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Hair Health

Alopecia Areata: Is it Hereditary?

Genes play a major role in our appearance. For example, you may have inherited your father’s striking eye color and his sunny smile. But did you inherit his bald patches? If you’re reading this article then you’ve probably noticed a family member’s thinning hair and wondered, “Is alopecia areata hereditary?” Let’s find out.

What is Alopecia Areata?

The term “alopecia” means hair loss. Therefore, alopecia occurs under a variety of conditions, like chemotherapy-induced alopecia and frontal fibrosing alopecia. Alopecia areata is an autoimmune condition that results in discrete bald patches throughout the scalp, face, or body. The immune system mistakenly targets hair follicles, which results in hair loss. In some cases, the entire head is affected causing complete baldness. (01)

Alopecia areata is not life-threatening, but it can negatively affect a person’s mental health. A study of individuals diagnosed with alopecia areata found high levels of anxiety (62%) and depression (38%) among participants. Therefore, hair loss conditions like alopecia areata don’t cause physical pain – but they can cause a great deal of psychological distress. (01)

What Causes Alopecia Areatea?

The body’s immune system fights against foreign invaders, protecting the body from pathogens. For the most part, the immune system does their job excellently. In some cases, however, the immune system can attack the body’s own cells. In the case of alopecia areata, the immune system strikes at the hair follicles, triggering an early start of the hair follicle’s “resting phase,” also called the telogen phase. The follicle loses its strand of hair and stops producing more strands.  The exact cause of alopecia areata is yet unknown.

What are the Symptoms of Alopecia Areata?

Most people visualize a bald head when they hear the term alopecia areata. However, alopecia areata can affect any part of the body, like the legs or beard area. Symptoms of alopecia area include:

  • Distinct oval or round-shaped patches on the scalp.
  • Areas of hair loss that get larger with time.
  • Two or more patches that grow larger and connect.
  • Hair loss that affects one side of the head more than the other (asymmetrical).
  • Fragile or white-spotted nails.

One of the hallmarks of alopecia areata are the short broken hairs or “exclamation point” hairs located at the perimeter of bald patches. These hairs are narrower at the base and thicker at the tip. A frustrating aspect of alopecia areata is the condition’s unpredictable nature. The condition may come and go, with hair regrowth and then subsequent episodes of hair loss. Some individuals may experience a complete loss of hair on their body, though this occurrence is very rare. (01)

What are the Types of Alopecia Areata?

Alopecia areata shows up differently in each person. For example, one person may find small bald patches on one side of their head, while another person with alopecia areata may experience total hair loss.

The three primary types of alopecia areata are: (02)

  • Patchy Alopecia Areata. Individuals with patchy alopecia areata develop one or more round bald patches on the scalp, eyebrows, armpits, or eyelashes.
  • Alopecia Totalis. Alopecia totalis causes complete baldness, resulting in total loss of hair on the scalp.
  • Alopecia Universalis. People with alopecia universalis experience a total loss of hair throughout their body, including the hair on their finger and toes.

Fortunately, lost hair from alopecia areata often grows back, particularly with treatment. Even with the loss of hair, hair follicles remain “alive” and operational. Therefore, it’s possible to regrow hair, even after long periods of hair loss. People with alopecia areata may experience cycles of hair loss and regrowth throughout their lives. New hair may appear fragile and white, at first, then slowly return to their original color. (02)

Who Gets Alopecia Areata?

According to the National Alopecia Areata Foundation (NAAF), about 7 million people in the U.S. are affected by the condition. Alopecia areata also affects all racial and ethnic groups throughout the world. Any person at any age can develop alopecia areata, but the condition appears before the age of 20 in about 60% of people with the disorder. When alopecia areata develops in children under 10, however, hair loss tends to be more extensive and progressive. (03)

People with following disorders have a higher risk of developing alopecia areata:

  • Vitiligo
  • Eczema
  • Allergies
  • Hypothyroidism
  • Down Syndrome
  • Systemic Lupus Erythematosus
  • Ocular Cicatricial Pemphigoid
  • Diabetes
  • Rheumatoid Arthritis

Cancer patients receiving treatment may also develop alopecia areata. For example, a cancer drug called nivolumab has been known to cause alopecia areata a few months after treatment. This form of alopecia areata is called nivolumab-induced alopecia. In this case, hair loss is thought to be a good sign that the cancer medication is doing its job well. (03)

Having a family member with alopecia areata may raise a person’s risk of developing the condition. Data indicates that approximately 10% to 20% of people with alopecia areata have a blood relative with the condition. Having said that, having a family member who is diagnosed with alopecia areata does not guarantee that you will develop the condition. (02)

Is Alopecia Areata Hereditary?

Whether alopecia areata is hereditary or not is unknown. Research into the condition has identified hair follicle specific genes, such as (peroxiredoxins) PRDX5 on chromosome 11q13. PRDXs are enzymes within hair follicles, and may be responsible for influencing autoimmune disease. Additionally, autoimmune disorders in general are thought to have genetic components, making them likely to have hereditary factors. (04)

However, the environment, lifestyle choices, and individual health may also play significant roles regarding whether an individual will develop an autoimmune condition like alopecia areata. A recent article in the journal Nature stated that autoimmune diseases occur due to a combination of variables, like genetic predisposition and environmental triggers that disturbs the immune system’s ability to decipher the body’s own tissues. (04)

It’s important to keep in mind that more than half of people who are diagnosed with alopecia areata do not have a family link to the condition. Furthermore, genetic diseases often skip generations or people in families with no predictable pattern. In short, there is no definite answer – at this time– whether autoimmune diseases like alopecia areata are hereditary.

As with many health conditions that have a genetic component, alopecia areata’s genetic links are not the only deciding factor.

So, is alopecia areata hereditary? All the signs point to a definite “maybe.”

Managing Alopecia Areata

Will your children develop alopecia areata? They may, but the chances are more likely that they will not. Will you develop alopecia areata if your mother has the condition? Your risk is higher than people who do not have a family member with the condition, but the chances are that you won’t develop alopecia areata. The crystal ball is murky when it comes to alopecia areata.

That said, the true issue is managing alopecia areata if and when it appears. Hair loss can cause psychological anguish. Getting a handle on alopecia areata symptoms before they worsen helps prevent undue stress. Happy Head’s board-certified dermatologists and hair specialists are here to help. Whether hair loss is due to alopecia areata, male pattern baldness, or telogen effluvium, we can answer your questions and assist in finding the right treatment. Contact us and start regrowing your hair today.

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