Why Grey Hair in Alopecia Areata ? | Dr Mukesh Aggarwal

Alopecia areata is an autoimmune condition that causes patchy hair loss. When hair regrows after an episode of alopecia areata, it is often reported to come back gray or white, even if the person's original hair color was different. Several factors contribute to this phenomenon:

1.) Selective Immune Attack: Alopecia areata is an autoimmune condition where the body's immune system mistakenly attacks its hair follicles. This immune attack primarily targets the hair follicles, leading to hair loss. Within the hair follicle, melanocytes are the cells responsible for producing melanin, the pigment that gives hair its color. These melanocytes can be particularly vulnerable during an autoimmune attack. The immune system may selectively target and destroy melanocytes in the hair follicles along with the follicular cells, reducing the ability of these cells to produce pigment.

2.) Regrowth Patterns: When hair begins to regrow after an episode of alopecia areata, melanocytes may take longer to recover than the hair follicles. Hair shafts may initially grow without pigment, resulting in gray or white hair. Hair follicles and melanocytes may not recover simultaneously. The initial hair regrowth might lack pigment; over time, as melanocyte activity resumes, hair color may return to normal.

3.) Age-Related Graying: As people age, the number and functionality of melanocyte stem cells in hair follicles naturally decline. This process can lead to reduced melanin production and the appearance of gray hair. When alopecia areata occurs in an aging individual, the natural decline of melanocytes is compounded by the autoimmune attack, making it more likely for hair to regrow gray.

4.) Melanocyte Dysfunction: Melanocytes are the cells responsible for producing melanin, the pigment that gives hair its color. During the hair loss phase of alopecia areata, the hair follicles may lose their melanocytes. When the hair regrows, there might be a delay or a reduction in the number of active melanocytes, resulting in gray or white hair.

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