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Back to Dermatology Diseases
Alopecia areata
Alopecia Areata ("baldness in spots") is a form of hair loss from
areas of the body, usually from the scalp. Because it causes bald
spots on the head especially in the first stages, it is also called
“spot baldness”. Hair loss can extend to eyebrows, eyelashes, facial
and nasal hair and create more bald spots elsewhere in the body.
Alopecia monolocularis describes baldness in only one spot, alopecia
multilocularis refers to multiple areas of hair loss. In Alopecia
totalis, the patient is totally bald. If all body hair, including
pubic hair, is lost, the diagnosis is alopecia universalis. The
disease may also be limited only to the beard (alopecia barbae).
Alopecia is thought to be a minor autoimmune disease that makes the
body to treat its hair follicles as foreign tissue and suppress or
stop hair growth. It is not contagious but may be hereditary - there
are a few recorded cases of babies being born with congenital
alopecia. Whether it is stress-related or not is controversial.
First symptoms are small, soft, round bald patches of just about any
shape. This usually happens in late teens but alopecia has been
observed with people of all ages. There may be different skin areas
with hair loss and regrowth in the same body at the same time. It may
go into remission for a time or permanently. The longer the hair loss
persists, the smaller the chance that it will grow back.
Effects of alopecia are mainly psychological (loss of self image due
to hair loss). However, patients also tend to have a slightly higher
incidence of asthma, allergies and atopic dermal ailments and even
hypothyroidism. Loss of hair also means that the scalp burns more
easily in the sun. Loss of nasal hair increases severity of hay fever
and similar allergic conditions. They may also have aberrant nail
formation because keratin forms both hair and nails.
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Episodes of alopecia areata before puberty predispose to recurrent
episodes after puberty. Pitting of the fingernails can hint at a more
severe or prolonged course.
It has been shown that zinc intake can support regrowth. Initial
stages may be kept from increasing by applying topical
corticosteroids. However, since the exact mechanisms are not
ultimately understood, there is no known cure to date. Hair implants
may help covering bald spots, but cannot guarantee satisfactory
outcome, since the bald areas might expand. Wigs should be prescribed
if patients, especially female patients, mention social discomfort.
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