ALOPECIA AREATA

General Information

DEFINITION--Sudden hair loss in circular patches on the scalp. Hair loss is not accompanied by other visible evidence of scalp disease. This is not contagious.

BODY PARTS INVOLVED--Hair; scalp; eyebrows; eyelashes; beard; genital area; underarm (sometimes).

SEX OR AGE MOST AFFECTED--Affects all ages and males more frequently than females.

SIGNS & SYMPTOMS

• Sudden hair loss in sharply defined circular patches. In rare cases, body hair loss may be total.
• No pain.
• No itch.

CAUSES

• Usually unknown, but heredity and emotional factors, such as anxiety, may contribute to hair loss. The autoimmune system may also be involved.
• May be caused by thyroiditis or pernicious anemia.

RISK INCREASES WITH

• Stress.
• Family history of alopecia areata.

HOW TO PREVENT--Cannot be prevented at present.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.

APPROPRIATE HEALTH CARE

• Self-care after diagnosis.
• Doctor's treatment.

POSSIBLE COMPLICATIONS

• Loss of all hair.
• Slow or incomplete regrowth.

PROBABLE OUTCOME--Usually curable, with spontaneous new growth, in 18 months to 3 years. Persons with a few small patches are generally cured completely. The disorder recurs in 25% of cases.

How To Treat

GENERAL MEASURES--

• Consider wearing a hairpiece or wig during the acute phase.
• Continue to bathe and shampoo as usual.
• Don't tug on normal hair close to areas of hair loss.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Topical steroids. Apply topical steroid once or twice a day unless directed otherwise. Apply immediately after bathing or shampooing for better spreading and penetration. For scalp and groin, use only low-potency steroid products without fluorine.
• Injections of steroids into affected areas and oral cortisone drugs for you to take on alternate days.
• Photochemotherapy with PUVA (See Glossary).
• A topical drug, minoxidil (a prescription drug used for hair growth), may help some patients.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of alopecia areata.
• The following occurs during treatment: Hair loss increases. Hair loss doesn't diminish in 4 weeks. Areas show signs of infection (redness, swelling, tenderness, warmth) after injections.