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Alopecia Areata is an autoimmune disease that affects around 1 in a 1000 people, making it a fairly common condition. It is typified by the sudden loss of a patch of hair. Most people will only experience a few patches although others may experience more widespread hair loss. The exact cause is often difficult to pinpoint; pregnancy, medication, contraceptives, hormonal malfunctions, arthritis and even syphilis are known to trigger Alopecia. Whatever the cause, the effect is that the immune system starts perceiving the hair follicles in the body as foreign objects and attacks them.

However, the good news is that your hair may grow back. When this condition sets in three factors can make all the difference: a good doctor, the right blood tests and an accurate clinical history.

If you are in the USA, the American Academy of Dermatology (www.aad.org) has a Physician Referral Service where you can enter the name of your city and get a list of dermatologists - make sure there is a mention of Alopecia Areata in their profile. If you cannot find a specialist in your area, use AAD's broad Statewide Search, it will give you dermatologists in your state by city.

Blood tests are a must for treating this kind of Alopecia. A good physician will recommend blood tests because that is the only way to determine the root of the problem. Cortizone injections or Rogaine may provide temporary relief, but the following tests can be used to determine appropriate treatment:

1. Hormone levels (DHEAS, Testosterone, Androstenedione, Prolactin, Follicular Stimulating Hormone, and Leutinizing Hormone)
2. Serum Iron, Serum Ferritin, TIBC (Total Iron Binding capacity)
3. Thyroid Stimulating Hormone (TSH)
4. VDRL
5. Complete Blood Count (CBC)

Like blood tests, an accurate clinical history goes a long way in helping your physician diagnose the exact cause of Alopecia. Your medical history needs to be investigated in tandem with the blood test reports for an accurate diagnosis to be made. Here are a few questions your physician is likely to ask you:

- Are you taking any medication?
- How long has this been a problem?
- Is the hair falling out fully intact, or does it break?
- Do you have a family history of diabetes, asthma, arthritis, lupus, vitiligo, anemia, or Addison's disease?
- Have you recently given birth, or gone through the menopause?

Once the diagnosis has been made treatment is based on a rather simple principle: stimulate hair growth until it can grow by itself. If a specific cause has been identified you may need to continue the prescribed treatment for a year or so before hair growth can start on its own.

Treatments are varied but the most common prescriptions are:

For mild cases:

i) Cortizone injections: these are administered into the patchy areas of the scalp.
ii) 5% Minoxidil applied twice daily.
iii) Anthralin cream or ointment.

For severe Alopecia Areata

i) Cortizone Pills (these have side-effects though).
ii) 5% Minoxidil applied twice daily.
iii) Topical Immunotherapy. Diphencyprone (DPCP) or Squaric Acid DibutylEster (SADBE). This treatment "agitates" follicles into growth by causing a localized allergic reaction.

It is important to remember that none of the above mentioned treatments are to be used without medical supervision. Only a good physician can tell you what you need to do and the first step in treating your hair loss is always to find a good physician.

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