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Alopecia Areata

Alopecia areata is an autoimmune disorder that causes your body to attack its own hair follicles and the hair will fall off, often in clumps the size and shape of a quarter. It can affect anywhere on the body. Some people lose only a few on a spot but some others can lose a lot.

The hair loss is quite unpredictable and usually happens in otherwise healthy people. Hair usually regrows but some may not. There are different types of this condition. Alopecia areata is most common in its main form, but there are other, more rare types:

Alopecia areata totalis- totally lost all the hair on your head.

Alopecia areata universalis- totally lost all the hair over your entire body.

Diffuse alopecia areata- sudden thinning of your hair rather than lost patches.

Ophiasis alopecia areata- hair loss in a band shape around the sides and back of your head.

It may also affect the nails in up to 46% of those affected. AA nails may appear pitted with lines, having splitting and/or white spots. The main and often the only symptom of alopecia is hair loss. You may notice:

Small bald patches on your scalp or other parts of your body

Patches may get larger and grow together into a bald spot

Hair grows back in one spot and falls out in another

You lose a lot of hair over a short time

More hair loss in cold weather

Fingernails and toenails become red, brittle, and pitted

The bald patches of skin are smooth, with no rash or redness. But you may feel a tingling, itching, or burning sensation on your skin right before the hair falls out.

What are the risk factors?

The lifetime risk of alopecia areata is approximately 2%. It affects children and adults of all skin and hair colours. Peak incidence occurs in the second and third decades and most patients experience onset before the fourth decade. Alopecia areata does not carry significant sex or ethnic predominance. When you have an autoimmune disease, you have a higher chance of getting alopecia areata where the hair follicles are attacked.

You’re more likely to get alopecia areata if you have:

A family history


Down syndrome

Pernicious anemia

Seasonal allergies

Thyroid disease


How to diagnose alopecia areata?

You may  have to see a doctor and he will ask the history of your hair loss and check your hair loss pattern and features. He may also examine your nails.

In case of doubt, you may need a biopsy, which means a small piece of skin is removed from your scalp and looked at under a microscope.

There are other conditions which can cause hair loss. So your doctor may test your skin for a fungal infection or give you blood tests to check for thyroid, hormone, or immune system problems.

What is the treatment for alopecia areata?

There are few different options for this condition:

Intralesional Steroid Injection– These are anti-inflammatory drugs that are injected into the scalp or other areas.

Minoxidil- It usually takes about 12 weeks before you see growth, and some patients are disappointed in the results.

Olumiant (baricitinib) – This is the latest form of treatment which is FDA approved for the treatment of adults with severe alopecia areata

If you have symptoms suggestive of alopecia areata, please consult your doctor first.

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