Alopecia areata(AA) is an autoimmune disease that causes hair loss in children, women, and men. Hair loss in AA occurs in small, round smooth patches that may go away on their own, or may last for many years. Some people with AA (about 5%) may lose all their scalp hair (alopecia totals) or all scalp and body hair (alopecia universalist). The self-immune system, for unknown reasons, attacks the hair root and causes hair loss.
Who gets Alopecia Areata?
AA occurs world-wide in both genders and in every ethnic group. Children and young adults are most frequently affected, but people of all ages are susceptible. One in five persons with AA has a positive family history.
What are the signs and symptoms of AA?
AA usually presents with one or more small, round, coin-size, bare patches. It most commonly involves the scalp, but can occur on any hair-bearing site including eyebrows, eyelashes, and beards. AA usually is asymptomatic, but some may notice minor discomfort or itching prior to developing a new patch.
What causes AA?
AA is not contagious. It is an autoimmune disease in which the body’s own immune system attacks the hair follicles. The exact cause is not known. A person’s particular genetic makeup combined with other factors may trigger AA.
What tests are done to confirm AA?
Your dermatologist may diagnose AA by clinical examination.
Is this a symptom of a serious disease?
AA is not a symptom of a serious disease and can occur in otherwise healthy individuals. People with AA may have a higher risk of asthma, atopic eczema, and nasal allergies, as well as other autoimmune diseases such as thyroid disease (Hashimoto’s thyroiditis), and vitiligo.
Will the hair grow back?
The course of the disease varies from person to person. Some people lose a few patches of hair, the hairs regrow, and the condition never returns. Other people continue to lose and regrow hairs for many years. The potential for full recovery is always there, even in people who have lost all the hairs on their scalp and body (alopecia totals/universalis). Hairsmay regrow white or fine initially, but the original hair color and texture may return later.
What are the treatment options available?
There is no cure for AA. While available treatments promote hair growth, new patches of hair loss may continue to appear.
Corticosteroids- can be given as injection into the areas of hair loss, taken as pills, or rubbed into affected areas. Steroids that are rubbed into affected areas are less effective than injections. Oral Corticosteroids are not used routinely, but may be used in severe or non-responsive cases.
Topical minoxidil 5% solution— solution applied twice daily to the scalp, brow, and beard areas may promote hair growth in both adults and children with AA.
Combinationof treatments may add to the effectiveness.
Other Alternative approaches
Wigs, caps, hats, or scarves are important camouflage options. This may option for people with extensive scalp hair loss.
Does alopecia areata affect life?
Alopecia areata does not affect general health, and doesn’t interfere with your ability to achieve your life goals at school, in sports, in your career, and in raising a family.
The future
Immunomodulatory and other therapies are being explored and researchers continue to advance the treatment options for alopecia areata.