Alopecia Areata

What Is Alopecia Areata?

Patients diagnosed with alopecia areata — a common autoimmune disease that causes hair loss — know how severe the effects of their condition can be regarding their physical, emotional, and social wellbeing. Alopecia areata, or patchy hair loss, affects approximately 6.8 million people in the United States, including men, women, and children of any age.

For patients with alopecia areata, our dermatologists and skin specialists at Advanced Dermatology and Skin Cancer Center are here to help you find effective relief through personalized treatment. We treat a wide variety of skin conditions, including alopecia areata and other types of chronic skin conditions.

Contact our team today to schedule an appointment.

What Causes Alopecia Areata?

In most alopecia areata cases, a patient’s hair falls out in small patches (typically the size of a quarter). For the majority of individuals with this condition, hair loss is minimal. In some patients, the degree of hair loss is extreme. It occurs when white blood cells attack cells within the hair follicles, causing hair follicles to shrink and dramatically slow hair production. The precise reason for this reaction is unknown. Still, science points to genetics as a prevalent source of alopecia areata causes — one in five patients diagnosed with alopecia areata have one or more family members who also have the disease. Other autoimmune disorders, such as atopy, thyroiditis, and vitiligo may be found in patients diagnosed with alopecia areata. Additionally, science indicates that certain environmental factors may be alopecia areata triggers in patients who are genetically predisposed to the condition.

Alopecia Areata Symptoms

Alopecia areata can affect any individual, regardless of gender and age, but most cases occur before the age of 30. The most common and prominent symptom of this disease is patchy hair loss in which coin-sized patches of hair fall out. However, any hair growth site on the body may be affected, including beards, eyebrows, and eyelashes. Loss of hair can be sudden, and the condition may develop in just a few days or multiple weeks. Patients may experience itching or burning in the area before hair loss.

An unpredictable disease, alopecia areata can cause hair to fall out, grow back, and fall out again in some patients. In other patients, lost hair grows back and remains. Even in extreme cases in which patients lose all of their hair, their hair may grow back. Hair is more likely to grow back in patients. This disease does not destroy hair follicles and, as such, hair may regrow if hair follicle inflammation subsides. Each case is unique, and patients may require treatment to help facilitate the regrowth of lost hair.

Clinical signs of alopecia areata include, but are not limited to, the following.

  • Exclamation mark hairs. These hairs grow in or around the edges of bald spots and are more narrow at the bottom than near the root.
  • Cadaver hairs. Cadaver hairs are characterized by hair breakage occurring before the hair reaches the skin’s surface.
  • White hairs. White hairs may grow in or around areas of the skin affected by hair loss due to this condition.

Alopecia areata can also affect the fingernails and toenails. The following changes to the nails may signal that the condition is developing.

  • Rough nails texture
  • Lackluster nails
  • Thin, breakable nails
  • Pinpoint dents
  • White spots and lines

Alopecia Areata Treatment

There is no known cure for alopecia areata, but there are treatments available that can help slow down the progression of hair loss and aid in regrowing lost hair quickly. Due to this condition’s unpredictable nature, treatments that work for some patients may not work for others — our dermatologists will work with you to find the most effective and beneficial treatment for your symptoms and goals. Treatments are typically chosen based on multiple factors, including the patient’s age, the extent of their hair loss, and the location of hair loss.

Available treatments for alopecia areata may include the following. Contact our dermatology associates to discuss the right treatment for you.

  • Corticosteroids. These are anti-inflammatory drugs prescribed for autoimmune diseases. They may be given as an injection to the scalp, in pill form, or as an alopecia areata treatment cream or a foam that is regularly applied to the scalp.
  • Minoxidil. Also known by the brand name Rogaine®, minoxidil is a topical medication used to treat pattern baldness. It typically takes approximately 12 weeks of treatment with this medication before hair begins to grow.
  • Anthralin. Patients more than ten years of age apply this medication to bald spots once or twice each day (or as instructed by our dermatologists) and wash it off after that. This is commonly used in combination with minoxidil for the best results.
  • Intralesional Corticosteroids. If alopecia causes the loss of eyebrow hairs, this medication may be injected to help facilitate hair regrowth. If successful, minoxidil may also be used as directed to help patients maintain the results.
  • Contact Immunotherapy. Also called topical immunotherapy, this treatment aims to alter the immune system to prevent attacks on the hair follicles. Contact immunotherapy may be used for those with rapid or widespread hair loss.
  • Methotrexate. This medication may be an option for patients with extensive hair loss and cases that have not responded to other forms of treatment. Methotrexate may be prescribed in conjunction with a corticosteroid for the best results.
  • Medication (JAK Inhibitors). The discovery of treatment with JAK inhibitors, including tofacitinib, ruxolitinib, and baricitinib, marks a breakthrough in hair regrowth research. Patients’ hair, however, may fall out if they stop taking this medication.

Types Of Alopecia Areata

During a clinical examination, patients might be diagnosed with one of the following types of alopecia, including alopecia areata, alopecia totalis, and alopecia universalis. Find an effective treatment personalized for your needs — contact our dermatology clinic today to schedule a consultation.

Alopecia Areata

“Alopecia” is a medical term for “bald,” while “areata” means “patchy.” If patchy baldness leads to total hair loss, it typically occurs within 6 months after symptoms first start. If the condition worsens, it may become alopecia totalis or alopecia universalis.

Alopecia Totalis

In some instances, alopecia areata can develop into the complete loss of hair on the scalp, at which point the condition is called alopecia totalis. Patients affected by alopecia totalis, an advanced form of the initial condition, are completely bald.

Alopecia Universalis

Alopecia universalis occurs when patients with alopecia areata experience complete hair loss, resulting in the entire body being hairless. Patients with this condition commonly experience hair loss from the eyebrows, eyelashes, face, chest, and back.

How To Manage Alopecia Areata

In addition to its aesthetic qualities, hair affords individuals a certain degree of protection against environmental elements. Those with alopecia areata who have lost their hair should consider adopting the following practices to supplement protection while exposed to the sun and other outdoor elements.

  • Wear a broad-spectrum sunscreen with a minimum SPF of 35.
  • Wear sun-protective clothing and a wide-brimmed hat.
  • Wear wraparound sunglasses to protect the eyes from the sun and debris that would otherwise be shielded by eyelashes and eyebrows.
  • Use headwear, such as wigs, hats, and scarves to protect the head from the sun.
  • Use ointment inside the nose to keep mucous membranes moist and protect against organisms usually trapped by nose hairs.

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