What causes or triggers Alopecia areata?

Causes – Autoimmune disease

Alopecia areata is an autoimmune disease.  An immune attack causes healthy hair follicles with pigment/colour to reduce in size.  A slow down in production can occur and therefore may stop hair growth in the affected areas.

Our immune system makes white blood cells (known as lymphocytes) and antibodies. These protect against foreign matter including viruses, bacteria and other germs.  An autoimmune disease is where your own immune system, the body’s blood cells and antibodies, mistakes part of the body as foreign and attacks its own tissues and healthy cells.

The causes of bald patches, as with Alopecia areata, are where white blood cells attack healthy hair follicles (roots) mistaken as affected or foreign.  This causes inflammation, reducing them in size, slowing down production and causing hairs to become weak and fall out.

Alopecia areata Causes

Patch of alopecia areata

Your hair follicles are not destroyed and actually remain alive. For some people, hair will regrow and not fall out again, if the immune reaction goes away or is treated, along with any suspected environmental triggers.

It is not yet known why autoimmune diseases occur, other than the suspicion that something triggers the immune system to mistake the body’s tissues as foreign.

Causes – Environmental Triggers

Environmental triggers including anxiety attacks and acute stressful episodes are occasionally believed to be among initiating causes.  Cases of traumatic events such as accidents, bereavement and separation have been linked as a trigger for alopecia areata.

Although, some think stress or anxiety as a trigger type to be coincidental due to many sufferers showing no signs of significant stress.

Causes – Hereditary, genetic predisposition

There is a genetic predisposition, an inherited factor, which is thought to make some people prone to autoimmune diseases. Around 20% of sufferers of alopecia areata have a close relative with symptoms or similar family history.

Alopecia areata can be passed through hereditary, however, it is not a single-gene disease, but is known as a ‘polygenic disease’.  This means that in order for a child to inherit and develop the disease, both parents must contribute specific genes, therefore most will not pass the disease on to their children.  Even in cases of identical twins (sharing all the same genes) where one twin is a sufferer, there is only around a 50% chance the other will become one too.

Those with the condition could also have a slightly higher chance of developing other autoimmune diseases.  These include diabetes, dermatitis, thyroid problems, vitiligo (white skin patches) and anaemia.

However, most alopecia areata sufferers do not develop any of these diseases as the risk is still very low.  A Doctor can recommend blood tests to check for antibodies with indicators of potential thyroid or anaemia problems.

Causes – Other triggers

Possible other triggers are thought to include viruses, infection and medicines, but no evidence has surfaced yet to confirm this theory.

Alopecia areata is not contagious nor catching and has not yet been connected to particular diets, food intolerance, vitamin or mineral deficiencies.

See our section describing What are the different types of the disease? – Understanding the variations and types.

The research of this disease is on-going, there are many respected publications, ranging from clinicians and doctors to those authors describing their personal journeys through coping and managing the disease.  Here are a few of the popular alopecia areata books:-

Head-On, Stories of Alopecia Paperback – 7 Jun 2015

This collection of personal narratives follows the courageous journeys of over 75 men, women, and children as they find their way after being diagnosed with alopecia areata, a hair loss condition that affects over 146 million people throughout the world. What begins as just a small bald spot eventually leads to a diagnosis of a confusing and relatively unknown autoimmune disease. They soon learn there are no reliable cures and that alopecia could possibly last a lifetime. Their discovery of acceptance, adaptability, and finally celebration are intertwined in these thought-provoking inspiring stories and captivating photos. As they unearth their new identities and reclaim their lives, there is no doubt you will begin to recognize your own distinct ability to tackle any challenge of your own, Head-On.

Hair regrowth in alopecia areata patients following Stem Cell Educator therapy Paperback – 26 Jan 2016

Alopecia areata (AA) is one of the most common autoimmune diseases and targets the hair follicles, with high impact on the quality of life and self-esteem of patients due to hair loss. Clinical management and outcomes are challenged by current limited immunosuppressive and immunomodulating regimens. Proceeds from the sale of this book go to the support of an elderly disabled person.