Subject(s)
Alopecia Areata , Humans , Alopecia Areata/therapy , Alopecia Areata/psychology , Risk Factors , CounselingABSTRACT
Telogen effluvium (TE) is a common cause of diffuse non-scarring hair loss that is usually precipitated by physiological stress such as childbirth or sudden weight loss. Despite its high rate of remission, this phenomenon of sudden excessive hair loss can be very worrisome and upsetting for affected individuals and may significantly impact their quality of life. Due to the multifactorial causes and precipitants of TE, it is often challenging to diagnose and manage. Further, the mechanisms through which physiological stress influences the human hair cycle is unknown, and there are no targeted treatments for the management of TE. This review will describe the approach in making a diagnosis of TE, summarize the latest developments made in understanding the mechanisms of TE, outline the treatments tried, and recommend ways for advancing the study of this dermatological condition.
Subject(s)
Alopecia Areata/etiology , Anxiety/therapy , Hair Follicle/growth & development , Stress, Psychological/therapy , Administration, Oral , Administration, Topical , Alopecia Areata/diagnosis , Alopecia Areata/psychology , Alopecia Areata/therapy , Anxiety/complications , Anxiety/psychology , Apoptosis/drug effects , Biopsy , Combined Modality Therapy/methods , Counseling , Diagnosis, Differential , Dietary Supplements , Hair Follicle/drug effects , Hair Follicle/pathology , Humans , Minoxidil/administration & dosage , Patient Education as Topic/methods , Plant Extracts/administration & dosage , Quality of Life , Stress, Psychological/complications , Stress, Psychological/psychology , Vitamin D/administration & dosageSubject(s)
Alopecia Areata/therapy , Behavior Therapy/methods , Delivery of Health Care, Integrated/methods , Dermatology/methods , Alopecia Areata/diagnosis , Alopecia Areata/psychology , Behavior Therapy/organization & administration , Delivery of Health Care, Integrated/organization & administration , Dermatology/organization & administration , Feasibility Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Pilot Projects , Program Evaluation , Prospective Studies , Treatment OutcomeABSTRACT
The study explored experiences of adolescents aged 15-19 with alopecia areata (AA) and investigated their accounts of coping behaviours. Interpretative Phenomenological Analysis was used to provide an in-depth and holistic perspective of their accounts. Semi-structured interviews were undertaken with a volunteer sample of eight respondents diagnosed with AA. Four key themes were identified: loss (self/social), concerns (physical/future), negative (emotions/thoughts), and coping styles (adaptive/maladaptive). Females experienced greater feelings of loss, were more concerned about their looks and their future, and reported more negative thoughts and emotions. Females felt angry and blamed God for their fate; males blamed both their fate and luck. Action-oriented and practical coping styles were adopted by all of them. After the realization that initial coping behaviours were ineffective, self-distraction, acceptance, and humour were used. Psychological relief followed with the practice of religion and planning for treatments to be undertaken in the future. The findings here are similar to research conducted in the West, though with more emphasis on religion. Health care providers and student counsellors need to understand the negative psychosocial consequences for adolescents living with a visible disfigurement and provide appropriate psychological and social support.
Subject(s)
Adaptation, Psychological , Alopecia Areata/psychology , Emotions , Adolescent , Attitude , Female , Humans , Interviews as Topic , Male , Pakistan , Qualitative Research , Religion , Social SupportSubject(s)
Dermatologic Agents/administration & dosage , Dermatologic Agents/adverse effects , Education , Fumarates/administration & dosage , Fumarates/adverse effects , Psoriasis/drug therapy , Administration, Oral , Alopecia Areata/drug therapy , Alopecia Areata/epidemiology , Alopecia Areata/psychology , Autoimmune Diseases/drug therapy , Autoimmune Diseases/epidemiology , Autoimmune Diseases/psychology , Biological Availability , Clinical Trials as Topic , Comorbidity , Dermatologic Agents/pharmacokinetics , Dimethyl Fumarate , Dose-Response Relationship, Drug , Drug Administration Schedule , Etanercept , Follow-Up Studies , Fumarates/pharmacokinetics , Humans , Immunoglobulin G/administration & dosage , Immunoglobulin G/adverse effects , Metabolic Clearance Rate/physiology , PUVA Therapy/methods , Pilot Projects , Prospective Studies , Psoriasis/epidemiology , Psoriasis/psychology , Quality of Life , Receptors, Tumor Necrosis Factor/administration & dosage , Registries , Sick RoleABSTRACT
Although there often exists important psychological comorbidity in patients with alopecia areata, few studies have investigated the role of psychotherapeutic interventions. The aim of this prospective cohort study was to investigate the long-term evolution of psychological symptoms in twenty-one patients with refractory alopecia areata. Patients received 10 individual sessions of hypnosis during an approximate 6-month period. Before treatment, patients presented a pathological psychological comorbidity. After treatment, a significant amelioration of alexithymia, anxiety, depression and mental well-being was observed. These improvements were maintained up to 6 months after the end of treatment. Important limitations of this study include the recruitment of highly motivated patients and a non-controlled study design. In summary, hypnotherapy may be effective for significantly improving and maintaining psychological well-being and quality of life in patients with refractory alopecia areata.
Subject(s)
Alopecia Areata/psychology , Hypnosis , Quality of Life , Adolescent , Adult , Affective Symptoms/diagnosis , Aged , Emotions , Female , Health Status , Humans , Male , Middle Aged , Surveys and Questionnaires , Young AdultSubject(s)
Alopecia Areata/psychology , Anxiety/psychology , Depression/psychology , Hair/growth & development , Hypnosis , Quality of Life/psychology , Adult , Alopecia Areata/therapy , Anxiety/therapy , Cohort Studies , Depression/therapy , Female , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
Alopecia areata (AA) is an autoimmune disease leading to loss of scalp hairs. The disease seems triggered by stress. Data on the possibility of using hypnotherapy in the treatment of AA are very limited. Twenty-eight patients with extensive AA, all refractory to previous conventional treatment, were treated with hypnosis at the Academic Hospital UZ Brussel, Brussels, Belgium. This paper describes in detail the authors' hypnotherapeutic approach combining symptom-oriented suggestions with suggestions to improve self-esteem. Twelve out of 21 patients, including 4 with total loss of scalp hair, presented a significant hair growth. All patients presented a significant decrease in scores for anxiety and depression. Although the exact mechanism of hypnotic interventions has not been elucidated, the authors' results demonstrate that hypnotic interventions may ameliorate the clinical outcome of patients with AA and may improve their psychological well-being.
Subject(s)
Alopecia Areata/therapy , Hypnosis/methods , Adult , Affective Symptoms/psychology , Affective Symptoms/therapy , Aged , Alopecia Areata/psychology , Female , Humans , Imagination , Male , Meditation , Phobic Disorders/psychology , Phobic Disorders/therapy , Pregnancy , Self Concept , Stress, Psychological/complications , SuggestionABSTRACT
BACKGROUND: Only limited data exist on the role of psychotherapy in alopecia areata (AA). OBJECTIVE: We sought to document the influence of hypnotherapy on psychologic well-being and clinical outcome in AA. METHODS: Hypnosis was used in 28 patients with extensive AA who were refractory to previous conventional treatments. It was added as a complementary treatment or used as the only treatment. RESULTS: In all, 21 patients, 9 with alopecia totalis or alopecia universalis and 12 with extensive AA, were analyzed during a 5-year period. After treatment, all patients had a significantly lower score for anxiety and depression. Scalp hair growth of 75% to 100% was seen in 12 patients after 3 to 8 sessions of hypnotherapy. Total growth occurred in 9 of these 12 patients, including 4 patients with alopecia universalis and 2 with ophiasis. In 5 patients, a significant relapse occurred. LIMITATIONS: This is a preliminary study with a limited number of patients. A larger randomized study is necessary. CONCLUSION: Hypnotherapy may enhance the mental well-being of patients with AA and it may improve clinical outcome.
Subject(s)
Alopecia Areata/psychology , Alopecia Areata/therapy , Hypnosis , Adolescent , Adult , Aged , Female , Humans , Male , Mental Health , Middle Aged , Recurrence , Treatment OutcomeSubject(s)
Alopecia Areata/diagnosis , Alopecia Areata/therapy , Administration, Topical , Alopecia Areata/psychology , Anti-Inflammatory Agents/therapeutic use , Aromatherapy , Child , Cyclopropanes/therapeutic use , Diagnosis, Differential , Female , Humans , Immunotherapy/methods , Injections, Intralesional , Remission, Spontaneous , Triamcinolone Acetonide/therapeutic useABSTRACT
Alopecia areata, a common cause of hair loss, is generally considered the consequence of an autoimmune process. Both physiological and psychological factors have been implicated. Previous studies have not incorporated behavior modification in their treatment designs. In this study, three treatment techniques (hair massage, relaxation procedures, and monetary reward) were applied to a 16-year-old male with a five-year history of alopecia areata. Comparison for seven months without treatment versus seven months with treatment showed that loss of hair was markedly reduced after three months of treatment. During the last four months of the study, new hair growth was evidenced.