Alopecia Areata

Alopecia areata

Alopecia areata: This disease causes hair loss and often occurs in otherwise healthy people.

Alopecia (al-oh-PEE-shah) means hair loss. When a person has a medical condition called alopecia areata (ar-ee-AH-tah), the hair falls out in round patches. The hair can fall out on the scalp and elsewhere on the body.

Alopecia areata can cause different types of hair loss. Each of these types has a different name:

Not everyone loses all of the hair on the scalp or body. This happens to about 5 percent of people.

Hair often grows back but may fall out again. Sometimes the hair loss lasts for many years.

Alopecia is not contagious. It is not due to nerves. What happens is that the immune system attacks the hair follicles (structures that contain the roots of the hair), causing hair loss. This disease most often occurs in otherwise healthy people.

 

Alopecia areata: Signs and symptoms

If you have alopecia areata, you may have one or more of the following:

Alopecia areata: It often begins with a round, smooth, bald patch.

Nail problems: Alopecia areata also can affect your fingernails and toenails. Nails can have tiny pinpoint dents (pitting). They also can have white spots or lines, be rough, lose their shine, or become thin and split. Rarely nails change shape or fall off. Sometimes nail changes are the first sign of alopecia areata.

Alopecia areata: Who gets and causes

Who gets alopecia areata?

People can have this type of hair loss at any age. It often begins in childhood. Some patients with alopecia areata have a family member who also has the disease.

What causes alopecia areata?

Alopecia areata is an autoimmune disease. Autoimmune means that the body's immune system attacks the body. When alopecia areata develops, the body attacks its own hair follicles. A person's genetic makeup, combined with other factors, triggers this form of hair loss. 

People with alopecia areata may have a higher risk for:

Alopecia areata: Diagnosis, treatment, and outcome

How do dermatologists diagnose alopecia areata?

Sometimes a dermatologist can diagnose alopecia areata by looking at the hair loss.

If the patch of hair loss is expanding, the doctor may pull out a few hairs. These hairs will be looked at under a microscope.

Sometimes the dermatologist will perform a skin biopsy to confirm that the disease is alopecia areata. To perform a skin biopsy, the dermatologist removes a small piece of skin so that it can be studied under a microscope.

Blood tests may be necessary if the dermatologist thinks the patient might have another autoimmune disease.

How do dermatologists treat alopecia areata?

There is no cure for alopecia areata. Hair often re-grows on its own. Treatment can help the hair re-grow more quickly. A dermatologist may prescribe one or more of the following to help the hair re-grow more quickly:

For adults with alopecia areata, these shots are often the first treatment tried. Patients receive shots every 3 to 6 weeks. Hair growth begins about 4 weeks after the last shot. Sometimes, it takes longer.

Topical corticosteroids are less effective than shots. This is often the best treatment for children. 

Corticosteroid pills can have serious side effects. Dermatologists do not routinely prescribe them for this reason. Pills may be a treatment choice for patients with many bald spots. 

With DPCP, it can take 3 months for the hair to start re-growing. 

Ask your dermatologist about possible side effects (health problems that can result from the medicines). If you have a bad reaction to a medicine, call your dermatologist right away.

Researchers are working to advance the treatment of alopecia areata. They are exploring other medicines that work on the patient’s immune system. They also are looking at lasers and other light-based therapies.

Outcome

When a person has alopecia areata, the hair will start to re-grow when the body gets the right signals. Sometimes this happens without treatment. Even with treatment, new hair loss can occur. Everything depends on how the immune system reacts.

The following explains what can happen

When hair re-grows, it can be white or fine at first. A person’s own hair color and texture often return later. 

If your hair loss bothers you a lot, you may wish to join a support group.

Alopecia areata: Tips for managing

Dermatologists offer the following tips to their patients who have alopecia areata:

Style your hair to cover the bald spots.
Wear a wig, cap, hat, or scarf. These do not interfere with hair re-growth.
Some people shave the head.
Use makeup to draw missing eyebrows.