Alopecia areata is a type
hair loss that occurs when your
immune system mistakenly attacks
hair follicles, which is where hair growth begins. The damage to the follicle
is usually not permanent. Experts do not know why the immune system attacks the
follicles. Alopecia areata is most common in people younger than 20, but
children and adults of any age may be affected. Women and men are affected
usually begins when clumps of hair fall out, resulting in totally smooth, round
hairless patches on the scalp. In some cases the hair may become thinner
without noticeable patches of baldness, or it may grow and break off, leaving
short stubs (called "exclamation point" hair). In rare cases, complete loss of
scalp hair and body hair occurs. The hair loss often comes and goes—hair will
grow back over several months in one area but will fall out in another
When alopecia areata results in patches of hair loss, the
hair usually grows back in a few months.1
Although the new hair is usually the same color and texture as the rest of the
hair, it sometimes is fine and white.
About 10% of people with
this condition may never regrow hair.2 You are more
likely to have permanent hair loss if you:
Because hair is an important part of appearance, hair
loss can result in feeling unattractive.
In some people with
alopecia areata, the fingernails and toenails become pitted—they look as if a
pin had made many tiny dents in them. They may also look like sandpaper.
Alopecia areata cannot be "cured" but it can be treated. Most people who
have one episode will have more episodes of hair loss.
is diagnosed through a medical history and physical examination. Your doctor
will ask you questions about your hair loss, look at the pattern of your hair
loss, and examine your scalp. And he or she may tug gently on a few hairs or
pull some out.
If the reason for your hair loss is not clear, your
doctor may do tests to check for a disease that could be causing your hair
loss. Tests include:
Because hair usually grows back
within a year, you may decide not to treat alopecia areata.
choose not to treat the condition and wait for your hair to grow back, you may
The most common treatment for patchy hair loss is many
corticosteroids into the scalp, about
1 cm (0.4 in.) apart, every 4
to 6 weeks.
some adults may be treated with topical corticosteroids that are applied to the
Minoxidil (Rogaine) may be used along with topical
Contact immunotherapy triggers an allergic reaction on the scalp that may help hair to grow. A medicine is
"painted" on the scalp once a week. This irritates the skin and makes it red
and scaly. Hair growth may appear within 3 months of beginning treatment.
effects of contact immunotherapy include a severe rash (contact dermatitis) and swollen
lymph nodes, especially in the neck.
Psoralen with ultraviolet A light (PUVA) therapy may
also be used to treat alopecia areata. PUVA usually is reserved for people who
have large areas of skin affected by the disorder or who cannot use other
treatments. For PUVA, a medicine called a psoralen is used to make the skin
more sensitive to ultraviolet A (UVA) light. Then the skin is exposed to UVA
areata does not affect you as another condition might: it is not painful, it
does not make you feel sick, and it does not result in serious health problems.
You cannot spread it to other people, and it should not interfere with school,
work, or recreation.
But if hair loss is making you feel
unattractive, it is important to talk to someone about it. A counselor can
help, as can talking to other people with the same condition.
The National Alopecia Areata Foundation (NAAF) funds
research and research workshops that promote knowledge about alopecia areata,
its causes, and treatments. The NAAF provides local support and education for
people who have alopecia areata and for their families and also acts as an
advocate for people who have alopecia areata.
The National Institute of Allergy and Infectious
Diseases conducts research and provides consumer information on infectious and
CitationsHague J, Berth-Jones J (2010). Alopecia areata. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 31–35. Edinburgh: Saunders Elsevier.Habif TP (2010). Hair diseases. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 5th ed., pp. 913–935. Edinburgh: Mosby Elsevier.
May 29, 2012
Adam Husney, MD - Family Medicine & E. Gregory Thompson, MD - Internal Medicine
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