Alopecia areata (ringworm), what is it? Why does it happen? Is it contagious? What are the types and symptoms? Do you need to see a doctor? How is it treated? You can find the answers to all these questions below.
What is alopecia areata?
Alopecia areata, also known as ringworm, is a condition that causes hair to fall out in small patches that may go unnoticed. However, these patches can grow and become noticeable later on. The disease develops when the immune system attacks the hair follicles and causes hair loss.
There may be sudden hair loss on the scalp, and in some cases there may be hair loss on the eyebrows, eyelashes, and other parts of the body as well as the face. It can also develop slowly and recur years later, even after it has passed.
The condition can cause total hair loss, called alopecia universalis , and can prevent hair from growing back. When the hair grows back, it is possible to shed the hair again. The extent of hair loss and regrowth varies from person to person.
There is still no definitive, targeted treatment for ringworm, but there are treatments that can help hair grow faster and prevent future hair loss, and there are different ways to cover up the hair loss. Resources are also available to help people cope with the stress associated with hair loss.
What causes alopecia areata?
Alopecia areata is an autoimmune disease . It happens when the immune system targets healthy cells instead of attacking foreign substances. Normally, the immune system protects your body against foreign invaders such as viruses and bacteria, but in this case it’s the opposite.
However, if you have ringworm, your immune system mistakenly attacks your hair follicles. Hair follicles are structures where hairs grow. The follicles shrink and stop hair production, causing hair loss. Researchers do not yet know the exact cause of this condition.
However, it often occurs in people with a family history of type 1 diabetes or other autoimmune diseases such as rheumatoid arthritis . For this reason, some scientists suspect that genetic factors may contribute to the development of alopecia areata. They also believe that certain factors in the environment are necessary to trigger ringworm in genetically predisposed individuals.
Types of alopecia areata
There are several types of ringworm. Each type is characterized by the degree of hair loss and other symptoms you may experience. Each type may have a slightly different treatment and prognosis.
Alopecia areata (irregular ringworm)
The main feature of this type of ringworm is one or more coin-sized patches of hair loss on the skin or body . If this condition expands, it may become alopecia totalis or alopecia universalis.
Alopecia totalis occurs when there is hair loss on the entire scalp. In this case, the head becomes completely bald.
In addition to partial hair loss, people with this type of alopecia areata lose all facial hair, including eyebrows and eyelashes. It is also possible to lose other body hair, including chest, back and pubic hair.
Diffuse alopecia areata
Diffuse alopecia areata can look very similar to male or female pattern hair loss. It results in sudden and unexpected hair thinning not just in one area but all over the scalp.
Hair loss that appears in the form of bands on the sides and back of the scalp is called ophiasis alopecia.
What are the symptoms of alopecia areata?
The main symptom of ringworm is hair loss. Hair usually falls out in small patches on the scalp. These patches are usually a few centimeters or less.
Hair loss can occur in other parts of the face as well as in other parts of the body such as eyebrows, eyelashes and beard. Some people lose their hair in just a few places, while others lose it in many.
You may first notice clumps of hair on your pillow or in the shower. If the dots are on the back of your head, someone might draw your attention here. However, other health conditions can also cause hair loss in a similar way. Hair loss alone is not used to diagnose ringworm.
In rare cases, some people may experience more extensive hair loss. This is often an indication of another type of alopecia, such as:
- Alopecia totalis, which is all hair loss on the scalp
- Alopecia universalis, which is the loss of all hair and hair on the whole body
Doctors may avoid using the terms “totalis” and “universalis” because some people may experience something in between. It is possible to lose all the hair on the arms, legs, and scalp, but those on the chest sometimes do not fall out.
Symptoms in men
Ringworm occurs in both men and women, but hair loss is likely to be more significant in men. This is even more possible if men have a family history of hair loss genetically.
Men may experience hair loss in their hair, scalp, chest and back hair. Compared to male pattern baldness, which is a gradual thinning of the hair all over, this condition manifests itself more sporadically.
Symptoms in women
Women are more likely to develop ringworm than men, but it is not clear why. Hair loss can occur on the scalp, eyebrows and eyelashes.
Unlike female pattern hair loss, which is the gradual thinning of hair that covers a large area, ringworm may be limited to a small area. Hair loss can also occur at the same time. The area may gradually enlarge, causing more hair loss.
Symptoms in children
Children can also develop ringworm. In fact, most people with the condition will experience their first hair loss before the age of 30.
While ringworm does have an inherited component, parents with the condition don’t always pass it on to a child. Similarly, children with this type of hair loss may not have a parent with the condition.
In addition to hair loss, children may experience defects such as area pitting or lesions. Adults can also experience this additional symptom, but it is more common in children.
How is alopecia areata diagnosed?
A doctor can diagnose ringworm by looking at the extent of your hair loss and examining a few hair samples under a microscope .
Your doctor may also perform a scalp biopsy to rule out other conditions that cause hair loss, including fungal infections such as tinea capitis . During a scalp biopsy, your doctor will remove a small piece of skin from your scalp for analysis.
Blood tests may be done if other autoimmune conditions are suspected . The detailed blood test performed depends on the condition the doctor suspects. However, a doctor will likely test for the presence of one or more abnormal antibodies. If these antibodies are found in your blood, it usually means you have an autoimmune disorder.
How is alopecia areata treated?
There is no targeted cure for ringworm, but there are treatments that can slow future hair loss or help hair grow faster.
The situation is difficult to predict, which means it may take a great deal of trial and error until you find something that works well. For some people, hair loss may get worse even with treatment.
Medication generally includes the following:
- Topical agents : You can rub the medication into your scalp to stimulate hair growth.
- Injections : Steroid injections are a common option for mild, patchy ringworm to help hair grow in bald spots.
- Oral medications : Cortisone tablets are sometimes used for extensive alopecia, but due to the possibility of side effects, you should discuss this option with a doctor.
Light therapy is also called photochemotherapy or phototherapy. It is a type of radiation therapy that uses a combination of psoralens and an oral medication called UV light .
Some people with ringworm choose alternative treatments to treat the condition. These may include:
- Aroma therapy
- low level laser therapy
- Vitamins such as zinc and biotin
- Aloe vera drinks and topical gels
- Applying onion juice to the scalp
- Essential oils such as rosemary, lavender, and peppermint
- scalp massage
- herbal supplements
Most alternative treatments have not been tested in clinical trials, so their effectiveness in treating hair loss is unknown. You should always talk to a doctor before trying any herbal or vitamin supplement.
Can ringworm be prevented?
Alopecia areata cannot be prevented because the exact cause is unknown.
This autoimmune disorder can be the result of several factors. These may include a family genetic history, other autoimmune conditions, and even other skin conditions.
But not everyone who has any of these factors will develop ringworm. Therefore, it is not yet possible to prevent this.
Finally, you may be interested in our article on the benefits of baby oil for hair .