Alopecia Areata

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Images of Alopecia Areata

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

Trusted Links

MedlinePlus: Hair Diseases and Hair Loss

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.