Alopecia areata is considered to be an immune mediated disorder stemming from the body mistakenly attacking it’s own cells. Scalp biopsies carried out to diagnose the cause of hair loss often show a large number of T-cells around the base of the follicle. These T-cells cause inflammation that eventually arrests cell growth and leads to the arrest of hair growth.
A number of studies have shown an imbalance in T-cell populations with a marked decrease in regulatory T-cells [2-4]. Regulatory T-cells regulate the immune response and prevent the immune response from overreacting to any perceived threats. A study in 2019 by the National Alopecia Areata Foundation identified a number of regulatory T-cells are preferentially located to hair follicles. They were required for proper hair cycling and hair growth, they looked at novel therapies to enhance regulatory T-cell populations.
For hair to grow normally, the hair must retain its immune privilege and be safe form the actions of the innate or adaptive immune system. There are a number of contributing factors that determine whether some is likely to suffer form alopecia areata including: genetics, environmental factors and prior infections.
In some cases, alopecia is the only known sign of celiac disease . One study found that a number of patients experienced complete remission of the disease after following a gluten free diet. The study looked at how celiac disses was associated with a number of allergies, inflammatory conditions and other miscellaneous diseases.