Why is the first episode of alopecia areata most likely to occur in late teens to early twenties – particularly for women?
The female humoral and cell mediated immune system response is on average more active than males and in theory may account for the increased longevity of women (Grossman 1989). In general, women are far better than men in fighting off bacterial and viral infection (Janeway 1993), but a more sensitive immune system will be more likely to develop autoimmune activity. Typically, autoimmune disease is far more common in females than males (Ollier 1992). Hormones including gonadal steroids, adrenal glucocorticoids, thymic hormones and prolactin are known to influence lymphocyte activity – but the most potent hormone affecting the immune system directly and indirectly is estrogen (Grossman 1989, Schuurs 1990). Allergies are classed as hypersensitivity reactions – an inappropriate over-reaction to foreign antigens whereas autoimmune diseases are an inappropriate over-reaction to self antigens. Extensive studies into allergy susceptibility show that for women the first symptoms most often occu
