Medical knowledge, Patient Education
Alopecia Areata, Adult
Alopecia areata is a condition that causes hair loss. A person with this condition may lose hair on the scalp in patches. In some cases, a person may lose all the hair on the scalp or all the hair from the face and body. Having this condition can be emotionally difficult, but it is not dangerous.
Alopecia areata is an autoimmune disease. This means that your body’s defense system (immune system) mistakes normal parts of the body for germs or other things that can make you sick. When you have alopecia areata, the immune system attacks the hair follicles.
What are the causes?
The cause of this condition is not known.
What increases the risk?
You are more likely to develop this condition if you have:
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A family history of alopecia.
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A family history of another autoimmune disease, including type 1 diabetes and thyroid autoimmune disease.
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Eczema, asthma, and allergies.
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Down syndrome.
What are the signs or symptoms?
The main symptom of this condition is round spots of patchy hair loss on the scalp. The spots may be mildly itchy. Other symptoms include:
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Short dark hairs in the bald patches that are wider at the top (exclamation point hairs).
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Dents, white spots, or lines in the fingernails or toenails.
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Balding and body hair loss. This is rare.
Alopecia areata usually develops in childhood, but it can develop at any age. For some people, their hair grows back on its own and hair loss does not happen again. For others, their hair may fall out and grow back in cycles. The hair loss may last many years.
How is this diagnosed?
This condition is diagnosed based on your symptoms and family history. Your health care provider will also check your scalp skin, teeth, and nails. Your health care provider may refer you to a specialist in hair and skin disorders (dermatologist).
You may also have tests, including:
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A hair pull test.
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Blood tests or other screening tests to check for autoimmune diseases, such as thyroid disease or diabetes.
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Skin biopsy to confirm the diagnosis.
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A procedure to examine the skin with a lighted magnifying instrument (dermoscopy).
How is this treated?
There is no cure for alopecia areata. The goals of treatment are to promote the regrowth of hair and prevent the immune system from overreacting. No single treatment is right for all people with alopecia areata. It depends on the type of hair loss you have and how severe it is.
Work with your health care provider to find the best treatment for you. Treatment may include:
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Regular checkups to make sure the condition is not getting worse . This is called watchful waiting.
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Using steroid creams or pills for 6–8 weeks to stop the immune reaction and help hair to regrow more quickly.
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Using other medicines on your skin (topical medicines) to change the immune system response and support the hair growth cycle.
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Steroid injections.
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Therapy and counseling with a support group or therapist if you are having trouble coping with hair loss.
Follow these instructions at home:
Medicines
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Apply topical creams only as told by your health care provider.
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Take over-the-counter and prescription medicines only as told by your health care provider.
General instructions
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Learn as much as you can about your condition.
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Consider getting a wig or products to make hair look fuller or to cover bald spots, if you feel uncomfortable with your appearance.
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Get therapy or counseling if you are having a hard time coping with hair loss. Ask your health care provider to recommend a counselor or support group.
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Keep all follow-up visits as told by your health care provider. This is important.
Where to find more information
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National Alopecia Areata Foundation: naaf.org
Contact a health care provider if:
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Your hair loss gets worse, even with treatment.
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You have new symptoms.
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You are struggling emotionally.
Get help right away if:
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You have a sudden worsening of the hair loss.
Summary
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Alopecia areata is an autoimmune condition that makes your body’s defense system (immune system) attack the hair follicles. This causes you to lose hair.
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Having this condition can be emotionally difficult, but it is not dangerous.
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Treatments may include regular checkups to make sure that the condition is not getting worse, medicines, and steroid injections.
This information is not intended to replace advice given to you by your health care provider. Make sure you discuss any questions you have with your health care provider.
