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Alopecia Areata

Alopecia Areata usually presents as well defined round to oval patches of hair loss of the scalp but also may present as bands of hair loss at the hair margins or less commonly as localized or diffuse patchy loss.  There may be only one or a few patches of hair loss or there may be more widespread involvement.  Alopecia totalis is alopecia areata that involves the entire head with complete loss of scalp hair.  Hair loss in other body areas such as eyebrows, eyelashes, beard, arms, legs, underarms, etc., may occur and when occurring in conjunction with alopecia totalis is called alopecia universalis. Alopecia areata is believed to be an autoimmune disease where the immune system is overactive and ‘attacks’ hair follicles causing hair to shed.  This hair loss can occur very quickly and can sometimes be associated with periods of emotional stress in genetically susceptible people.

Most people with alopecia areata are healthy but there is a greater lifetime risk of having other autoimmune diseases such as: celiac disease (gluten sensitivity), rheumatoid arthritis, diabetes, thyroid disease, psoriasis, atopic dermatitis, lupus, vitiligo and anemia.

Alopecia areata in its more limited form is often self-resolving but with more extensive involvement or with involvement of the hair margins the prognosis is more guarded.

Treatment: Treatment options for alopecia areata include topical steroids and non-steroid anti-inflammatory medications, cortisone injections, topical medications (including sensitization therapy) that modify follicular inflammation, oral steroids, ultraviolet light treatments and other systemic medications that decrease the aberrant immune response.