ALOPECIA AREATA

Basic information

description

Sudden hair loss in circular patches on the scalp. The hair loss does not occur with other visible evidence of scalp disease. It can involve hair on the scalp, eyebrows, eyelashes, genital area, or underarms (sometimes). Alopecia can occur at any age, from birth to older adults. Many cases start before age 20.

frequent signs and symptoms

• Sudden hair loss in sharply defined circular patches. In rare cases, body hair loss may be total (alopecia universalis).
• Pain and itching may occur in some cases.
• Nails may be affected, such as pitting, in more severe cases.

causes

Unknown. It is thought to be one of a group of autoimmune disorders. In these disorders, the immune system by mistake attacks the body itself. Heredity and emotional stress or psychiatric disorders may play a role.

risk increases with

• Family history of alopecia areata.
• Stressful life event preceding the hair loss may be a factor.
• Certain medical disorders may occur along with alopecia, but do not appear to be a cause or a risk factor.

preventive measures

Cannot be prevented at present.

expected outcomes

The outcome varies depending on the amount of hair loss. There is no permanent cure, and the disorder may come and go. Most people have only a few areas of alopecia, and regrowth occurs in about a year.

possible complications

• Loss of all hair.
• Slow or incomplete regrowth.
• Treatment may not be effective in extensive hair loss.
• Disorder frequently recurs.

diagnosis & treatment

general measures

• Your health care provider will do a physical exam of the affected scalp area. Medical tests are usually not needed unless some underlying disorder is suspected.
• In a simple, self-limited case where the alopecia is not noticeable, no treatment may be needed. In other cases, drugs may be used for treatment depending on amount of hair loss and age of patient. No one treatment helps everyone with the disorder.
• A change in hairstyle may cover the affected area.
• Consider wearing a hairpiece or wig until the hair grows in again.
• For loss of eyebrow hair, dermatography may help. Small dots of colored pigment are injected into eyebrow area.
• Continue to bathe and shampoo as usual. The disorder is not contagious. Don't tug on normal hair close to areas of hair loss.
• Seek counseling if coping with the hair loss is causing emotional problems. Support groups are also available.
• To learn more: National Alopecia Areata Foundation, P.O. Box 150760, San Rafael, CA 94915; (415) 472-3780 (not toll-free); website: www.naaf.org.

medications

• Topical steroids or topical anthralin may be prescribed. Follow instructions carefully.
• Topical minoxidil (a drug used for hair growth) may help. Its effectiveness is highly variable.
• In some cases, you may have injections of steroids into affected areas.
• Oral cortisone drugs may be recommended.
• Topical immunotherapy may be recommended. This involves producing a skin reaction to help hair growth.
• Photochemotherapy with PUVA may be recommended. It combines the use of a drug that sensitizes the skin along with a controlled dose of ultraviolet light.

activity

No limits.

diet

No special diet.

notify our office if

• You or a family member has symptoms of alopecia areata.
• The following occurs during treatment:
• Hair loss increases or hair loss doesn't improve.
• Areas show signs of infection (redness, swelling, tenderness, warmth) after injection treatment.