What is alopecia areata?
Alopecia areata is a type
hair loss that occurs when your
immune system mistakenly attacks
hair follicles , which is where hair growth begins. The damage to the follicle
is usually not permanent. Experts do not know why the immune system attacks the
follicles. Alopecia areata is most common in people younger than 20, but
children and adults of any age may be affected. Women and men are affected
What happens in alopecia areata?
usually begins when clumps of hair fall out, resulting in totally smooth, round
hairless patches on the scalp. In some cases the hair may become thinner
without noticeable patches of baldness, or it may grow and break off, leaving
short stubs (called "exclamation point" hair). In rare cases, complete loss of
scalp hair and body hair occurs. The hair loss often comes and goes—hair will
grow back over several months in one area but will fall out in another
When alopecia areata results in patches of hair loss, the
hair usually grows back in a few months.1
Although the new hair is usually the same color and texture as the rest of the
hair, it sometimes is fine and white.
About 10% of people with
this condition may never regrow hair.2 You are more
likely to have permanent hair loss if you:
- Have a family history of the
- Have the condition at a young age (before
puberty) or for longer than 1 year.
- Are prone to allergies
- Have extensive hair loss.
- Have abnormal color,
shape, texture, or thickness of the fingernails or toenails.
Because hair is an important part of appearance, hair
loss can result in feeling unattractive.
In some people with
alopecia areata, the fingernails and toenails become pitted—they look as if a
pin had made many tiny dents in them. They may also look like sandpaper.
Alopecia areata cannot be "cured" but it can be treated. Most people who
have one episode will have more episodes of hair loss.
How is alopecia areata diagnosed?
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
- Blood tests, including testing for a specific
condition, such as an overactive or underactive thyroid gland (hyperthyroidism or
How is it treated?
Because hair usually grows back
within a year, you may decide not to treat alopecia areata.
choose not to treat the condition and wait for your hair to grow back, you may
- 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
The most common treatment for patchy hair loss is many
corticosteroids into the scalp, about
1 cm (0.4 in.) apart, every 4
to 6 weeks.
some adults may be treated with topical corticosteroids that are applied to the
Minoxidil (Rogaine) may be used along with topical
Anthralin is an ointment that may help hair grow again. It looks and feels like tar, and it can irritate and stain the skin. So anthralin is applied to bare patches on the scalp only for a short time and then is washed off. It may take 2 months or more for new hair to grow.
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.
effects of contact immunotherapy include a severe rash (contact dermatitis) and swollen
lymph nodes, especially in the neck.
How will alopecia areata affect your life?
areata does not affect you as another condition might: it is not painful, it
does not make you feel sick, and it does not result in serious health problems.
You cannot spread it to other people, and it should not interfere with school,
work, or recreation.
But if hair loss is making you feel
unattractive, it is important to talk to someone about it. A counselor can
help, as can talking to other people with the same condition.
Organizations National Alopecia Areata Foundation www.naaf.org National Institute of Allergy and Infectious Diseases (U.S.) www.niaid.nih.gov
Hague J, Berth-Jones J (2010). Alopecia areata. In MG Lebwohl et al., eds., Treatment of Skin Disease: Comprehensive Therapeutic Strategies, 3rd ed., pp. 31–35. Edinburgh: Saunders Elsevier.
Habif TP (2010). Hair diseases. In Clinical Dermatology: A Color Guide to Diagnosis and Therapy, 5th ed., pp. 913–935. Edinburgh: Mosby Elsevier.