I’ve lost every hair on my head AND body

This must have been very upsetting for you. The kind of hair loss you have experienced is a form of the autoimmune disorder alopecia areata, which causes patches of baldness usually on the scalp.

You have a variant known as alopecia universalis, in which all head and body hair is completely lost. About one in 50 of us develops the type that affects the scalp, but the alopecia universalis variant is rarer.

The disorder occurs when the immune system starts to attack the hair follicles. Why this happens is unclear, but the fact that a fifth of affected people have a relative with the condition suggests a genetic link.

Patients with the disorder are also more likely to have other conditions caused by a faulty immune system, such as thyroid problems and pernicious anaemia (where the cells in the lining of the stomach that secrete intrinsic factor, essential for the absorption of vitamin B12, are attacked).

Your doctor quite rightly carried out tests for these, which perhaps should be repeated in a year.

You might assume that because it’s an autoimmune condition, suppressing this reaction might help, yet the results of the few available studies on this kind of approach are mixed.

One treatment option is steroids in the form of prednisolone tablets, a powerful immune system suppressant. But even though this may induce hair growth, there is a high likelihood of relapse, and the drug has side-effects (including sleep disturbance, high blood pressure and a risk of diabetes).

however, one study did find that combining steroids with minoxidil, a drug that can help stimulate hair growth applied as a lotion or cream, can prolong the results.

Other immunosuppressive treatments have been disappointing. Azathioprine, for instance, produced 75 per cent hair regrowth in half of a small group of patients, but half also had side-effects such as diarrhoea, changes in liver function and an inflamed pancreas.

Topical immunotherapy has been shown to improve symptoms by 40 to 60 per cent, with an acceptable degree of hair regrowth.

This highly specialised treatment, carried out only by dermatologists, involves painting the scalp weekly with a chemical that induces an allergic response, causing inflammation, redness and skin blistering or dermatitis.

This usually subsides within two weeks and hair can start to regrow within three months. exactly why this helps is unknown, but it is likely that the allergic reaction disrupts the inflammation that is damaging the hair follicles.

Many other remedies have been tried — including laser treatment (thought to boost circulation around the follicles), bexarotene (a form of chemotherapy) and botulinum toxin injections — but to little or no avail.

interestingly, in a study of 29 adults with alopecia areata who were prescribed simvastatin plus ezetimibe (both usually given to lower cholesterol), 14 patients had at least 20 per cent hair regrowth; nine had 70 per cent.

We don’t yet know the mechanisms or the full extent of this treatment’s possibilities, but there is no doubt it is safer and less toxic than all the options described earlier.

i hope and expect you will at least have a six-month review with the dermatologist to discuss what lies ahead. A RECENT blood test showed that my platelets were not right, but my doctor did not know why. A second test showed my platelets were still a bit low. Could I have something seriously wrong with me, such as cancer? Mrs J. Thornton, North Yorkshire. PlATeleTs, which are produced in the bone marrow, are fragments of cells that play a role in blood clotting. A low count (thrombocytopenia) has many causes.

When deciding the diagnosis, we first have to consider whether the patient is otherwise healthy, with no symptoms — as in your case — or whether they already have a condition or are acutely ill.

The normal platelet count is 150,000 per cubic millilitre of blood. Mild thrombocytopenia is 100,000 to 150,000, moderate is 50,000 to 99,000 and severe is below 50,000.

More than 2 per cent of healthy adults have a level below 150,000, and healthy people can have significantly lower levels at times and still be fine, which highlights the importance of a repeat blood test. Your doctor’s advice that your platelets are ‘still a bit low’ implies that you are in the mild category, which is reassuring.

so what causes a lower platelet count? The most common reason in otherwise healthy people is immune thrombocytopenia, when the body creates antibodies to the platelets. Blood clots in the system may also be using them up (e.g. a deep vein thrombosis), or there may be a build-up of platelets in the spleen.

Another possibility is that fewer platelets are being produced in the bone marrow. if the cause is a bone marrow disorder, this will affect other types of blood cells as well — yet your tests didn’t appear to show any other abnormalities.

VirAl illnesses — such as German measles, mumps, chicken pox, hepatitis C and glandular fever — can also lower platelet production, but usually this resolves as the patient recovers.

importantly, almost any medication can lower the platelet count — either by damaging production in the bone marrow or triggering platelet antibodies.

These include many antibiotics, some epilepsy drugs, paracetamol, ibuprofen and even quinine, found in tonic and bitter lemon drinks. There are also herbal preparations and foods that can have the same effect, including some Chinese teas, walnuts, sesame seeds and cranberry juice.

Cancer can cause thrombocytopenia, but only when the disease is widespread (essentially the tumour displaces the bone marrow), so be reassured that a low platelet count is not a cause nor a sign of cancer.

Ask your GP to repeat the count in six months; if the level falls to 100,000 or lower, you should be referred to a consultant haematologist. But i would suggest there is nothing seriously wrong.

WRITE TO DR SCURR

TO contact Dr Scurr with a health query, write to him at Good Health, Scottish Daily Mail, 20 Waterloo Street, Glasgow G2 6DB or email drmartin@dailymail.co.uk — including contact details. Dr Scurr cannot enter into personal correspondence. His replies cannot apply to individual cases and should be taken in a general context. Always consult your own GP with any health worries.

I HAVE gradually lost all the hair on my head and body. My doctor has sent me for blood tests to check my thyroid and iron levels — but nothing is unusual. A dermatologist gave me steroid cream, which has not helped.

I am 54 and menopausal. Is there anything else I can do? T. Rayner, Great Dunmow, Essex.