What is alopecia

Understanding your condition

The word alopecia means hair loss. Thinning or baldness can be a common complaint for both men and women, but around 2% of the population develop alopecia areata. Living with alopecia areata can affect self-esteem, confidence and mental health.

Alopecia areata is an autoimmune condition where the immune system attacks hair follicles all over the body or scalp, or in patches. The three most common forms are areata (patchy hair loss of the scalp), totalis (all or most hair loss of the scalp) and universalis (loss of all hair, including body, brows and lashes), however there are a variety of sub types based on location and hair loss pattern.

young woman with alopecia hair lost patches sitting on couch expressionless looking direct at camera
young woman with long hair holding mobile phone gazing out window

Functional medicine for alopecia

There are a variety of reasons for experiencing hair loss; medical conditions, hormonal changes such as the birth of a child, nutrient deficiencies, stress, genetics and certain medications.

Natural functional medicine alopecia treatment may help to prevent further hair loss, and encourage new growth, depending on the underlying cause of your condition.

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How much hair loss is normal?

On average we lose about 100 hairs per day, usually without noticing, as new hair is growing all the time. Hair growth occurs in 3 stages:

  • Anagen - an active phase, where the new hair is formed and pushes the club hair  (hair that is no longer in the anagen phase) out of the follicle. This phase is active for 2-6 years, growing around 1cm every 28 days
  • Catagen - around 3 % of all hair is in this transition phase lasting around 2-3 weeks. Growth stops and the outer root sheath shrinks attaches to the root and forms a club hair
  • Telogen - approx. 7% of all hair is in this resting stage lasting 100 days on the scalp, and longer for arm, leg, eyebrow and eyelash hair. We shed around 25-100 of these fully formed, dormant telogen hairs each day
  • Exogen - the shedding phase, where after 3 months, hairs are naturally shed. This is often considered as the 2nd part of the telogen phase

Genetically inherited factors affecting the androgen receptor AR gene cause most hair loss. Called androgenetic alopecia, it’s thought to be related to the way hair follicles produce 5-alpha reductase, an enzyme that converts testosterone to DHT affecting the growth in the anagen phase. This causes shorter growth cycles and thinner, shorter hair strands, and delays in growing replacement strands.

In the scalp disorder telogen effluvium, a shock to the body such as infection, starvation, childbirth, drugs, stress or immunological disorders can trigger an often temporary, episode of hair loss. Accelerating the time taken from the anagen into the exogen phase, this condition can be associated with scalp pain, burning, or stinging sensations called trichodynia, and is more common in men.

What are the common causes of alopecia areata?

Emerging research suspects that people with a genetic predisposition can develop autoimmune conditions when they encounter an environmental trigger. Specifically, in alopecia areata it is suspected that the immune system mistakes hair follicles for a pathogen due to an immune system vigilance at the skin level.

Possible triggers include:

  • Microtrauma to the skin
  • Bacterial infections such as Lyme disease
  • Viral infections such as hepatitis B virus, Epstein Barr virus (glandular fever / mononucleosis)
  • Parasites
  • Stress / anxiety / trauma
  • Allergies, or histamine reactions
  • Gut flora disruption
  • Presence of another autoimmune disease, such as vitiligo, lupus, or Hashimoto’s thyroiditis
  • Thyroid disorders
  • Scalp trauma due to head injury, or hair transplant surgery
  • Drugs
  • Vasculitis
  • Skin allergies to skin care products or sunscreens
  • Chronic fever
  • Exposure to environmental chemicals, heavy metals or mould

Other risk factors for alopecia (hair loss, generally) are:

  • Eczema, dermatitis
  • Hormone imbalance
  • PCOS
  • Male gender
  • Stress, or shock (either physical or emotional)
  • COVID 19 has been identified as a risk factor for telogen effluvium

Other considerations for hair loss are:

  • Nutrient deficiencies either due to dietary or absorption problems
  • Traction alopecia - from tight hairstyles such as plaits, pigtails or ponytails
  • Trichotillomania - a mental disorder where sufferers pull hair from their scalp
  • Harsh chemicals causing thinning and breakage
  • Medications such as the contraceptive pill, non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen, aspirin, or Nurofen, and some acne medications

Luckily, in many cases of alopecia areata, despite being damaged, the hair follicles retain the ability to regrow hair, meaning hair loss is not permanent in most cases.

Dyeing hair with alopecia

Many people ask about dyeing hair with alopecia. You can dye your hair if you have alopecia, because the part of the hair that is dyed is the hair shaft, and it does not reach the follicles which are damaged by the immune system in alopecia. However, hair dyes contain chemicals that can damage hair, expose the body to toxins, add an unnecessary load to the liver and are not advised for people looking for healthy, recovery from autoimmune conditions.

What causes eczema?

Genetics

Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.

These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.

Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected. 

Food allergy and sensitivity

Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.

Compromised gut health

The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.

Nutritional deficiencies

Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).

Weather and environment

Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.

Hormones

Hormones also play a role in the course of atopic dermatitis, including the stress hormone cortisol which triggers an inflammatory immune response affecting all organs of the body, including the skin.

Mould exposure

Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.

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Types of alopecia

There are 3 main types of alopecia - areata, totalis and universalis. In all forms of alopecia areata, hair follicles remain alive, ready and able to resume normal growth. Alopecia areata is broken down into the following sub types:

  • Alopecia areata monocularis - only one spot of baldness, anywhere on the scalp
  • Alopecia areata multilocularis - multiple spots of baldness on the scalp / head
  • Alopecia areata barbae - hair loss limited to only the beard
  • Alopecia areata totalis - hair loss to all of the scalp
  • Alopecia areata universalis - hair loss to the whole body, scalp, limbs, pubic and facial hair
  • Alopecia areata ophiasis - baldness from ear to ear, at the back of the head
  • Alopecia areata incognita and diffuse alopecia areata - common in 20-40 year old women, a rapid, widespread and diffuse hair loss pattern
  • Perinaevoid alopecia areata - spots of differently coloured skin, called pigmented nevi (usually, moles)
  • Cicatricial alopecia - rare and diverse group of disorders, which destroys hair follicles and replaces with scar tissue, causeing permanent hair loss
  • Triangular alopecia areata - a rare form where baldness occurs in a triangular shape
  • Reticular alopecia areata - a net-like pattern of hair loss, in between areas of hair on the scalp
  • Lichen planopilaris - an autoimmune condition and variant of lichen planus that mostly affects adult women
  • Diffuse / androgenetic alopecia areata - a short ‘anagen’ phase of growth, causing an inability of the hair to grow. This results in incomplete hair loss to the whole scalp, but without distinct patches. A subset of this category is called Female androgenetic alopecia (FAGA)

Alopecia treatment - the conventional approach

There is no single treatment for alopecia areata, however depending on your condition, your doctor may prescribe medications such as:

  • Corticosteroids - powerful anti-inflammatories, for short term use
  • Topical sensitisers - to create a reaction that includes itching and scaling and then eventually, hair growth. Two of these are called squaric acid dibutyl ester (SADBE) and diphenyl cyclopropenone (DPCP)
  • Anthralin (Dithrandol) - a tar-like synthetic substance that alters the immune function at skin level, applied for 30 mins to hours, to affected areas and then washed off
  • Platelet Rich Plasma (PRP) injections of the patients’ own platelet cells, taken in a blood draw and centrifuged to isolate platelets. This contains growth factors that can stimulate the healing of soft tissues
  • Immunomodulatory drugs - especially JAK inhibitors such as tofacitinib and ruxolitinib - however, these drugs have not yet been approved in Australia

And for androgenetic alopecia, your GP might prescribe medications called 5-alpha reductase inhibitors, or other medications such as:

  • Minoxidil (Rogaine) - a topical solution used for male and female pattern hair loss
  • Ketoconazole

In 2022 the FDA in the US approved a systemic anti-inflammatory drug called baricitinib (Olumiant), that has shown promise, however, has a number of side effects.

Your doctor may also make recommendations for laser treatment or surgical hair follicle transplantation.

Conventional medications from an alopecia specialist can be helpful, however, all medications carry the risk of side effects. This leads many people with alopecia to look for natural hair loss treatments which  address the underlying cause and improve overall health, rather than simply suppress symptoms.

Alternative treatment for alopecia - the functional medicine approach

Natural functional medicine alopecia treatment starts with an in-depth investigation to identify the root cause and contributing factors. Even where there is a genetic component, there are modifiable factors that can prevent further loss or even restore hair growth in some cases. Unlike conventional treatment,functional medicine treats the whole person.

In the initial in depth case-taking appointment we investigate:

  • Your birth story and lifetime medical history
  • Medications and supplements
  • Surgeries and accidents
  • Family and genetic history
  • Environmental exposures
  • Symptom history
  • Nutrition, diet and absorption
  • Lifestyle factors and stress

Your alopecia treatment may include functional testing, such as:

  • Microbiome and stool testing - looking for gut flora dysbiosis, or parasites
  • Specific markers for inflammation, digestive function & nutrient absorption
  • Food sensitivities and allergy testing
  • Heavy metal or environmental toxin exposure
  • Hormone levels
  • Other autoimmune markers

Depending on your condition, a personalised functional medicine alopecia treatment may target the following:

  • Removing causative factors such as some chemical hair care products, certain hairstyles that pull on hair, and other damaging products, environmental chemical exposures, or mould exposure
  • Detoxification and liver, kidney and gallbladder support - where heavy metal, environmental chemicals or mycotoxins exposure has been identified. A careful strategy to bind to and eliminate toxins is followed to support, rather than stress, these vital organs. Improper detoxification may underlie hormonal imbalance hair loss types
  • Restoring a healthy microbiome - Your alopecia areata natural treatment may start with restoring healthy digestive function. The microbiome and gut health can affect every part of the body, and having strong and diverse microbiota species is directly related to immune health
  • Poor nutrient absorption and vitamin deficiencies due to digestive dysfunction may mean insufficient levels of important vitamins and minerals required for hair growth, such as Vitamins A, C and D, zinc, silica, and Omega 3 fatty acids
  • Intestinal hyperpermeability (leaky gut) can allow particles to cross over from the intestines and into circulation, triggering the immune system to overreact
  • Restoring hormonal balance - balancing of testosterone and D-HT levels, and / or thyroid hormones
  • Potential autoimmune triggers such as environmental toxins, mould, thyroid dysfunction, or immune system stressors
  • Reducing inflammation with anti-inflammatory foods, herbal medicines and supplements
  • Modulating the stress response - we can’t always change the stressors around us, but we can change the way we respond to them. Mindfulness, engaging in nature such as forest bathing, meditation, yoga, and tai chi are all ways we can help our nervous system develop tolerance and reduce stress and anxiety
  • Reduce the impact of medications and other health conditions

Dietary, herbal and supplemental strategies may include (depending on your condition):

  • Autoimmune diet, anti-inflammatory diet, or a specific diet plan personalised to your body’s needs - eliminating any food intolerances, allergies or sensitivities
  • Including foods high in zinc to support testosterone production, skin and hair cells and immune function, such as seafood, oysters, pepitas (pumpkin seeds) and legumes
  • Reducing or eliminating alcohol consumption which can impact testosterone, and disrupt healthy microbiome makeup and diversity, linked to immune function
  • Increase foods high in Omega 3 fatty acids, such as grass-fed meat and wild caught oily fish like sardines, mackerel, anchovies, salmon and herring
  • Improve vitamin D status - where required
  • Herbal medicines such as - horsetail, saw palmetto, green tea, gingko, rosemary, prickly ash, Korean ginseng, Siberian ginseng, withania or schisandra

At Melbourne Functional Medicine, your comprehensive, personalised treatment plan is supported by your health coach and practitioner team. You’ll have people on your side to help you succeed in making the necessary changes for your health. Our unique 6 month program has all of the elements you need to help you achieve your health goals. Hear their stories, then book a free discovery call to find out how we can help you, too.

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Are you ready for a personalised, natural functional medicine treatment? Our unique model of care was designed with you in mind. Find out how below, then book a call today!

FAQs

Why is my hair falling out?

Firstly, it’s important to know that everybody loses around 100 hairs per day, and this is a normal part of the growth to shedding hair cycle. When 100 long hairs fall out, this can look like a lot. However, if you are losing more than this, then there are a variety of reasons.

They can include:

  • Hormone imbalance and androgenetic alopecia (male or female), which is thought to be related to the way hair follicles produce an enzyme that converts testosterone to DHT affecting the growth phase of the hair. This causes shorter cycles of growth and thinner, shorter hair strands with delays in growing replacement strands.
  • Nutrient deficiencies either due to inadequate diet or absorption problems
  • Traction alopecia - from tight hairstyles such as plaits, pigtails or ponytails
  • Harsh chemicals causing thinning and breakage
  • Medications such as the contraceptive pill, non-steroidal antiinflammatory drugs (NSAIDs) such as Ibuprofen, aspirin, or Nurofen, and some acne medications.
  • Shock can trigger telogen effluvium. When a shock such as infection, starvation, childbirth, drugs, stress or immunological disorders triggers an episode of hair loss, it may be only temporary. The condition accelerates the growth to shedding cycle of hair and may be associated with scalp pain, burning, or stinging sensations called trichodynia which is more common in men.
  • Alopecia areata is an autoimmune condition where the body mistakenly attacks hair follicles, causing short term or permanent hair loss. Different types of alopecia areata are characterised by hair loss patterns and locations on the body. As with all autoimmune conditions, the cause is due to a complex interplay between genes and the environment. If you have the genes, you will not necessarily develop the disease unless a trigger such as gut flora disruption, stress, infection, some medications, environmental chemical exposure, mould exposure and a number of other factors occurs.

If you’re looking for a natural hair loss treatment, contact us to find out more.

Which vitamin deficiency causes hair loss?

Dietary lack of zinc, selenium, silica, folate, Vitamin D, Omega 3 fatty acids, or biotin can all contribute to hair loss, however, the reason for each person’s hair loss is likely to be different as there are a variety of reasons for hair loss.

Seeking the help of a functional medicine specialist with a special interest in alopecia can help to determine the cause and contributing factors for your hair loss, and provide natural, evidence based alopecia areata naturopathic treatment strategies.

Can stress cause severe hair loss? Can stress cause alopecia areata?

Yes. A recognised condition called telogen effluvium occurs when a stressor such as sickness, shock, trauma, starvation, childbirth, drugs or immunological disorders triggers hair loss by disrupting the growth to shedding cycle of hair. Often the hair loss occurs some time after the trigger.

Stress can also be a factor in developing the autoimmune condition alopecia areata, causing the body to mistakenly attack hair follicles. Stress can also alter the hormonal balance and this can also be a trigger for alopecia areata.

An alopecia naturopathic treatment can help to get to the root of hair loss, and create a plan that helps to reduce stress and support the body to encourage hair growth. Find out more about an alopecia alternative treatment by contacting us.

Can you pass alopecia to a child?

Yes, and no. You can pass on the genetic susceptibility to autoimmune alopecia areata, and you can pass on genetic susceptibility to the hormonal imbalance of androgenetic alopecia.

However, genetic susceptibility does not mean that you will always go on to develop these conditions. Alopecia specialists recommend avoiding the triggers, maintaining a healthy hormonal balance and the necessary nutrients for hair and skin health are some of the ways to avoid developing alopecia.

Alopecia areata treatment in Australia from functional medicine practitioners can help reduce the chances of triggers causing the disease. Reducing the chances means also living a healthier life, potentially with less hair loss and in some cases regrowth. This depends on the condition, how long you have had it and the factors involved in both causing and contributing to it.

Is alopecia an autoimmune disorder? How do you get alopecia areata?

Yes, alopecia areata is an autoimmune disorder.

The word ‘alopecia’ simply means hair loss, and there are a variety of causes for hair loss.

In the various types of alopecia areata, the body mistakenly attacks the hair follicle causing the hair to fall out in patches, different areas of the body, or the whole body. Like all autoimmune conditions, this is thought to happen in genetically susceptible people, when encountering a trigger such as:

  • Exposure to environmental chemicals, heavy metals or mould
  • Microtrauma to the skin
  • Bacterial infections such as Lyme disease
  • Viral infections such as hepatitis B virus, Epstein Barr virus (glandular fever / mononucleosis)
  • Stress / anxiety / trauma
  • Allergies, or histamine reactions
  • Gut flora disruption
  • Presence of another autoimmune disease, such as vitiligo, lupus, or Hashimoto’s thyroiditis
  • Thyroid disorders
  • Scalp trauma due to head injury, hair transplant surgery
  • Drugs
  • Vasculitis
  • Skin allergies to skin care products or sunscreens
  • Chronic fever
  • Eczema, dermatitis
  • Hormone imbalance
  • PCOS
  • Male gender
  • Stress, or shock (either physical or emotional)
  • COVID 19 has been identified as a risk factor for telogen effluvium

How can I reverse alopecia naturally?

Depending on the cause of alopecia, there’s a variety of treatments from functional medicine alopecia practitioners that may be able to prevent further hair loss, slow future loss, or even regrow your hair.

Firstly, your practitioner will need to identify the underlying cause and contributing factors of your alopecia.

They will then design a personalised, holistic treatment strategy to address the factors affecting your hair loss.

Natural treatments for alopecia may include lifestyle changes to help be more resilient to stress, improve sleep, or reduce exposure to environmental chemicals.

They may include herbal medicines to improve circulation and nutrient delivery to affected areas, such as rosemary, gingko, yarrow or prickly ash. Silica containing herbs such as horsetail may be required. Herbs for balancing hormones such as green tea or saw palmetto, and for helping to calm the nervous system such as Siberian ginseng, schisandra and/or withania (ashwaganda) may be needed.

Whilst there is no alopecia areata diet, or alopecia areata elimination diet, your alopecia treatment plan may include a diet that addresses nutritional deficiencies, reduces inflammation, and removes any specific foods that you may be intolerant or allergic to.

Nutrient absorption, gut health and function, infection, parasites, exposure to mould and toxins are other factors that may need to be identified and addressed, which will require a multi-facted alopecia treatment plan. A holistic, alopecia naturopathic treatment, delivered by functional medicine trained naturopaths will provide a solution that will improve your hair and overall health.

How to stop alopecia areata from spreading? How long does an episode of alopecia areata last?

In order to stop or slow spreading of alopecia, you will need to discover what the underlying cause and contributing factors are. We are all different, and the lifestyles we lead, the food we eat, our genetic makeup, our microbiome are all unique. These are all areas that will impact hair loss.

Alopecia areata episodes can last for months to a year, as the hair follicles retain the ability to regrow hair. Once it starts to regrow, hair growth occurs at around 1 cm per 28 days, and has 3 stages of growth. Improving your health, removing the triggers and providing your body with what it needs to recover may help start this growth process.

If you’re looking for the best hair loss treatment in Australia, an alopecia natural treatment that addresses all the factors that caused the condition is the ideal approach. Our practitioners at Melbourne Functional Medicine can help with an alopecia alternative treatment.

Can alopecia areata go away?

Alopecia areata is an autoimmune condition where the body’s own immune system attacks the hair follicles, causing hair loss. Luckily, in most cases this is not permanent, as the follicles retain the ability to regrow, and when given the right circumstances, will regrow missing patches of hair.

Even so, the underlying causes and contributing factors may return if they have not been addressed. People who have one autoimmune condition will often develop other autoimmune conditions, a sign of a dysregulated immune system. Often, there are gut flora disturbances, but also a whole range of other factors can contribute. If you have alopecia areata, then addressing your underlying factors may help you avoid developing other autoimmune conditions, and improve your overall health.

If you’re seeking an alopecia treatment in Australia, or you’re looking for a general hair loss treatment, a functional medicine practitioner at Melbourne Functional Medicine can help.

Can’t find what you’re looking for? Reach out to the team directly – we’ll be happy to assist.