Alopecia areata is a common autoimmune condition in which the body’s immune system targets
and attacks the hair follicles causing patches of hair loss. Hair loss is often distinct and can be seen
on any body part including the scalp, face, body or extremities.
Signs & Symptoms of Alopecia Areata
The autoimmune skin condition usually starts out with the loss of small, round patches of hair. Individuals with alopecia areata may experience one or more of the following symptoms:
Patchy hair loss: Smooth, bare patches appear on the scalp or other areas of the body that have hair including the eyebrows, eyelashes, beard area, legs or other areas.
Exclamation marks: Short hairs appear at the edges of bare patches. The hairs become narrow at the bottom, resembling an exclamation mark.
Degree of hair loss: Most often, alopecia areata is self-limited with patchy hair loss that gradually grows back over time. Although, patients may experience repeat episodes of hair loss and regrowth. Less often, patients may lose all the hair on their scalp or a specific body part, which is referred to as Alopecia Totalis. In rare cases, individuals may lose the hair on their entire body, referred to as Alopecia Universalis.
Fingernails may also be affected by alopecia areata. Nail symptoms include dents, white spots and roughness.
Often, the condition is unpredictable with hair growing back and falling out over and over. According to an April 2012 article that appeared in the New England Journal of Medicine, approximately 66 percent of those with alopecia areata are under 30 years of age.
Diagnosing Alopecia Areata
Diagnosis of alopecia areata is often determined by clinical evaluation by your dermatologist. Occasionally, a biopsy of the skin may be performed to rule out other conditions. Sometimes a physician may also order blood work to assess for other possible autoimmune conditions.
Treatment of Alopecia Areata
Although there is no permanent cure for alopecia areata, there are treatment options that help control the condition and help with the growth of hair.
Treatment options include:
Corticosteroids: Corticosteroids are considered first-line treatment for alopecia areata. Corticosteroids can either be applied topically to the skin as creams or ointments, or may be injected directly into areas of hair loss. Corticosteroid injections are often more effective than creams or ointments. Injections are usually done every 3-6 weeks, with hair growth typically beginning 3-4 weeks after the last shot. Although steroid injections are considered an effective form of treatment, “too much” treatment can also cause thinning or atrophy of skin. The number of treatments is often limited to prevent thinning of the skin.
Minoxidil (Rogaine): Usually prescribed in combination with other treatments, Minoxidil is applied twice daily to areas of hair loss and may help accelerate hair growth.
Anthralin: This medication is applied directly to the affected skin for a short period of time and gradually increased to a period of 1 hour. Following treatment, the medication is carefully washed off to prevent irritation. Side effects include irritation of the skin.
Diphencyprone (DPCP): DPCP is an effective form of therapy which produces an allergic response to trick the immune system and allow hair re-growth. Treatment may result in severe irritation of the skin.
Hair growth may occur with or without treatment. In some individuals hair regrowth is permanent, while others lose and regrow hair over and over. If you have concerns about patchy hair loss, contact our office to set up an appointment with one of our board-certified dermatologists.