Alopecia areata is a condition in which the body attacks its own hair cells, causing hair loss. The hair loss can be total (including facial hair such as the eyelashes and eyebrows) or partial, resulting in a bald spot. Any disorder in which the body attacks its own cells is called an autoimmune disorder, and alopecia areata is an example of this kind of disorder. In general, autoimmune disorders are poorly understood, and there is rarely treatment for them; fortunately, those affected by alopecia areata sometimes experience regrowth of the hair. Though there is no certain treatment for hair loss, your doctor can help with keeping the skin healthy. Alopecia areata is not a contagious condition. This condition runs in families and can be worse depending on the season. There are a variety of reasons for a person to develop hair loss, and it is important to discuss your concerns with your doctor.
Who's At Risk
Hair loss can occur in anyone at any age, though people with other autoimmune disorders are more commonly affected. Examples of some conditions that are associated with hair loss include lupus, vitiligo, and thyroid disease.
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.
Psychological support may be beneficial.
Wigs may be worn to camouflage hair loss.
When to Seek Medical Care
People experiencing areas of patchy hair loss are advised to seek evaluation from a primary care provider.
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
Bolognia, Jean L., ed. Dermatology
, pp.1035-1038. New York: Mosby, 2003.
Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine
ed, pp. 641-643, 647. New York: McGraw-Hill, 2003.