Alopecia Areata

What Is Alopecia?

Alopecia areata is an autoimmune disorder that causes your hair to come out, often in clumps the size and shape of a quarter. The amount of hair loss is different in everyone. Some people lose it only in a few spots. Others lose a lot. Sometimes, hair grows back but falls out again later. In others, hair grows back for good.

There are different types of this condition. Alopecia areata is most common in its main form, but there are other, more rare types:

  • Alopecia areata totalis means you’ve lost all the hair on your head.
  • Alopecia areata universalis is the loss of hair over your entire body.
  • Diffuse alopecia areata is a sudden thinning of your hair rather than lost patches.
  • Ophiasis alopecia areata causes hair loss in a band shape around the sides and back of your head.

Alopecia Symptoms

The main and often the only symptom of alopecia is hair loss. You may notice:

  • Small bald patches on your scalp or other parts of your body
  • Patches may get larger and grow together into a bald spot
  • Hair grows back in one spot and falls out in another
  • You lose a lot of hair over a short time
  • More hair loss in cold weather
  • Fingernails and toenails become red, brittle, and pitted

The bald patches of skin are smooth, with no rash or redness. But you may feel a tingling, itching, or burning sensation on your skin right before the hair falls out.

Alopecia Causes and Risk Factors

When you have an autoimmune disease, your immune system attacks your body. With alopecia areata, it’s the hair follicles that are attacked.

Doctors don’t know why it happens. But they think people who get it have something in their genes that makes it more likely. Then something happens to trigger the hair loss.

You’re more likely to get alopecia areata if you have:

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Alopecia Diagnosis

If you think you have alopecia areata, you may want to see a skin specialist called a dermatologist. They will:

  • Talk to you about your symptoms
  • Take a close look at the areas where you have hair loss
  • Pull gently on the hairs at the edges of the bald patch to see if they come out easily
  • Check individual hairs and follicles to see if they’re abnormally shaped
  • Examine your nails

Rarely, you may have a biopsy, which means a small piece of skin is removed from your scalp and looked at under a microscope.

Many conditions can cause hair loss. So your doctor may test your skin for a fungal infection or give you blood tests to check for thyroid, hormone, or immune system problems.

Alopecia Treatment

Alopecia areata can’t be cured. But it can be treated and hair can grow back. If you have it, there are several things to try:

Corticosteroids. These are anti-inflammatory drugs that are prescribed for autoimmune diseases. They can be given as an injection into the scalp or other areas. They can also be given as a pill or rubbed on the skin as an ointment, cream, or foam. The downside is that it may take a long time to work.

Topical immunotherapy . This is used when there’s a lot of hair loss or if it happens more than once. Chemicals are applied to the scalp to produce an allergic reaction. If it works, this reaction is actually what makes the hair grow back. It also causes an itchy rash and usually has to be repeated several times to keep the new hair growth.

Minoxidil ( Rogaine ). This treatment, which is put on the scalp, is already used for pattern baldness. It usually takes about 12 weeks before you see growth, and some users are disappointed in the results.

Other treatments for alopecia areata include medications that are sometimes used for other autoimmune disorders. These medicines have differing amounts of success in regrowing hair.

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Alopecia Home Care

Apart from medications, there are other things you can try if you have alopecia areata.

Wear wigs, hats, or scarves. They cover your hair loss and will protect your head from the sun.

Reduce stress. Personal troubles seem to trigger alopecia areata, although this has not been proven scientifically.

Alopecia Outlook

Alopecia areata isn’t usually a serious medical condition, but it can cause a lot of anxiety and sadness. Support groups are out there to help you deal with the psychological effects of the condition.

If you lose all your hair, it could grow back. If it doesn’t, there are different ways to cover your hair loss and protect your scalp.

If you notice sudden hair loss, always check with a doctor. There can be other reasons for it besides alopecia areata.

WebMD Medical Reference Reviewed by Hansa D. Bhargava, MD on September 10, 2020

Sources

SOURCES:

National Alopecia Areata Foundation.

Harvard Health Publishing: “Alopecia Areata.”

American Academy of Dermatology Association: “Hair Loss Types: Alopecia Areata.”

UpToDate: “Patient education: Alopecia areata (Beyond the Basics).”

Mayo Clinic: “Hair loss.”

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