In alopecia, immune system attacks hair, creates bald spots

Round-to-oval bald patches are the signature of alopecia areata. They're found on the scalp and sometimes on the eyebrows or beard, or the legs or arms. About 1 percent of the population suffers from it. It strikes women and men in equal numbers and is found in all races.

The cause is probably an immune attack by the body on its own hair follicles. What sets off the attack is something yet to be explained. Often, alopecia areata runs in families. Sometimes it's seen in association with other illnesses, like type 1 diabetes, lupus, asthma or thyroid gland inflammation.

The course alopecia areata takes is unpredictable. Many see a regrowth of hair in one year without any treatment. A small percentage have to deal with it on a more or less constant basis. Most suffer from relapses after they have had a recovery.

What can be done depends on the size of the bald spots and their number. For a few, small patches of cortisone drugs applied to the bald spots can sometimes coax hair to grow back. Minoxidil (Rogaine) comes in liquid form and can also restore hair for some. The doctor can inject the bald patches with a cortisone drug to kick-start hair regrowth.

For larger and more numerous bald spots, the above methods can be used, but medicines that moderate the immune attack are often effective. DPCP is an example of one of those medicines.

DEAR DR. DONOHUE: I was wondering if I was ruining the principle of eating an orange by peeling off the white covering left after an orange's skin is removed. Am I throwing away precious nutrients?

— Anonymous

I don't know what that white stuff is, but I always get rid of it. I don't like the looks or the taste of it. I'm positive we're not throwing away precious nutrients. Maybe a little fiber, but we can get fiber in other ways.

DEAR DR. DONOHUE: I am 77 and weigh 166 pounds. For the past three months, I have been trying to lose weight, but the scale doesn't budge. What am I doing wrong? I walk 3 miles every other day and take exercise classes twice a week. I hardly eat anything. My daughter says my metabolism isn't working. What can I do? — T.Y.

I have to repeat information that is true but unpalatable. Weight is lost only when calorie output exceeds calorie intake. I know some people have a terrible time losing weight, and it might be that they have a slower metabolism. One can increase body metabolism through exercise and through muscle building. Muscles burn calories; fat doesn't.

How fast are you walking? If you pick up the pace by only half a mile per hour, you'll burn 30 more calories for every hour of exercise. And if you walk every day of the week, that's not a paltry number of calories.

You have to know the exact number of calories you eat each day. Get a paperback book that gives you the calorie content of food. Such books are not expensive. Total your daily calories for one full week. You might be surprised by the number you consume in a day. Cut back 500 calories a day, and you should lose a pound a week.