Alopecia Areata

by Sheron Hopkins

Alopecia areata is a specific type of hair loss.

It can affect any area of the body with hair, and presents with several different patterns. Alopecia areata affects approximately 0.1-0.2% of the population.

There are several types of alopecia areata. The most common type is alopecia areata monolocularis, wherein only a single bald spot is present. This occurs in approximately 80% of patients with alopecia areata. Another type is alopecia areata barbae, wherein only the beard is lost.

The ophiasis pattern is characterized by loss of hair at the sides and the back of the scalp, while the sisaipho pattern spares these areas.

More extensive patterns of the disease are known as totalis alopecia areata and alopecia areata universalis. Totalis alopecia areata affects the entire scalp, leaving the patient bald. The last type, alopecia areata universalis, affects the entire epidermis. Alopecia areata universalis results in the loss of all of a person’s body hair, including his or her pubic hair. About 1% of patients with alopecia areata have this pattern of hair loss.

Alopecia areata is believed to be due to an autoimmune process in the body. There has also been note of a genetic component. Approximately 10-20% of patients with alopecia areata have another family member who has a form of alopecia areata. In about 15%, a precipitating factor can be identified, such as drug use, trauma or illnesses.

Alopecia areata can occur at any time during one’s life, but usually occurs before the patient turns 20. The condition starts out with small circular patches, typically on the scalp. Patients may also have what is known as exclamation point hairs. These hairs gradually become thinner as they reach the base, thus appearing like exclamation points. Nails can also be involved, resulting in abnormalities such as pitting.

Some patients with alopecia areata experience re-growth of the lost hair spontaneously within a year. Patients with extensive hair loss, however, will probably not grow their hair back anymore. The longer the time the hair has been lost, the less likely it will grow back.

Certain therapies are currently being used for alopecia areata, which have varying efficacies in different patients. Corticosteroids are currently being used, both as cream and in injectable form. These therapies include the use of topical immunotherapy, phototherapy, anthralin and minoxidil. Some studies have also looked into the efficacy of essential oils. Alternative treatment modalities have also been utilized, such as acupuncture and massage techniques. Combinations of these treatments have also been used. However, at present, there is still no effective treatment for alopecia areata.

Although not a fatal condition, alopecia areata can cause severe emotional and psychological stress to patients. Patient education is an important part in the treatment of the condition. Patients should be informed about the relapsing course of the disease and their prognosis.

If you or somebody you know has alopecia areata, the National Alopecia Areata Foundation can help and provide more information on the condition. There are also various alopecia areata support groups that patients can join.

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