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Alopecia Areata

Definition

Alopecia areata happens when the immune system attacks healthy tissue that holds the hair follicles in place. This leads to patchy hair loss.

Hair Loss
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Causes

The exact cause for the change in the immune system is not known. It is most likely a combination of genes and factors in the environment.

Risk Factors

This problem is more common in people under 30 years of age. People who have a personal or family history of these problems are also at higher risk:

  • Alopecia areata
  • Being more likely to get allergic skin diseases or allergic reactions
  • Having another autoimmune disorder, such as lupus

Symptoms

The main symptom is sudden, patchy hair loss. It is most common on the scalp but can also happen in beards, eyebrows, or anywhere on the body. Rarely, a person may lose all hair on the body.

Hair loss may happen once, over a long time, or it may come and go.

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the areas of hair loss. This is often enough to make the diagnosis.

If the diagnosis is unclear, a skin biopsy may be done.

Treatment

There is no cure. Hair will grow back on its own for most people. If hair does not grow back, the goal of treatment is to help hair regrow. Choices are:

Medications

Medicines may be given to help regrow hair, such as:

  • Corticosteroids
  • Minoxidil
  • Medicine to suppress the immune system

Procedures

Procedures may be an option if medicines do not work. Some choices are:

  • Laser therapy to stimulate hair growth
  • Hair transplant surgery
  • Medical tattooing to give the appearance of eyebrows

Other Treatments

Hair loss can cause social anxiety for some. A wig or hairpiece may help ease these feelings. Counseling or support groups may also help.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

American Academy of Dermatology
https://www.aad.org

National Alopecia Areata Foundation
https://www.naaf.org

CANADIAN RESOURCES:

Canadian Dermatology Association
https://dermatology.ca

Health Canada
http://www.canada.ca

REFERENCES:

Alopecia areata. American Academy of Dermatology website. Available at: https://www.aad.org/public/diseases/hair-and-scalp-problems/alopecia-areata. Accessed December 31, 2020.

Alopecia areata. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/alopecia-areata. Accessed December 31, 2020.

Alopecia areata. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: https://www.niams.nih.gov/Health_Info/Alopecia_Areata/default.asp. Accessed December 31, 2020.

Messenger AG, McKillop J, et al. British Association of Dermatologists' guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012 May;166(5):916-926.

Last reviewed December 2020 by EBSCO Medical Review Board Daniel A. Ostrovsky, MD  Last Updated: 12/31/2020