Alopecia areata is a common disorder that causes hair loss. “Alopecia” is a Latin term that means baldness, and “areata” refers to the patchy nature of the hair loss that is typically seen with this condition.
In most people with alopecia areata, hair falls out in small, round patches, leaving coin-sized areas of bare skin. This patchy hair loss occurs most often on the scalp but can affect other parts of the body as well. Uncommonly, the hair loss involves the entire scalp (in which case the condition is known as alopecia totalis) or the whole body (alopecia universalis). Other rare forms of alopecia areata, which have different patterns of hair loss, have also been reported.
Alopecia areata affects people of all ages, although it most commonly appears in adolescence or early adulthood. Hair loss occurs over a period of weeks. The hair usually grows back after several months, although it may fall out again. In some cases, unpredictable cycles of hair loss followed by regrowth can last for years. In addition to hair loss, some affected individuals have fingernail and toenail abnormalities, such as pits on the surface of the nails.
The hair loss associated with alopecia areata is not painful or disabling. However, it causes changes in a person’s appearance that can profoundly affect quality of life and self-esteem. In some people, the condition can lead to depression, anxiety, and other emotional or psychological issues.
Alopecia areata affects approximately 4% of the population (90,000 in the UK alone), and around 98% of those diagnosed recover. Alopecia areata can affect all ethnic groups and ages, but is most likely to occur between the ages of 20 and 50.
It also occurs equally in both men and women.
The main diagnostic feature of alopecia areata is the presence of bald patches surrounded by little ‘exclamation mark hairs’.
They are thicker at the top and taper to a thinner end, with the root a blob at the bottom.The number of exclamation mark hairs you have can indicate how active the alopecia areata is. In general, the more there are, the more rapid its progress. However, sometimes there are no visible exclamation mark hairs at all. In these cases, alopecia areata may be diffuse (spread over a large area), but this is rare.
In alopecia there is also inflammation present at the lower end of the hair follicle, but you can’t see it. Rarely, small patches of alopecia areata can grow, overlap and progress to total baldness, or alopecia totatlis.
Alopecia areata is widely accepted to be an autoimmune disorder, where your body sees certain hair cells as foreign enemies and attacks them. What triggers this response isn’t entirely understood, but 90% of cases are associated with stress, shock, bereavement or an accident and/or illness.
There is also often a genetic predisposition and there are in fact several reported cases of alopecia areata’s occurrence in twins. Alopecia areata is also more common in those that suffer from hayfever, eczema, Addison’s disease, pernicious anaemia, rheumatoid arthritis, ulcerative colitis, lichen planus, diabetes mellitus, vitiligo, lupus and thyroid disease.
In many cases, alopecia areata spontaneously resolves itself with Corticosteroid Injections.
Corticosteroid injections are thought to be the most effective of treatments for Alopecia Areata, especially when used on small patches. They are given every few weeks, and can be used to treat bald areas on your scalp, eyebrows and body.
Pain at the injection site and thinning of the skin.
The benefits of topical corticosteroids are debatable. They’re applied daily to affected scalp areas, but cannot be used on your face or body. Possible topical creams and gels include: betamethasone, hydrocortisone and mometasone.
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