Last Updated on 5th January 2023 by Caroline Haye
The bald truth about leucoderma and alopecia
First of all, apologies for the subtitle. I couldn’t resist. 😉 But read on, because the truth isn’t as bald as the heading suggests. Assuming you are reading this because you are wondering, does vitiligo cause hair loss?, I hope to be able to provide you with some answers. And hopefully some reassurance too.
Since my blog is entirely about vitiligo I’m guessing you already know what that is. You may have it yourself or maybe you are researching the subject for a loved one. But, if not, and your first question is, what is vitiligo?, then you may want to look that up before you read the rest of this post.
The next obvious question is, what is alopecia? Like vitiligo, it is a word you may only have come across if you have been directly affected by it. But, in fact, it describes a condition that we are all familiar with.
What is alopecia?
In the same way as leucoderma is sometimes used to describe vitiligo, alopecia is a less familiar word for hair loss. It comes from the Greek word for fox and, supposedly, refers to the patchy hair loss associated with those animals that had the mange. It’s the word your doctor would use and it can refer to any kind of hair loss.
So alopecia is not a disease in itself (although it can be a symptom of various diseases). It is an umbrella term for all types of balding or thinning of the hair anywhere on the body. And you may be surprised at how many types there are.
What are the different types of alopecia?
You can read a longer description of the main types of alopecia in this article: Disabled World. Language: English. Author: Danny Ashton. Electronic Publication Date: 2012/09/26. But I have provided a brief definition of most of them (in brackets) below.
- Alopecia areata (the autoimmune condition sometimes associated with vitiligo)
- Androgenic alopecia (a.k.a. male pattern baldness)
- Alopecia universalis (total hair loss of the scalp and body)
- Alopecia totalis (total hair loss of the scalp only)
- Ophiasis (a subtype of alopecia areata causing wave-like patterns on the scalp)
- Traction alopecia (caused by long-term pulling of the hair roots)
- Chignon alopecia (a type of traction alopecia often due to certain hairstyles)
- Hypotricosis (a total absence of hair growth)
- Telogen effluvium (temporary hair loss due to stress)
- Lichen planopilaris (scarring hair loss due to lichen planus)
- Trichorrhexis nodosa (a defect in the hair shaft that causes brittle hair)
- Folliculitis (a bacterial infection of the hair follicles)
So, now that we have a rough idea of the various types of hair loss and their causes, where is the link with vitiligo?
Alopecia areata
As you saw from the list above, the type of hair loss that is sometimes associated with vitiligo is alopecia areata. The “areata” part of the name means “limited to certain areas”. In other words, occurring in patches (usually fairly small). So, unlike generalised hair loss or male pattern baldness, alopecia areata affects clearly defined patches of skin and hair, rather like vitiligo does.
This similarity is just one of several features both conditions have in common. Perhaps the most relevant, in the context of vitiligo, is that they are both autoimmune conditions. In other words, the symptoms of both diseases are the result of the immune system mistakenly attacking healthy cells. And both conditions appear to have a genetic dimension, meaning that a family history increases the likelihood of developing them.
There is no cure (yet) for either condition, although the hair in alopecia areata often grows back, whereas the skin colour in vitiligo does not usually return. Interestingly, when hair regrows in cases of alopecia areata, it often grows back white. In some cases, this happens because the individual has both autoimmune conditions. But in others this depigmentation is just temporary… Possibly due to a short-term disturbance to the pigment cells (melanocytes) because of their proximity to the affected hair follicles.
The similarities and differences between alopecia areata and vitiligo have not been widely studied. But Dr John Harris’ article on the subject makes for interesting reading. Not just interesting either. Dr Harris is also characteristically optimistic, in that he highlights ways in which comparative and collaborative studies of both conditions could help develop treatments for both.
So, back to the reason you may be reading this. The question of how likely vitiligo is to cause hair loss.
Will my vitiligo cause alopecia?
Once we start thinking in terms of genetic factors and links between autoimmune conditions, it’s easy to start worrying about one condition leading to another. But it’s important to put the probabilities into their proper perspective.
Approximately 1% of the population develops vitiligo. And the risk of having alopecia areata at some point in your life is thought to be no more than 2%. According to the British Skin Foundation, roughly 20% of alopecia areata sufferers have a family history of the disorder. And the hereditary percentage for vitiligo is a similar figure. Meanwhile, an estimated 15 to 25% of people with vitiligo are likely to develop other autoimmune conditions, with thyroid disease (not alopecia areata) being one of the most common.
These statistics are interesting in themselves. But they are not easy to relate to each other. So it’s comforting to know that, when all factors are taken into account, the chances of vitiligo leading to alopecia seem to be comparatively low. Dr Harris estimates the incidence at 1:100,000 people within the general population… Which means you have something like a 0.001% chance of developing both conditions.
