What Is Alopecia Areata?
Alopecia areata is a disease that causes hair to fall out in
small patches. It develops when the immune system attacks the hair follicles,
resulting in hair loss. Sudden hair loss may occur on the scalp and other parts
of the body. The condition rarely results in total hair loss, or alopecia
universalis, but it can prevent hair from growing back. When hair does grow
back, it’s possible for the hair to fall out again. The extent of hair loss and
regrowth varies from person-to-person.
There’s currently no cure for alopecia areata. However, there are
treatments that may help hair grow back more quickly and that can prevent
future hair loss. There are also resources available to help people cope with
What Are the Symptoms of Alopecia Areata?
The main symptom of alopecia areata is hair loss. Hair usually
falls out in small round patches on the scalp. These patches are usually
several centimeters or less. Hair loss might also occur on other parts of the
body. You may first notice clumps of hair on your pillow or in the shower. However,
other types of diseases can also cause hair to fall out in a similar pattern.
Hair loss alone shouldn’t be used to diagnose alopecia areata.
In rare cases, some people may experience more extensive hair
loss. This is usually an indication of another type of alopecia, such as:
- alopecia totalis, which is the loss of all hair
on the scalp
- alopecia universalis, which is the loss of all
hair on the entire body
The hair loss associated with alopecia areata is unpredictable
and random. The hair may grow back at any time and then may fall out again. The
extent of hair loss and regrowth varies greatly from person-to-person.
What Causes Alopecia Areata?
Alopecia areata is an autoimmune disease. An autoimmune disease
develops when the immune system mistakes healthy cells for foreign substances.
Normally, the immune system defends your body against foreign invaders, such as
viruses and bacteria. If you have alopecia areata, however, your immune system
mistakenly attacks your hair follicles. Hair follicles are the structures from
which hairs grow. The follicles become smaller and stop producing hair, leading
to hair loss.
Researchers don’t know what triggers the immune system to attack
hair follicles, so the exact cause of this condition isn’t known. However, it
most often occurs in people who have a family history of other autoimmune
diseases, such as type
1 diabetes or rheumatoid
arthritis. This is why some scientists suspect that genetics may contribute
to the development of alopecia areata. They also believe that certain factors in
the environment are needed to trigger alopecia areata in people who are
genetically predisposed to the disease.
How Is Alopecia Areata Diagnosed?
Your doctor will review your symptoms to determine if you have
alopecia areata. They may be able to diagnose alopecia areata simply by looking
at the extent of your hair loss and by examining a few hair samples under a
Your doctor may also perform a scalp biopsy to rule out other
conditions that cause hair loss, including fungal infections, such as tinea
capitis. During a scalp biopsy, your doctor will remove a small piece of skin on
your scalp for analysis.
Blood tests might be done if other autoimmune conditions are
suspected. The specific blood test performed depends on the particular disorder
your doctor suspects. However, your doctor will likely test for the presence of
one or more abnormal antibodies. If these autoantibodies are found in your
blood, it usually means that you have an autoimmune disorder.
Other blood tests that can help rule out other conditions include
- C-reactive protein and erythrocyte sedimentation
- iron levels
- antinuclear antibody test
and total testosterone
stimulating and luteinizing hormone
How Is Alopecia Areata Treated?
There’s no known cure for alopecia areata, but the condition can
be treated. Treatment may be able to stop future hair loss or help the hair
grow back more quickly.
You can rub certain medications such as minoxidil
(Rogaine) into the scalp to help stimulate hair growth. Other common therapies
include steroid injections or corticosteroid creams and ointments. In some
cases, photochemotherapy may be used to promote hair growth. Photochemotherapy
is a type of radiation treatment that uses a combination of oral medication and
Some people with alopecia areata choose alternative therapies to
treat their condition. These may include:
- herbal supplements
Most alternative therapies haven’t been tested in clinical
trials, so their effectiveness in treating hair loss isn’t known.
There are also some steps that may be taken to help minimize
- applying sunscreen to protect exposed areas from
- wearing sunglasses to shield the eyes from sun
and dust if the eyelashes have fallen out
- wearing a wig, hat, or scarf to protect the
The effectiveness of each treatment will vary from
person-to-person. Some people don’t even need treatment since their hair grows
back on its own. In other cases, however, people never see improvement despite
trying every treatment option. You might need to try more than one treatment to
see a difference. Keep in mind that hair regrowth may only be temporary. It’s
possible for the hair to grow back and then fall out again.
How to Cope with Alopecia Areata
Alopecia areata can be emotionally challenging, especially when
hair loss affects the whole scalp. People with the condition may feel isolated or
become depressed. If you’re feeling overwhelmed, counselors or support groups
may help you cope with the effects of the disease. Support groups can provide a
safe environment for you to share your experience and express any stress or
anxiety you may be feeling. The National
Alopecia Areata Foundation (NAAF) has support groups that meet in various
places across the United States. The NAAF also has conferences and online
message boards to help people connect with others who have the disease.
If the hair loss is bothersome, you can try to cover up bald
patches with a wig, hat, or stylish scarf. You may also apply a hair-colored
powder or cream to the scalp to make the hair loss less obvious. Applying eyebrow
pencil can help mask missing eyebrows.