Alopecia X is possibly one of the biggest mysteries in veterinary research medicine these days. We have an idea of what is going on, but continue to circle the wagons around the exact cause or causes.
In fact, I do not want to broach the numerous descriptive names, history of the research, or the current research being conducted, as it might divert your focus from what you need to do for your dog.
At this time, diagnosing Alopecia X is a process of elimination. Treating Alopecia X is a process of trial and error.
Let’s step back a minute…what is alopecia? Alopecia is hair loss and is a symptom of many conditions. Alopecia X is the current name for an idiopathic (unknown) condition that is most likely heritable. We believe it is heritable or has a genetic predisposition because it primarily affects Nordic breeds such as the Siberian Husky, Malamute, Chow Chow, and Samoyed, as well as the Spitz breeds such as Pomeranian and Keeshond, and the French origin Miniature and Toy Poodle.
Alopecia X affects males predominantly – but not exclusively – and can happen at any age from puberty onwards. After the hair is lost, the hair usually never grows back.
Typically, veterinarians will notice a symmetrical gradual loss of hair over the body and back legs while the head and forelimbs maintain their hair.
My concern here is the need for diagnostic confirmation as there has been a bias towards over-diagnosis introduced by the vague aforementioned general presentation of Alopecia X.
As I always say, diagnostics is just as much about ruling out diagnoses as it is about ruling in. Testing for the following conditions should include, in this order:
- Hypothyroidism – Endocrine disorder; ask your veterinarian to send the blood sample to Hemopet for the Hemopet Thyroid Profile 5 (T4, FT4, T3, FT3, TGAA) or the equivalent test run at Michigan State University.
- Cushing’s Disease – Endocrine disorder; your veterinarian will have to send a blood sample to the University of Tennessee for the ACTH test.
- Sebaceous adenitis – Autoimmune condition
- Demodicosis – Condition caused by demodex mites
- Bacterial infections
- Fungal infections
Testing for these other conditions should be ancillary. They can cause hair loss, but usually scratching is the primary symptom perpetuating the hair loss:
- Food sensitivities – NutriScan is the test I recommend.
- Seasonal, environmental sensitivities
Once these other conditions have been ruled out, or if they are concurrently present and do not remedy the hair loss, veterinarians have several different tools at their disposal. None of them are effective for every single dog, so it is trial and error.
- Neutering or spaying – After this surgical procedure, we may notice that hair will grow back, but may eventually stop growing again. If you noticed above, I mentioned that symptoms usually occur at or after puberty. So, castration and spaying basically will take the dog back to a prepubescent state. However, I say this cautiously: there might still be an association to with sex hormones, although adrenal sex-steroid hormone panels have not revealed an abnormality.
- Melatonin – Melatonin has been found effective in approximately 30-40% of the time but can adversely affect dogs with diabetes. You can purchase it over-the counter for your dog, but I advise you to talk to your veterinarian first about dosage and brand. Only plain melatonin should be used for at least 2 months before deciding if it is helping to re-establish hair growth.
- Growth hormones – Giving growth hormones and drugs that alter the adrenal glands’ production of cortisol and hormones is the least advisable, as the side effects outweigh the benefits.
- Microneedling – This experimental treatment was performed on only two Pomeranians by the microneedling device puncturing the skin. Both dogs showed 90% improvement in coat coverage within 12 weeks and the new coat remained stable for the next 12 months.
- The best solution is to make sure a dog diagnosed with Alopecia X is covered with a T-shirt or garment at all times when outside.
Cerundolo R and Lloyd D. Alopecia X in Chows, Pomeranians and samoyeds. Vet Rec, 143(6): 143, 1998.
Frank, Linda A., DVM. “Hair Loss.” The University of Tennessee College of Veterinary Medicine, n.d. Web. 28 Aug. 2016. http://www.vet.utk.edu/hairloss/.
Schilly DR and Panciera DL. Challenging cases in internal medicine: What’s your diagnosis? Vet Med, July: 600-604, 1997.
Stoll, S., Dietlin, C. and Nett-Mettler, C. S. (2015), Microneedling as a successful treatment for alopecia X in two Pomeranian siblings. Vet Dermatol, 26: 387–e88. doi:10.1111/vde.12236