This image displays a close-up of the scalp with a round area of non-scarring hair loss typical of alopecia areata.  This image displays a circular area of hair loss, with no redness or scarring of the scalp, typical of alopecia areata. This image displays patches of hair loss in the beard area typical of alopecia areata as well as areas that were affected previously, with the hair regrowing in white (without pigment). This image displays a patient with alopecia areata that has had some spontaneous regrowth, covering many of the areas of hair loss. This image displays a normal, healthy scalp with alopecia areata. This image displays broken hairs in hair follicles with an otherwise smooth scalp caused by alopecia areata. This image displays nail pits and ridges typical of alopecia areata. This image displays hair regrowing as is typical with alopecia areata. Alopecia Areata can effect the eyebrows as well as any other hair growth areas. The beard area can be involved in alopecia areata, even when the scalp is not.  Areas of hair loss are typically round and quite  noticeable when the beard grows. A round area of non-scarring hair loss due to alopecia areata.
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Hair Loss (Alopecia Areata)  Information for adults

Picture of Hair Loss (Alopecia Areata): This image displays a close-up of the scalp with a round area of non-scarring hair loss typical of alopecia areata.  Divider line
This image displays a close-up of the scalp with a round area of non-scarring hair loss typical of alopecia areata.
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Overview
Alopecia areata is an autoimmune condition resulting in hair loss. The immune system of the body mistakenly stops hair growth for unknown reasons. Hair loss may be patchy or sparse and may involve the rest of the body in addition to the scalp. Hair in most people spontaneously regrows, though recurrences of the condition are also typical. Genetic and environmental factors play a role in hair loss; the condition may be seasonal as well.
Who's At Risk
Hair loss can occur in people of all ages. The most frequent association is with thyroid disease, although hair loss can be found in those with the following conditions:
  • Lupus
  • Lichen planus
  • Vitiligo
  • Down syndrome
Signs and Symptoms
Hair loss most commonly occurs on the scalp, but it can also target the eyebrows, eyelashes, beard, and other body sites. Symptoms may include the following:
  • Round, patchy areas of non-scarring hair loss, ranging from mild to severe
    • Mild: 1–5 scattered areas of hair loss on the scalp and beard
    • Moderate: More than 5 scattered areas of hair loss on the scalp and beard
    • Severe: loss of all of the hair on the scalp and body
  • Scalp burning (without redness), accompanying lesions
  • Pitting and ridging of the fingernails
Hairs that do grow back often lack color, or may be either temporarily or permanently white. This hypopigmentation is not seen in other forms of alopecia.
Self-Care Guidelines
Psychological support may be beneficial.

Wigs may be worn to camouflage hair loss.
When to Seek Medical Care
Those experiencing areas of patchy hair loss are advised to seek evaluation from a primary care provider or dermatologist.
Treatments Your Physician May Prescribe
Both topical and systemic medications may be prescribed, as well as injections. Treatments include:
  • Localized steroid injections (to help speed regrowth)
  • Clobetasol propionate gel or solution, a potent topical steroid
  • Anthralin cream, a topical irritant
  • Light therapy
  • Topical steroids plus minoxidil (Rogaine®)
  • Systemic steroids, such as prednisone, though they have no long-term benefit and are not recommended for use beyond the short-term

References

Bolognia, Jean L., ed. Dermatology, pp.1035-1038. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp. 641-643, 647. New York: McGraw-Hill, 2003.
Last Updated: 22 Dec 2008