Alopecia areata is a common ailment. One person in 1,000 will have the disease at any given time. It most often affects the scalp but other hair-bearing areas can be involved, such as the beard, eyebrows, eyelashes, or pubic hair. Nails will be involved in about 10% of the cases.
Most of the time, it is confined to one or two patches on the body. In some cases, the scalp itches slightly, but most often there are no other symptoms. Most children with alopecia areata have no other health problems. In extreme cases, patients can lose all scalp hair (alopecia totalis) or even all scalp and body hair (alopecia universalis). This disease affects all races and an equal number of males and females. It is not contagious. Some patients get better completely while others have problems that persist.
The exact cause of this ailment is unknown, but it appears that the immune system may be involved. Simply speaking, the immune system gets “out of tune” and rejects the hair, causing it to fall out. Similar diseases (vitiligo, or white spot disease, and thyroiditis, an inflamed thyroid) are more common in persons and family members of persons with alopecia areata.
Dermatologists most often find this skin ailment by doing an exam. In some cases, lab tests may be needed. These include a hair pull for microscopic exam, a skin biopsy, hair cultures for fungus, and blood tests.
Often no treatment is needed. In some cases, steroid is applied to the area or injected into the area of hair loss. This can cause the skin to thin and to lose color (depigmentation). Anthralin is sometimes applied to the area and washed off after a period of time. This can irritate and discolor the skin for a short time. Other treatments that have been used with mixed results include PUVA (oral psoralen plus exposure to ultraviolet light), minoxidil (Rogaine®), chemicals which cause a contact allergy, and other experimental prescriptions.
It’s hard to predict the course of alopecia areata (rate of hair loss, extent, and hair regrowth). To date, there has been no treatment found that works in all patients. Patients may get better only to have symptoms return (relapse) or get worse (exacerbation).
UW Dermatology Department
1 S. Park St 7th Floor
Madison, WI 53715
Clinic: 608 287-2450
American Family Children’s Hospital
Pediatric Dermatology Specialty Clinic
1675 Highland Ave.
Madison, WI 53792
Clinic: 608 263-6420
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Last Updated: 11/14/2012
Copyright © 11/14/2012 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6456
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