The autoimmune condition Alopecia Areata may be the second most common form of hair loss behind androgenetic alopecia, but it remains far more mysterious. Although researchers have managed to identify certain triggers, the reason this enigmatic condition occurs is still unconfirmed.
Whilst it has been linked to sudden shock, stress, genetic factors and even allergies, a new study published in the Journal of Cosmetic Dermatology has found that people with Alopecia Areata appear to have fewer vitamin D receptors than those with genetic hair loss or those with no hair loss at all.
However, although both male and female pattern hair loss is far more established in that its pathogenesis is better understood, researchers also discovered that these common forms of thinning may also be influenced by people’s levels of vitamin D receptors.
Cairo University trial
According to the study, the ‘expression of vitamin D receptors (VDRs) on keratinocytes is essential for maintenance of normal hair cycle, especially anagen initiation’. The ‘anagen’ phase of the hair growth cycle is the active growth stage so, if anything impacted on this – such as a lack of expressive vitamind D receptors – then this would negatively influence the growth of new hair.
Cairo University carried out the trial comprising 60 volunteers, equally split into categories of those with alopecia areata, those with androgenetic alopecia (male or female pattern hair loss) and a control group with no hair loss conditions.
Lead by Dr. Marwa M.T. Fawzi, the team investigated levels of vitamin D receptors in the skin and blood of each participant by taking blood samples and lesional scalp biopsies for examination.
What the results from these tests showed was that the two groups with hair loss, whether autoimmune or genetic, had noticeably lower VDR levels than those in the control group – those unaffected by any hair loss conditions.
Researchers discovered that the tissue VDR readings were ‘significantly lower’ in the women with Alopecia Areata than they were in men with the same condition (P = 0.046). However, both serum and tissue VDR levels were ‘significantly higher’ in women with female pattern hair loss than they were in men with male pattern baldness (P = 0.004).
As such, the Cairo team concluded the report into their findings by stating that ‘this study suggests an important role for VDR in the pathogenesis of AA and AGA through documenting lower serum and tissue VDR levels in AA and AGA patients in comparison with controls’.
Understanding hair loss to treat it
In order to effectively treat hair loss conditions it is important to fully understand the reasons why they occur and the biological process they trigger which causes the hair fall. As more research is done into the different conditions, more information becomes available, thus allowing new and improved hair loss treatments to be developed.
In the case of Alopecia Areata and its more severe sister conditions Alopecia Totalis and Alopecia Universalis, the links between various autoimmune conditions have pointed doctors in the direction of a group of drugs known as Janus Kinase inhibitors. Clinical trials investigating a number of JAK inhibitors have so far proved incredibly promising, regrowing hair in a number of patients from those with moderate Alopecia Areata to others who were previously completely bald due to Alopecia Universalis.
These drugs have not yet been licensed as they are still in testing to ensure they reach the necessary levels of efficacy and safety; topical applications are currently being explored in an attempt to minimise some of the more extreme side effects connected with oral use, particularly in the case of tofacitinib.
The basics of how thinning hair caused by androgenetic alopecia in both men and women are well known; when the body converts testosterone to the more potent androgen dihydrotestosterone (DHT) those with a genetic predisposition to this condition are exposed to the hair miniaturisation process. This is where DHT binds to the hair follicles around the top of the head, attacking them, making them increasingly weaker and thinner until, in some cases and particularly with men, hair growth is no longer possible.
Despite this, researchers frequently discover new genes involved in the process. Only recently a study at UCL identified a number of genes which they managed to link to different hair characteristics – from greying to hair loss – for the first time.
With each new discovery comes the opportunity to explore novel hair loss treatments or improve upon those already available – some of which can be incredibly effective already. There are two clinically-proven medications for treating male pattern baldness, one of which – minoxidil – is also suitable for use in treating women’s hair loss. At Belgravia we have experienced further successes in using specially chosen formulations of high strength minoxidil from those available at our in-clinic pharmacies, as a treatment for alopecia areata. So, although there is always room for new ideas and solutions, given new treatments can take many years to become available to the public, it is good to know there are already trusted treatments available to prevent shedding and promote regrowth.
The Belgravia Centre
The Belgravia Centre is the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.