Ophiasis alopecia is probably not the first condition that comes to your mind if you are experiencing hair loss. That is because this rare type of alopecia areata only affects 0.02% of the population [2]. However, if your hair is shedding in a snake-like pattern on the back of your head and around your ears, you may want to consider this possibility. Although it is more common in children, adults can also develop it.
The good news is that ophiasis alopecia does not normally cause inflammation [3], so it should not lead to any physical discomfort, such as itching, tenderness or a burning sensation on your scalp.
Unfortunately, the prognosis for ophiasis alopecia is also poorer than for other forms of alopecia areata. It is often resistant to treatment, and while, in some cases, it can spontaneously go into remission after a while, relapses are usually to be expected [2].
Keep reading this article to find out all you need to know about:
Ophiasis alopecia is a rare form of alopecia areata. Under its most common presentation, alopecia areata manifests as smooth, round, patchy bald spots on any part of your body which is covered with hair (scalp, beard, eyebrows, etc.) [5] However, rare variations of this condition can manifest differently.
Ophiasis alopecia is named after the Greek word for “snake” – ophis. That is because it creates a bald band on the back of your head, which may sometimes be straight but is usually wavy [6]. Since this usually occurs on an area of your scalp known as occipital, it is sometimes referred to as occipital alopecia.
A systematic review of 94 studies about alopecia areata and its varieties, including a total research population of over 300 million people, revealed that while 2.11% of all people experience alopecia areata, only 0.02% develop ophiasis alopecia [7].
Ophiasis alopecia is most frequently seen in children and infants, often developing before the onset of puberty. However, adults can also experience this condition [7][3].
The causes of alopecia areata are not yet fully understood. However, most researchers believe it is an autoimmune condition [3], which means your white blood cells are attacking your hair follicles, mistaking them for harmful entities. This damages your hair follicles, making them temporarily or permanently unable to produce hair.
Since ophiasis alopecia is a form of alopecia areata, it is likely caused by an autoimmune response which attacks the hair on the back of your scalp and the area around your ears (and, in very rare cases, the hairline).
There are not many symptoms of alopecia ophiasis aside from the tell-tale bald band at the back of your head. You should not experience any discomfort, scalp irritation or inflammation alongside it [3]. Normally, you may notice the following:
On rare occasions, ophiasis alopecia can be mistaken for a different condition which causes hair loss, called traction alopecia.
Traction alopecia is a condition that develops from frequently wearing tight hairstyles, or heavy hair extensions, which cause hair loss by pulling on the hair root. While it often occurs in the front and sides of your head (as that is where most of the tension is with hairdos such as braids, buns or ponytails, which cause hair loss), it can form on any part of your scalp where the hair has experienced tension [11].
Here are some guidelines to help you tell if it’s traction alopecia or ophiasis alopecia:
Ophiasis alopecia will sometimes resolve on its own, with no treatment, after approximately 15-20 months. However, hair regrowth is rarely permanent, and you may expect the condition to relapse after a while [3].
Sometimes, some hair regrowth can be achieved with medication. In other situations, ophiasis alopecia can be lifelong since there is no known cure, and it is often resistant to treatment.
While there are currently no treatments available that can cure ophiasis alopecia, there are some medications and therapies which can improve the symptoms of the condition and achieve some hair regrowth in certain patients.
Common treatments for alopecia areata may lead to some symptom improvement in certain ophiasis alopecia patients, but it must be kept in mind that this form is often resistant to medication, such as [6] [13]:
People with ophiasis alopecia are also not normally considered good candidates for a hair transplant, as hair transplants for alopecia areata don’t often work. That is because the new hair grafts would also be attacked by your immune system.
Some of the therapies which have shown promising results in certain people who experience ophiasis alopecia include:
This procedure involves collecting blood from the patient, processing it to separate out the blood components called platelets, and then reinjecting the platelets into the affected area of the patient’s scalp. This triggers the body’s natural healing response and stimulates hair follicles for hair growth.
One study found this treatment efficient in stimulating hair growth in a patient with this condition after 3 months of use. The patient had previously not responded to treatments with Minoxidil and topical steroids [14].
Also known as derma rolling for hair growth, microneedling is a therapy which uses a tool called a derma roller to create microscopic punctures in the scalp, triggering your body’s natural healing reaction and helping hair growth medicine achieve better skin penetration.
It is likely that this property of increasing skin penetration has helped a patient with ophiasis alopecia respond and achieve some hair growth after undergoing microneedling alongside treatment with topical corticosteroids for 6 months [6].
Besides ophiasis alopecia, there are some other rare forms of alopecia areata, which have specific manifestations [15][16][17]:
Any type of hair loss can cause significant anxiety and distress. However, treatment-resistant forms such as ophiasis alopecia can be particularly frustrating, and they can chip away at your self-esteem. If you or a loved one are experiencing this condition, you should know support is available. Consider the following options to help you cope with your alopecia:
There are many online and offline communities built to provide mutual support for people who experience alopecia areata. It can be very helpful to encounter other people who share your struggles, listen to their stories and share yours with them. They can also provide insight into their own coping strategies, which may be helpful in dealing with your own condition. You can find a UK alopecia areata support group here.
Hair loss has been connected to increased levels of anxiety, depression, low self-esteem, feelings of shame and anger and social withdrawal. It can significantly affect your personal, social and even professional life [21]. So, if you are experiencing a persistent low mood or negative emotions in relation to your alopecia, do not hesitate to see a psychologist. They can help you develop healthy coping strategies. And, should your distress become more severe, they can refer you to get a prescription for antidepressants or anti-anxiety medication, as needed.
It isn’t easy to share our emotions regarding aspects of ourselves that make us feel embarrassed or insecure. However, those who love you will be there for you regardless of your physical appearance and the state of your hair. If you feel comfortable doing so, opening up to friends and family about the difficult feelings your hair loss is causing you can make you feel heard and supported. And it gives them a chance to be there for you and show you that your value extends far beyond your scalp and hair.
It can be difficult for children to understand why their hair is falling off and they may be facing bullying or social exclusion because of it. And if you are the parent of a child with alopecia, you may feel distraught and powerless to help them. However, there are some things you can try to help them gain a better understanding of their condition and build their self-esteem:
If you suspect that you may be experiencing ophiasis alopecia, it is best to book a consultation with one of our top trichologists from the first signs of hair thinning and balding. They will examine your scalp, perhaps conduct some tests, and provide you with an accurate diagnosis.
Moreover, they will be able to provide personalised treatment recommendations which may help manage your symptoms and restore some hair growth.
And even if your condition should not respond well to treatment, they will still be able to provide you with helpful tips and tricks to make the best out of the situation, such as showing you the best ways to hide your hair thinning.
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