"You have a bald patch," informed the barber casually. Maheshbhai went home and checked his scalp. Sure enough, there was a round area devoid of hair and smooth as a baby’s bottom! Panic gripped him! He had never seen anything like it before.
His mother comforted him. “This is undri, beta. It is caused by worms that eat away the hair. Just apply garlic juice for a few days to kill the germs and soon your hair will grow back,” she assured him.
He did as instructed. There was some stinging initially that he ignored. Soon the burning intensified and he had a raging rash with blisters on the scalp. The bald patch in this story is a condition called alopecia areata (AA) and what followed was a severe reaction to garlic.
AA is an autoimmune disorder in which the body launches an immune response against its own hair follicles. The condition may be genetic in some people. In quite a few cases, it is triggered off by highly stressful situations. Some patients have other autoimmune phenomena simultaneously, particularly antibodies directed against the thyroid gland.
There may be one or two patches of AA. Some develop multiple patches. It can be embarrassing when large patches occur or eyebrows and eyelashes are affected. Men are distressed when half a moustache is lost. A very small percentage may lose all hair on the scalp and even all over the body.
A single patch of AA will re-grow hair within six months to a year even without treatment. There are many options for treating AA. But none of them is uniformly effective.
A popular folk solution is application of irritants like onion and garlic juice. Sometimes even jamalgota (croton oil) is pressed into service. The irritation seems to stimulate re-growth. Unfortunately, the irritation that follows can sometimes get out of hand.
The course of AA and the response to treatment is unpredictable and varies from person to person. Till the hair grows back completely, it is often a good idea to camouflage the spots. Wigs or patches improve appearances considerably. Masking the eyebrows with an eye pencil can make the face presentable. Men may be forced to go for a clean shave if a beard or moustache is involved.
A dermatologist will choose the right combination of immune response modifiers, hair growth stimulants, irritants and contact sensitisers to handle the situation. Remember to give at least two to three months before discarding a treatment modality as useless.
National Alopecia Areata Foundation ( www.alopecia areata.com) is a valuable information resource for patients with extensive alopecia areata.