Alopecia areata is a medical condition where people lose hair in patches of their scalp, face, body or, less commonly, all three. Very rarely, people lose all of their hair on their scalp (known as ‘alocpecia totalis’) or all of the hair on their body (alopecia universalis).
Alopecia is not contagious and is believed to occur when the immune system attacks the hair follicles, which contain the roots of the hair, causing hair loss. It most often afflicts people who are otherwise healthy.
- Patchy hair loss: Often, the hair loss will start with one or a few coin-sized smooth bare patches appearing, or sometimes people first notice its onset when they discover clumps of hair on their pillow or shower drain. While the hair loss typically appears on the scalp, it can affect eye lashes, eyebrows and any part of the body.
- ‘Exclamation point’ hairs: The distinctively shaped hairs tend to be present in the early stages of alopecia areata and are seen at the edges of an area of hair loss. They are short (about 3mm-4mm) and are usually wider at the top then get progressively thinner as the hair meets the scalp. They tend to be darker at the top and lighter at the scalp end.
- Widespread hair loss: Over time, some patients go completely bald and, sometimes lose their body hair too.
- Nail problems: Sometimes finger and toe nails are the first to show signs of alopecia, through pitting, white spots or lines, or they might appear to be weak and in poor condition.
When to see a doctor
Anyone who loses an unusual amount of hair should see a dermatologist as it is important to establish the cause. In addition, you dermatologist can prescribe medications to help you.
Diagnosis & Treatment
Sometimes a dermatologist can diagnose alopecia areata simply through its visible characteristics. If a patch of hair loss is growing, the doctor may pull out a few hairs to examine under a microscope.
The dermatologist may order blood tests if she thinks the patient might have another autoimmune disease. A small skin biopsy might be performed to confirm the disease is alopecia areata. This is to rule out other causes of hair loss, for example a fungal infection.
As for treatment, there is no cure for alopecia areata, but hair often re-grows on its own. Our dermatologist can prescribe a variety medications and treatments to help the hair re-grow more quickly. The more extensive the hair loss and the more time has passed, the less likely hair is to grow back on its own.
Even with treatment, however, patients should be realize that new hair loss can occur. The outcome will depend on how the immune system reacts.