit behind alopecia areata. This imbalance causes lymphoid leukocytes to target and damage growing hair follicles, triggering hair loss.

Genetic Factors

Genetic predisposition plays a significant role in the development of alopecia areata. Individuals with a family history of hair loss are at an increased risk of developing this condition. Research strongly suggests that genetic factors contribute to the development of this autoimmune disorder.

Stress and Psychological Factors

While not all cases of bald spots are stress-related, mental stress, such as acute anxiety or depression, is considered a potential trigger.

Symptoms of Alopecia Areata

Alopecia areata typically presents as smooth, hairless, round or oval patches on the scalp without noticeable inflammation or redness. Patients may also experience nail deformities, such as pitting or brittleness, coinciding with the onset of bald spots.

Treatments for Alopecia areata

Common treatment options for alopecia areata include topical steroids and immunosuppressants, which help reduce inflammation caused by the autoimmune response and prevent further attacks on hair follicles by the immune system.

Other Hair Loss Problem

Hair Growth Cycle

Understanding the hair growth cycle is crucial for identifying when hair loss becomes a concern. Every individual’s hair undergoes distinct stages of growth. The first is the anagen or “growth” phase, where approximately 85-90% of our hair is actively growing. The second is the catagen or “recession” phase, where about 1% of hair follicles begin to shrink. The final stage is the telogen or “resting” phase, where 10-15% of hair ceases to grow.

Normally, hair loss occurs as hair follicles transition from the resting phase to the growth phase, with new hair replacing the old. Since about 1% of our hair follicles are constantly transitioning, we lose approximately 100 hairs daily, which is considered normal.

Excessive Hair Loss

Losing more than 100 hairs daily may not always be a cause for immediate concern. To accurately diagnose hair loss, doctors assess the condition of the hair, including the amount of hair loss and the presence of bald patches. One of the most common causes of hair loss is stress, which can be triggered by various factors, including pregnancy, COVID-19, surgery, or certain medications.