Alopecia Areata

Alopecia areata is a common type of hair loss.
In most patients, alopecia areata manifests as round or oval patches of complete hair loss that appear very rapidly.
The scalp is the most common place involved, although any hair-bearing area on the body can be affected, including the eyebrows and eyelashes.
Most cases of alopecia areata involve only localized areas; a smaller percentage of cases are more extensive.
Most cases of alopecia areata eventually resolve on their own, although some cases may last for years and some patients may experience recurrences.
The cause of alopecia areata is not known, although most evidence suggests that it is caused by immune attack of the hair follicles; why this occurs is unknown.
Alopecia areata often develops during or after stressful events.

Treatment

Although eventually alopecia areata resolves on its own, most people prefer to speed this process up. The most commonly used treatment for alopecia areata in our practice is to inject the bald spots with small doses of corticosteroids (these are anti-inflammatory steroids, not muscle building anabolic steroids). This is usually done every 1-2 months until the spots resolve. The injections only work for the site injected; they probably do not prevent other sites from becoming involved.
The injections can sometimes cause thinning of the skin or dimples in the areas of injection. These fill in with time, although they very rarely can be permanent.
Alopecia areata may also be treated with topical steroid liquids, but this is less effective than the injections. Sometimes the liquids are a better choice in children, however, as they often do not tolerate injections well.
There are several other treatments for alopecia areata, although we use them much less frequently because of side effects or unreliable results.
Alopecia areata is not thought to be affected by hairstyling practices. It doesn't matter what type of shampoo you use, how often you wash your hair, whether you use a conditioner, blow dryer, etc.
The tendency to get alopecia areata is sometimes hereditary.
Most individuals with alopecia areata are otherwise completely healthy, although sometimes it can be associated with thyroid disease, particularly Hashimoto's thyroiditis. In some patients this can develop years later. Some healthcare providers recommend a screening thyroid test annually if you have had alopecia areata; this is done with a simple blood test.

Websites

National Alopecia Areata Foundation (NAAF), www.naaf.org