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Alopecia areata

Definition

Alopecia areata is a condition that causes round patches of hair loss. It can lead to total hair loss.

Alternative Names

Alopecia totalis; Alopecia universalis; Ophiasis; Hair loss - patchy

Causes

Alopecia areata is thought to be an autoimmune condition. This occurs when the immune system mistakenly attacks and destroys healthy body tissue.

Some people with this condition have a family history of alopecia. Alopecia areata is seen in men, women, and children. In a few people, hair loss may occur after a major life event such as an illness, pregnancy, or trauma.

Symptoms

Hair loss is usually the only symptom. A few people may also feel a burning sensation or itching.

Alopecia areata usually begins as 1 to 2 patches of hair loss. Hair loss is most often seen on the scalp. It may also occur in the beard, eyebrows, pubic hair, and arms or legs in some people.

Patches where hair has fallen out are smooth and round in shape. They may be peach-colored. Hairs that look like exclamation points are sometimes seen at the edges of a bald patch.

If alopecia areata leads to total hair loss, it often occurs within 6 months after symptoms first start.

Exams and Tests

The health care provider will examine you and ask about your symptoms, focusing on areas where you have hair loss.

A scalp biopsy may be done. Blood tests may also be done to check for autoimmune conditions and thyroid problems.

Treatment

If hair loss is not widespread, the hair will often regrow in a few months without treatment.

For more severe hair loss, it is not clear how much treatment can help change the course of the condition.

Common treatments may include:

  • Steroid injection under the skin surface
  • Medicines applied to the skin
  • Ultraviolet light therapy

A wig may be used to hide areas of hair loss.

Outlook (Prognosis)

Full recovery of hair is common.

However, some people may have a poorer outcome, including those with:

  • Alopecia areata that starts at a young age
  • Eczema
  • Long-term alopecia
  • Widespread or complete loss of scalp or body hair

When to Contact a Medical Professional

Call your provider if you are concerned about hair loss.

References

Habif TP. Hair diseases. In: Habif TP, ed. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 6th ed. Philadelphia, PA: Elsevier; 2016:chap 24.

Vivehanantha S, Berth-Jones J. Alopecia areata. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson I, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 4th ed. Philadelphia, PA: Elsevier; 2014:chap 10.


Review Date: 10/24/2016
Reviewed By: David L. Swanson, MD, Vice Chair of Medical Dermatology, Associate Professor of Dermatology, Mayo Medical School, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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