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Alopecia Areata - Topic Overview

How is alopecia areata diagnosed?

Alopecia areata 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:

  • Hair analysis. Your doctor will take a sample of your hair and examine it under a microscope. A scalp sample is also sometimes taken.
  • Blood tests, including testing for a specific condition, such as an overactive or underactive thyroid gland (hyperthyroidism or hypothyroidism).

How is it treated?

Because hair usually grows back within a year, you may decide not to treat alopecia areata.

If you choose not to treat the condition and wait for your hair to grow back, you may wish to:

  • Wear hairpieces. Hairpieces are made from human or synthetic hair that is implanted into a nylon netting. Hairpieces may be attached to the scalp with glue, metal clips, or tape. But hair weaving, which involves sewing or braiding pieces of longer hair into existing hair, is not recommended because it may cause permanent hair loss.
  • Use certain hair care products and styling techniques. Hair care products or perms may make hair appear thicker. Dyes may be used to color the scalp. But continual use of perms or dyes may result in more hair loss.

The most common treatment for patchy hair loss is many injections of corticosteroids into the scalp, about 1 cm (0.4 in.) apart, every 4 to 6 weeks.

Children and some adults may be treated with topical corticosteroids that are applied to the affected skin.

Minoxidil (Rogaine) may be used along with topical corticosteroids.

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. Side 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 light.

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