Understanding Alopecia Areata

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Alopecia areata is an autoimmune disease. This means it’s caused by the body’s immune system attacking its own tissues. The immune system attacks the hair follicles. It causes hair to stop growing, and then break off and fall out. Genetic makeup and other factors may trigger this condition.

If you have been diagnosed with alopecia areata, you may have a higher risk for:

• Another autoimmune disease such as thyroid disease or vitiligo

• Asthma and allergies such as eczema (atopic dermatitis) and hay fever

The main symptom is one or more bald patches on the scalp that occur over a few weeks as hair falls out. Bald patches most often occur on the scalp, but hair can also fall out on the face and other parts of the body. The skin may itch or burn before the hair falls out. Then the skin may be smooth, or have some short hairs left. In some people, the rest of the hair on the head and the entire body may also thin or fall out.

Some people also have small dents or pits in their fingernails or toenails. Other symptoms may include roughness, cracks, white spots or lines, or loss of shine on the nails.

You can choose not to have any treatment. For many people, the hair will grow back in time. In some cases, it may fall out again. Treatment doesn’t prevent hair from falling out in the future.

Some medicines can help regrow hair faster, or stop hair from falling out. These medicines include:

• Corticosteroid medicine. This is injected into the areas where hair is falling out or gone. The injections are done every 4 to 12 weeks. Corticosteroid medicine can also be used as an ointment or cream put on the skin. These are often used along with the injections.

• Immunotherapy medicine. This is a type of medicine that causes an allergic reaction on the skin. You apply it once a week as a lotion onto the skin of the scalp.

• Topical minoxidil. You put this over-the-counter medicine right on the scalp. It may help new hair grow.

• Other medicines. Many other medicines can be used, but they may suppress the immune system. They can have unwanted side effects. Some newer immunologic medications, originally developed for other diseases, are showing promising results in early studies.

Medicines used for treatment have side effects. They also work better on some people than others. It depends on how severe your hair loss is. Talk with your healthcare provider about what medicines are the best options for you.

For many people, the hair grows back within a year. But your hair may fall out again in the future. This process may occur a few times over several years. Or the hair may not fully grow back. In some people, all the scalp hair or body hair may fall out.

Hair loss is more likely to happen again if you have any of these:

• Hair loss for more than 1 year

• Nail symptoms

• A family history of alopecia areata

• Hair loss that started in childhood

• Loss of a lot of hair

• Loss of hair in a band from the ears around the back of the head

Hair loss can cause stress and other emotional upset. Talk with your healthcare provider about finding support groups in your area to help you manage your condition. You can also talk to your provider about cosmetic fixes. A wig can be used to conceal bald patches. Tattooing of the eyebrows can restore the look of eyebrow hairs. Your healthcare provider may have resources to help.

Call your healthcare provider right away if you have any of these:

• Symptoms that don’t get better, or get worse

• New symptoms