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

  • Causes
    • The cause of alopecia areata is unknown. Some people with this condition have a family history of alopecia.

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

      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.

      Forms of alopecia include:

      • Alopecia areata -- patches of hair loss
      • Alopecia totalis -- complete loss of scalp hair
      • Alopecia universalis -- total loss of all body hair
  • 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, 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.

      In alopecia totalis, total hair loss often occurs within 6 months after symptoms first start.

  • Exams and Tests
    • A scalp biopsy may be done. Several 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

      Wigs 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
      • Long-term alopecia
      • Widespread or complete loss of scalp or body hair
  • When to Contact a Medical Professional
    • Call your health care provider if you are concerned about hair loss.

  • References
    • Sperling LC, Sinclair RD, El Shabrawi-Caelen L. Alopecias. In: Bolognia JL, Jorizzo JL, Schaffer JV, et al., eds. Dermatology. 3rd ed. Philadelphia, PA: Elsevier Mosby; 2012:chap 60.