What is Ringworm (Alopecia Areata)? Ringworm Causes and Treatment

by Abbas Jahangir · June 22, 2024

Ringworm, or alopecia areata as it is called in the medical literature, is a common autoimmune disorder that causes regional hair loss. Autoimmune disorders generally refer to the immune system’s attempt to fight against its own cells and tissues. In this disorder, the affected area is the hair follicles. In most people who develop this condition, hair loss is found in coin-sized round patches. This condition, which occurs in several areas in most people, tends to be quite severe in some people. In some cases, ringworm develops to affect the entire hair and the hair on the scalp may fall out completely. In more severe cases, people may lose all their body hair.

What is Ringworm (Alopecia Areata)?

Ringworm (alopecia areata) is an autoimmune disorder characterized by regional hair loss that affects the hair follicles and nails. These spills, which initially appear as small patches, may be so insignificant that they cannot be noticed. Then, the combination of these small patches may cause you to notice that you are experiencing hair loss in a significant area.

There are different types of ringworm with different characteristics. In addition to sudden and regional hair loss on the scalp, in some cases eyebrows, eyelashes, beard and other body hair are also affected. In some cases, this condition develops very slowly and may recur over the years.

Alopecia areata disease is divided into many subtypes. Ringworm is the most common of these subtypes. The type of alopecia in which all hair on the scalp is affected is called “alopecia totalis”. When this effect covers the whole body, it is called “alopecia universalis”. In some people, sudden excessive thinning and weakening of hair without hair lightness is defined as “diffuse alopecia areata”. Ringworm cases in which the hair loss occurs in the form of a hair band on the nape and behind the ears instead of round patches are called “ophiasis”.

What Causes Ringworm (Alopecia Areata)?

Ringworm is an autoimmune event. In autoimmune disorders, the immune system identifies healthy body cells as a foreign invader and produces antibodies against these structures. Ringworm is a disease caused by the immune system’s incorrect evaluation of hair follicles. Hair follicles are structures that allow hair to grow. Impact on these structures stops hair growth and results in hair loss. It is currently unclear what the actual factor that triggers this underlying cause of alopecia is. Ringworm is generally detected more frequently in individuals with a family history of other autoimmune diseases such as thyroid gland disease, diabetes and rheumatoid arthritis. Therefore, it is thought that the triggering condition is caused by genetic factors.

Situations that pose a risk for the development of alopecia areata and may be among the causes of ringworm can be summarized as follows:

Having other family members affected by ringworm
Asthma
down syndrome
pernicious anemia
seasonal allergies
Thyroid gland diseases
Vitiligo

In addition to genetic factors, various environmental factors may also be effective in the emergence of this disease. Stress is one of the most important environmental factors.

What are the symptoms of ringworm (Alopecia Areata)?

The most obvious symptom of ringworm is patchy hair loss. This shedding usually starts on the scalp and is about the size of a coin. Apart from the scalp, the onset of ringworm can also occur in the beard and eyebrow area. Hair loss occurs quite suddenly and the duration of its occurrence may vary between 5 days and 5 weeks. In addition to hair loss, some people may also experience itching and burning in the affected area. In this disorder, hair follicles do not disappear completely.

Hair strands that fall off the surface can grow back if the inflammation in the hair follicles decreases. It has been observed that in people suffering from this condition, when the hair loss is limited to only a few areas, the condition can heal without treatment. In one third of cases, the course of ringworm may worsen or regional hair loss may occur in recurring cycles over a period of time. In one in 10 patients, ringworm may progress to forms that affect other parts of the body.

Ringworm can also cause some changes in the fingernails and toenails. These changes in the nails are especially seen in ringworm cases in children. Caution should be exercised as these changes may occur as the first symptom of the disease in some people:

Pinhole-shaped cavities
White spotting or streaking
Hardening of nails
Nails look pale
Thinning or splitting of nails

In addition to these symptoms on the nails, other clinical findings that occur during ringworm can be summarized as follows:

Hair growing in the shape of an exclamation mark
Detecting that some of the hair strands in the affected area fall out before reaching the surface
Graying of hair around the affected area

The course of ringworm may vary from person to person and the process may not be predictable. While in some people it is observed that normal hair grows back in the affected area, in some people this may not happen and hair loss may progress to a more severe level.

Factors such as the onset of the disease at an early age, excessive hair loss, accompanied by nail changes, the presence of other members of the family affected by this disease, and the presence of other autoimmune diseases are considered among the risk factors that indicate that ringworm may have a bad course.

How is Ringworm (Alopecia Areata) Diagnosed?

After applying to health institutions with complaints of ringworm, physicians can diagnose ringworm only by clinical observation. If necessary, a few hair samples can be taken and examined under a microscope.

In individuals thought to be accompanied by various autoimmune diseases, blood tests may be useful to clarify these problems. Diagnosis of autoimmune diseases can be made by detecting antibodies synthesized by the immune system in the body. Can be used in the diagnostic approach for ringworm disease

The examinations can be summarized as follows:

Iron parameters, vitamin, B12,
Antinuclear antibody test
Examination of thyroid hormone levels
Blood sugar

Ringworm is not a contagious disease, but some people may require a biopsy to rule out fungal infections such as tinea capitis, which is characterized by hair loss. Skin biopsy may also be useful in clarifying diffuse forms of alopecia.

Another answer to the question of how to understand that you have ringworm is dermoscopy. Dermoscopy is another useful diagnostic tool that can be used to diagnose ringworm. Through dermoscopy, physicians can examine the presence of signs such as yellow or blackheads, hair breakage, short vellus hairs, and exclamation mark hairs in the affected area.

How is Ringworm (Alopecia Areata) Treated?

With various medical interventions within the scope of alopecia areata treatment, hair loss can be reduced and the lost hair can grow faster. Ringworm is a very complex disease in terms of the healing process. In some people, many alopecia areata treatment methods can be tried to determine which application is more effective. In severe cases, hair loss may worsen despite various medical interventions.

Applying creams that have a local blood flow-increasing effect or containing corticosteroids to the affected area, administering or administering steroid injections are approaches that may be effective in reversing hair loss in some people. Apart from steroid treatment, in some cases, methods such as drugs that suppress the functions of the immune system, drugs that support hair growth, or ultraviolet light therapy can also be used within the scope of ringworm treatment.

Although ringworm (alopecia areata) is not a serious health problem, it is a problem that can cause unhappiness and anxiety in people regarding their appearance. If you detect signs and symptoms of this disorder in your body, it is recommended that you seek support from specialist physicians.