Alopecia Areata

What is Alopecia Areata

Alopecia areata is a condition that causes you to lose hair. You may lose hair on your scalp in patches. In some cases, you may lose all the hair on your scalp (alopecia totalis) or all the hair from your face and body (alopecia universalis).

Alopecia areata is an autoimmune disease. This means that your body’s defense system (immune system) mistakes normal parts of the body for germs or other things that can make you sick. When you have alopecia areata, the immune system attacks the hair follicles.

Alopecia areata usually develops in childhood, but it can develop at any age. For some people, their hair grows back on its own and hair loss does not happen again. For others, their hair may fall out and grow back in cycles. The hair loss may last many years. Having this condition can be emotionally difficult, but it is not dangerous.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in people who have:

  • A family history of alopecia.
  • A family history of another autoimmune disease, including type 1 diabetes and rheumatoid arthritis.
  • Asthma and allergies.
  • Down syndrome.

What are the signs or symptoms?

Round spots of patchy hair loss on the scalp is the main symptom of this condition. The spots may be mildly itchy. Other symptoms include:

  • Short dark hairs in the bald patches that are wider at the top (exclamation point hairs).
  • Dents, white spots, or lines in the fingernails or toenails.
  • Balding and body hair loss. This is rare.

How is this diagnosed?

This condition is diagnosed based on your symptoms and family history. Your health care provider will also check your scalp skin, teeth, and nails. Your health care provider may refer you to a specialist in hair and skin disorders (dermatologist). You may also have tests, including:

  • A hair pull test.
  • Blood tests or other screening tests to check for autoimmune diseases, such as thyroid disease or diabetes.
  • Skin biopsy to confirm the diagnosis.
  • A procedure to examine the skin with a lighted magnifying instrument (dermoscopy).

How is this treated?

There is no cure for alopecia areata. Treatment is aimed at promoting the regrowth of hair and preventing the immune system from overreacting. No single treatment is right for all people with alopecia areata. It depends on the type of hair loss you have and how severe it is. Work with your health care provider to find the best treatment for you. Treatment may include:

  • Having regular checkups to make sure the condition is not getting worse (watchful waiting).
  • Steroid creams or pills for 6–8 weeks to stop the immune reaction and help hair to regrow more quickly.
  • Other topical medicines to alter the immune system response and support the hair growth cycle.
  • Steroid injections.
  • Therapy and counseling with a support group or therapist if you are having trouble coping with hair loss.

Follow these instructions at home:

  • Learn as much as you can about your condition.
  • Apply topical creams only as told by your health care provider.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Consider getting a wig or products to make hair look fuller or to cover bald spots, if you feel uncomfortable with your appearance.
  • Get therapy or counseling if you are having a hard time coping with hair loss. Ask your health care provider to recommend a counselor or support group.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

  • Your hair loss gets worse, even with treatment.
  • You have new symptoms.
  • You are struggling emotionally.

Summary

  • Alopecia areata is an autoimmune condition that makes your body’s defense system (immune system) attack the hair follicles. This causes you to lose hair.
  • Treatments may include regular checkups to make sure that the condition is not getting worse (watchful waiting), medicines, and steroid injections.

Alopecia Areata, Pediatric

Alopecia areata is a condition that causes your child to lose hair. Your child may lose hair on his or her scalp in patches. In some cases, your child may lose all the hair on his or her scalp (alopecia totalis) or all the hair from his or her face and body (alopecia universalis).

Alopecia areata is an autoimmune disease. This means that your child’s body’s defense system (immune system) mistakes normal parts of the body for germs or other things that can make him or her sick. When your child has alopecia areata, the immune system attacks the hair follicles.

Alopecia areata usually develops in childhood and is different for each child. For some children, their hair grows back on its own and hair loss does not happen again. For others, their hair may fall out and grow back in cycles. The hair loss may last many years. Having this condition can be emotionally difficult, but it is not dangerous.

What are the causes?

The cause of this condition is not known.

What increases the risk?

This condition is more likely to develop in children who have:

  • A family history of alopecia.
  • A family history of another autoimmune disease, including type 1 diabetes and rheumatoid arthritis.
  • Asthma and allergies.
  • Down syndrome.

What are the signs or symptoms?

Round spots of patchy hair loss on the scalp is the main symptom of this condition. The spots may be mildly itchy. Other symptoms include:

  • Short dark hairs in the bald patches that are wider at the top (exclamation point hairs).
  • Dents, white spots, or lines in the fingernails or toenails.
  • Balding and body hair loss. This is rare.

How is this diagnosed?

This condition is diagnosed based on your child’s symptoms and family history. Your child’s health care provider will also check your child’s scalp skin, teeth, and nails. Your child’s health care provider may refer your child to a specialist in children’s hair and skin disorders (pediatric dermatologist). Your child may also have tests, including:

  • A hair pull test.
  • Blood tests or other screening tests to check for autoimmune diseases, such as thyroid disease or diabetes.
  • Skin biopsy to confirm the diagnosis.
  • A procedure to examine the skin with a lighted magnifying instrument (dermoscopy).

How is this treated?

There is no cure for alopecia areata. Treatment is aimed at promoting the regrowth of hair and preventing the immune system from overreacting. No single treatment is right for all children with alopecia areata. It depends on the type of hair loss your child has and how severe it is. Work with your child’s health care provider to find the best treatment for your child. Treatment may include:

  • Having regular checkups to make sure the condition is not getting worse (watchful waiting).
  • Steroid creams or pills for 6–8 weeks to stop the immune reaction and help hair to regrow more quickly.
  • Other topical medicines to alter the immune system response and support the hair growth cycle.
  • Steroid injections. This treatment is only used in older children.
  • Therapy and counseling with a support group or therapist. Children may have trouble coping with hair loss and reactions from others.

Follow these instructions at home:

  • Learn as much as you can about your child’s condition.
  • Apply topical creams only as told by your child’s health care provider.
  • Give your child over-the-counter and prescription medicines only as told by your child’s health care provider.
  • Consider getting your child a wig or products to make hair look fuller or to cover bald spots, if your child feels uncomfortable with his or her appearance.
  • Educate others about your child’s condition. Let them know that your child is not sick and that alopecia areata is not contagious.
  • Get therapy or counseling for your child if your child is having a hard time coping with hair loss. Ask your child’s health care provider to recommend a counselor or support group.
  • Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if:

  • Your child’s hair loss gets worse, even with treatment.
  • Your child has new symptoms.
  • Your child is sad or depressed or avoids enjoyable activities.

Summary

  • Alopecia areata is an autoimmune condition that makes your child’s body defense system (immune system) attack the hair follicles. This causes your child to lose hair.
  • Treatments may include regular checkups to make sure that the condition is not getting worse (watchful waiting), medicines, and steroid injections.
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