Alopecia Areata

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Alopecia Areata

Alopecia areata is a condition that causes hair loss in small, round patches.  This condition can either disappear without treatment, or it may last for years.  Some people with alopecia areata may lose all scalp hair or both scalp and body hair.  Alopecia areata is thought to be an autoimmune condition in which the immune system mistakenly attacks and destroys healthy body tissue, such as the hair root and causes hair loss.

Who gets alopecia areata?

Alopecia areata can form in any person regardless of age, race, or sex.  Heredity is thought to play a part in the development of the disease. Around 20% of people with alopecia areata have a family member who also has the disease.

What are the signs and symptoms of alopecia areata?

While the size and shape of the areas of hair loss can vary, small, round bald patches are most often clinically seen.  It can affect any hair-bearing site, but is most commonly found on the scalp. The possibility of hair regrowth is always present. The majority of the time, there are no symptoms besides hair loss, however, in some cases a burning or itching sensation may occur.

What causes alopecia areata?

Alopecia areata is an autoimmune disease.  This occurs when the immune system mistakenly attacks and destroys healthy body tissue. In the case of alopecia areata, the healthy tissue that is attacked are the hair roots. Once the immune system begins attacking the hair roots, the hair follicle loosens and falls out. Environmental factors and a person’s genetic makeup both contribute to triggering alopecia areata. It is not contagious.

What tests are done to confirm alopecia areata?

Typically, a dermatologist will be able to diagnose alopecia areata by examining the affected area.  Occasionally, a skin biopsy may need to be performed to confirm the diagnosis.

Will the hair grow back?

Typically, the hair does grow back, but there is always a chance of the hair falling out once again.  It is hard to predict when the hair will fall out or when the hair might grow back due to the course of the disease varying from person to person.  This condition can either disappear without treatment, or it may last for years.

What treatments are available?

Alopecia areata cannot be cured. However treatment is available.  While treatments are aimed at promoting hair growth, there is always a chance of new patches of hair loss to continue.  Treatment options for alopecia areata include:

  • Corticosteroids – anti-inflammatory drugs that suppress the immune system and are typically prescribed for autoimmune diseases.  They can be administered to the affected area through injection, orally, or applied topically.  Response to therapy may be gradual and can vary from patient to patient.
  • Topical immunomodulators – sensitization with DCP, DNCB, or squaric acid can “reset” the immune response in the skin. This treatment typically takes several months. It is most useful for patients with large areas of involvement.
  • Topical minoxidil 5% solution – is a topical drug that is used to treat pattern baldness.  It typically takes 12 weeks of treatment before hair begins to grow back.
  • Anthralin – is a synthetic tar-like substance that alters the immune function of theskin.  It is applied for 20 to 60 minutes and then washed off to avoid skin irritation.

Other Alternatives

Wearing wigs, caps, hats, or scarves are alternative options that will not interfere with hair regrowth.  These are good options for patients who decide against treatment.

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