Alopecia Areata can respond well to steroid treatment.
When we hear the word steroids, our minds usually jump to images of fake-tanned body builders standing in uncomfortable looking poses. The word steroid, when used in that context refers to anabolic steroids. Male sex hormones that help lay down muscle mass.
When one looks at our physiology a little, this confusion soon goes away.
Our bodies evolved in an environment of dealing with basic predatory threats in the animal kingdom. The stress response is often referred to as the fight or flight mechanism, because we produce a cocktail of hormones that make us stronger to fight a predator or flee the scene.
Studying animals in Africa help us understand our own physiology better. Fights are sudden and violent, during which a lot of the dust from the dry plains is disturbed.
As we use more air during combat, we would cause an allergic reaction if our stress hormones did not suppress the normal inf lammatory response.
The body therefore makes a short term survival decision that overrides longer term health consideration. For example blood is diverted away from digestion and directed to muscles as there is no point in wasting energy digesting your lunch at the point you are likely to become someone else's lunch !
Corticosteroids are a class of drugs that mimic the actions of our adrenal hormones. They are used because they can lower our immune response and suppress inflammation.
Alopecia areata is an auto-immune disease. What happens is that the immune system gets confused and mounts an immune attack on the hair follicles in given regions of the scalp or other areas like the brows or beard.
As steroids are known to suppress the immune system, they can be applied to and absorbed by the skin to create a localised area in which the immune system is suppressed.
Corticosteroids were first used in 1948 to treat arthritis and had a rather dramatic effect due to their ability to suppress inflammation. However as the stress response is a very short term reaction and such longer term use soon began to demonstrate the side effect of steroid use.
The following are the most common side effects with topically applied steroids. However the chances of developing them will depend on the size of the area being treated, the strength of the steroid together with how long treatment is continued for.
1) Changes in skin pigmentation
2) Thinning of the skin, which may result in permanent stretch marks.
3) Fine blood vessels in the skin may enlarge and become visible under the skin surface, resulting in a permanent change.
4) Allergies.
5) Bruised skin
6) Infections
More serious side effects like growth problems in children and Cushing's syndrome, can come about if larger areas are treated over prolonged periods.
It follows that the doctor will look to administer the lightest stren gth steroid possible for a short period of time to avoid such side effects.
We often find that parents take a child with alopecia areata to their doctor and when they read the potential side effects of the treatement and then too worried to use it.
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