Ophiasis Pattern & Alopecia

Cornelius Celsus was the first doctor to describe alopecia areata and called it ophiasis, reports researchers in an “Internet Journal of Dermatology” article, and some people still refer to it as Celsus alopecia today by some. Today, ophiasis is known as a type of alopecia areata, an autoimmune disease in which hair loss occurs.

Types of Alopecia Areata

• There are many types of alopecia areata. The most dramatic types are alopecia totalis, alopecia universalis and alopecia ophiasis. In alopecia totalis all of the hair on the scalp is lost, according to White and Cox, authors of “Diseases of the Skin.” Alopecia universalis is a loss of hair from the entire body and alopecia ophiasis refers to hair loss on the back and sides of the head.
  Alopecia ophiasis involves hair loss in a band. Ophiasis is the Greek word for serpent and refers to the turban or snake-like pattern of hair loss on the scalp, according to Alopecia Areata Info. The website reports that alopecia ophiasis is among the most difficult types of the condition to treat.
  The ophiasis pattern occurs in 5 percent of childhood cases of alopecia areata, reports Linda Little for “Skin and Allergy News.” In 25 percent of such cases, fingernails thicken or form ridges and pits.
  “This form heralds a bad prognosis,” says Dr. Ronald Hansen, pediatrician and dermatologist at Phoenix Children’s Hospital.

Causes of Alopecia Areata

• White and Cox write that alopecia areata is an autoimmune disease but its triggers, what area is affected and what causes hair loss to progress or hair regrowth to occur is unknown.
  Most patients experience small patches of hair loss and are entirely healthy otherwise, write White and Cox, but in severe cases, alopecia areata occurs along with other conditions such as anemia, atopic diathesis, Down syndrome and thyroid problems.

Who is Affected

• Alopecia affects 1 percent of the American population, according to Linda Little, and half that number are children. White and Cox write that the classic alopecia areata patient is a teenager or young adult.
  Japanese researcher Ikeda classified alopecia areata into four categories according to severity and associated health conditions, reports Alopecia Areata Info.
  Type I patients make up 80 percent of the alopecia areata cases. They have small localized patches of hair loss, no family history of the condition and aren’t usually afflicted with other disorders.
  Type II patients usually suffer from allergies, asthma or dermatitis and often present the ophiasis pattern of hair loss. Three-quarters of these patients end up with total hair loss on the scalp.
  About 4 percent of alopecia areata cases are Type III cases. The patients have chronic diseases and a family history of hypertension. Thirty-none percent of these patients develop total hair loss on the scalp.
  Type IV cases affect people over the age of 40 and lead to total hair loss on the scalp 10 percent of the time.

Psychological Treatment

• In most alopecia areata cases, the hair loss occurs in small patches and will grow back eventually. Whether hair loss is small or localized or whether it is extensive, Dr. Hansen says it can be psychologically devastating. Treatment of alopecia areata must include psychological counseling.
  This is especially true of young females, says Hansen. Some boys won’t mind total hair loss because many sports heroes shave their heads, but baldness isn’t the norm for females. He adds that wigs aren’t made for small children normally and that many insurance plans won’t pay for wigs anyway.

Treatment

• When the hair loss is limited it is 95 percent likely that the hair will grow back without treatment, reports Linda Little, but alopecia totalis, alopecia universalis and alopecia ophiasis cases require treatment and regrowth isn’t a given.
  Topical steroids can’t penetrate the scalp, says Dr. Hansen; injecting steroids produces better results but can be painful and scary for young patients.
  Topical sensitizers rubbed onto the scalp can create an allergic response that triggers hair growth.
  Both injected steroids and topical sensitizers work about 60 percent of the time.
  Oral steroids work best to grow hair, but hair loss occurs as soon as treatment ends so Dr. Hansen calls them “a dead end.”