Therapeutic Modalities For Alopecia Areata

Alopecia areata is a common, autoimmune disease that can affect any hair- bearing area. Alopecia areata is a lymphocyte cell-mediated inflammatory type of hair loss, but its pathogenesis is not fully understood. The disease can present as a single patch of hair loss, multiple patches, or extensive hair loss in a form of total loss of scalp hair (alopecia totalis) or loss of entire scalp and body hair (alopecia universalis). A number of treatments can induce hair regrowth in alopecia areata but do not change the course of the disease. Treatment is more effective in patchy alopecia areata than in alopecia totalis/alopecia universalis. Therapy for alopecia areata should be tailored in light of severity of the condition and the patient’s age.

Many therapeutic modalities have been used to treat alopecia areata, with variable efficacy and safety profiles. The treatment plan is designed according to the patient’s age and extent of disease. Several studies have shown the efficacy of intralesional corticosteroid injections. For limited scalp alopecia areata, intralesional corticosteroid therapy is considered as the drug of choice by many experts. The most widely used agent is triamcinolone acetonide. The injections can be repeated at 4–6 weekly intervals. The use of mesotherapy multi-injectors with 5–7 needles is an alternative approach to decrease injection pain and to make the procedure more homogenous. Side effects include skin atrophy and telangiectasia which can be minimized by the use of smaller volumes and avoiding superficial injections.

Many forms of topical corticosteroids have been prescribed for alopecia areata, including creams, gels, ointments, lotions, and foams. Topical corticosteroids are far less effective in alopecia totalis and alopecia universalis. A highly potent topical corticosteroid under occlusion is the preferred method when using topical corticosteroids. Folliculitis is a common side effect to topical corticosteroids.

PUVA is a method of administering a dilute psoralen solution selectively to the scalp for 20 minutes using a cotton towel as a turban. The patient’s scalp is then exposed to ultraviolet A radiation. Treatment sessions are performed two or three times per week. PUVA-turban therapy lacks the systemic side effects of oral PUVA and can be considered as alternative therapy for patients with alopecia areata.

One important step that should not be overlooked during the course of management of alopecia areata is offering psychological support to foster increased self-esteem and adaptation to this disease. Helping patients with alopecia areata cope with depression and an unpredictable disease like alopecia can be achieved by several ways, including education of the patient about the nature of disease, psychotherapy, hypnotherapy, antidepressants and support groups. Hypnotherapy may significantly improve depression, anxiety, and quality of life, but not hair regrowth .

If these therapies fail or are not tolerated, third-line therapeutic options can be discussed with patients in terms of the expected outcome of therapy and possible side effects. These agents include methotrexate with or without a systemic corticosteroid, azathioprine, cyclosporine, and pulse therapy of corticosteroids. While using these drugs, close monitoring of patients is important to avoid possible side effects.

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Yoga as Alopecia Areata Treatment

The term alopecia means hair loss or baldness. Hair loss occurring in patches is known as alopecia areata. Like many other health problems, it sometimes starts after a stressful event, or may be related to long standing stresses due to wrong life style. The cause of Alopecia areata (AA) is autoimmunity. The body’s healthy immune system consists of white blood cells. Its function is to guard its own tissues and fight against only the foreign dangerous cells such as bacteria or viruses and destroy them. In AA the lymphocytes perceive the specialized cells in the root of the hair as foreign and try to destroy them. This is accomplished by the release of local chemical messengers called cytokines. AA is often discovered by a hairdresser, since there are usually no symptoms. AA has three stages. First there is sudden loss of hair, then enlargement of the patches of hair loss followed by regrowth. One patch can be falling out while another is regrowing. AA does not result in physical disability, but it can be emotionally very distressing. Luckily the hair usually grows back slowly by itself. Sometimes the new hair that grows may be grey or white, but after a while the original color usually returns. Some lotions applied to the scalp do seem to result in temporary improvement in some people, but the hair falls out again as soon as they are stopped. Medicines which are often tried include steroids. The integrated approach of yoga therapy is useful in removing the root cause of the disease and hence it provides the right approach to management of AA. A healthy vegetarian diet cooked and served fresh with minimal spices and also consisting of plenty of raw vegetables, non-citrus fruits and sprouts are valuable. The component of physical practices constitutes about 50% of the time spent for the daily practices. The special techniques designed for AA should bring about activation followed by reduction of the Prana activity in the patch of the skin. Hence selection of asana depends on the area affected. For example if the area is the top of the head , many inverted postures which stretch the skin of the scalp such as Sarvangasana, Halasana, Matsyasana, Sirsasana and their modified versions are selected by the expert yoga therapist. Yoga uses the power of the mind to achieve this through the technique of focusing and defocusing on the stretched zone during and immediately after the asana. Hence while maintaining in the final posture of the selected asana full attention on the stretched part is maintained for a while. The important component of the local correction comes up only during the next phase of defocusing of the stretched area that follows immediately after releasing the posture. This is the principle of self - correction through mind body interaction. The deep local rest to the fighting cells is the way to stop the unnecessary inflammation, by reducing the local abnormal cytokine concentration. There is a lot of product for natural hair care on the market today. Marbo Hair is one of the products that are 100 % natural. This product can be effectively used for loss of all body and facial hair. Using regularly Marbo Lotion and Marbo Shampoo stimulates new hair growth on thinning scalp and bald regions, while your hair becomes firmer and healthier.