What is Alopecia Areata

Alopecia Areata

Alopecia affects men and women of all ages. It usually begins in early childhood, teenage years, or young adulthood. It can appear on the scalp, but it can also occur on other parts of the body including the eyebrows, eyelashes, and fingernails. Go to for more information.

Many people with alopecia have a family history of the condition or other autoimmune diseases like thyroiditis and vitiligo (a disorder that causes patchy whitening of the skin). Alopecia can be emotionally distressing.

Alopecia areata is an autoimmune disease, which means your immune system mistakenly attacks parts of your body that grow hair. Your immune system attacks the follicles on your scalp and other areas that grow hair, causing the hair to fall out. It also can attack your eyelashes, eyebrows, and arms and legs. The attack usually doesn’t destroy the follicles, so your hair often grows back. In some cases, it progresses to baldness or complete loss of body hair (alopecia universalis).

You have a greater chance of getting alopecia areata if someone in your family has it. The condition can happen at any age, but it starts most often in childhood, adolescence, or young adulthood. It affects men and women equally. It is more common in people with a family history of thyroid disease, vitiligo, or Down syndrome.

Scientists aren’t sure what causes alopecia areata. But they do know that genes play a role. One study of more than 1,000 alopecia areata patients found that there were certain genes, called PDE5A and PPARGC1A, that increased your risk. If you have these genes, you have about a 55% chance of developing the disease. If both your parents have the gene, you have a 90% chance of developing it.

Other genetic factors may contribute to the disease, too. It’s also possible that a stressful event can trigger it, though this is less common. Many people develop alopecia areata after a physical or emotional shock, such as surgery, illness, divorce, or death of a loved one.

Your doctor can diagnose alopecia areata by looking at your scalp or other affected areas of the body for bare patches. He or she might take a sample of hair and examine it under a microscope for signs of the disease, such as a lack of new growth or an unusual pattern of hair growth.

You may also have other hair problems with alopecia areata, such as “exclamation mark” hairs (short, narrow hairs that get wider toward the bottom) or cadaver hairs (hairs that break before they reach the skin surface). Some people who have alopecia areata can also have fingernail and toenail abnormalities, such as pitting and multiple ridges.


The most common symptoms of alopecia areata are smooth, round patches of hairless skin that vary in size. These patches are usually skin-colored or peach, but they can also be white. The remaining hairs are often short and may have a peculiar shape, such as “exclamation mark” hairs that narrow at the bottom or c-shaped hairs that grow in or around the edges of bald spots. People with alopecia areata may also experience changes in fingernails or toenails, including the formation of pits or grooves in the surface of the nail.

Hair loss from alopecia areata can happen slowly, over the course of several months or years. However, it can also occur very quickly. For some individuals, the disease is only confined to one or two small areas of the scalp. In other cases, it progresses to involve the entire scalp and all other hair-growing sites on the body, such as eyebrows and eyelashes or the beard area and arms. Hair loss from alopecia areata is not painful, but it can be emotionally distressing.

Some people with alopecia areata have a very mild form of the condition, where only one or more areas of the scalp are affected. Often, these patches of hair re-grow without treatment. In other cases, alopecia areata is more severe and the regrowth of hair is slower. Some individuals, however, lose their hair permanently or experience a constant cycle of regrowth and loss.

Cicatricial alopecia, which affects the forehead, temples and other areas of the head, is a more serious form of hair loss. In this condition, the inflammation that destroys hair follicles in some patients also causes scar tissue to form in those same areas. As a result, hair no longer grows in those areas, and the skin may appear dry and flaky, or have a reddish hue.

Many different treatments are available to help promote regrowth of hair in people with alopecia areata. These include steroid injections, which can be done by healthcare professionals using a tiny needle. The treatment can be effective, but it must be repeated regularly to maintain the benefits. Other options for treating alopecia areata are medications taken by mouth and cosmetic products such as wigs and hats.


Hair loss can be a very distressing condition and it is important to seek medical advice to confirm the diagnosis. A dermatologist is best equipped to diagnose the problem and counsel you on what may help regrow your hair. Your doctor will look at your scalp and other areas with loss carefully. He or she may also look at your nails and take a blood test to see if there is any other disease that can cause this type of hair loss.

Your physician will ask you questions about your family history of this type of alopecia and other autoimmune diseases. The family history is important because some of the genetic alopecias are more serious and have a greater chance of passing to other family members.

He or she will want to know if your symptoms have started recently, how much hair has been lost and the size of the patches of alopecia areata. Other questions may be about your other health problems, any medications you are taking and whether or not you have had a history of infections like TB or cancer. Your doctor may want to do a scalp biopsy to make sure that this is the only reason you are losing your hair. This is usually a painless procedure. A sample of the skin is removed and sent to a laboratory for examination under a microscope.

Some doctors may be able to diagnose this problem by examining your scalp for signs of alopecia areata, such as exclamation mark hairs (short hairs that get narrower at the bottom and grow in or around the edges of the bald spots). They may also check under a light microscope for histopathologic changes that show perifollicular inflammation.

Other tests to be done may include a blood test, which can detect if there is any other disease that can affect the hair growth, such as thyroid disease. The blood test can also check to see if you have a low iron count, which can sometimes lead to alopecia areata. In some cases, a fungal culture can be taken to determine if you have a common skin disease called tinea capitus (scalp ringworm). This is more common in women than men.


While there is no cure yet for alopecia, treatment options can help with the appearance of thicker hair. Many people with alopecia areata may benefit from treatments like a scalp micropigmentation (SMP) treatment. In this treatment, a skilled technician uses tiny needles to deposit pigmented dots on the head that appear to give the appearance of thicker hair. The results can be very natural-looking, and the procedure can even cover scars or birthmarks.

SMP can be a great option for those with alopecia areata, and it can also be used to conceal the effects of other hair loss conditions, including male or female pattern baldness or hair loss due to cancer treatments. It is important that patients choose a qualified practitioner, however, and make sure that they are comfortable with the technique before they undergo the treatment.

Alopecia areata can affect anyone, at any age. It is a very unpredictable condition, and some people will experience it for only a few weeks while others will suffer from the disease for their entire life. Alopecia areata often runs in families, so if you have family members who have the disorder, it is more likely that you will develop it as well.

Medications to treat the condition include corticosteroids, immunosuppressants, and medications that stimulate hair follicle growth. These can be taken orally or in injections and may be combined with a hair transplant to increase the chances of success.

Another type of medication is called a Janus kinase inhibitor, and it has been shown to stimulate regrowth in some people with the condition. More research is needed on this drug, but it shows promise and gives hope to those who suffer from alopecia areata.

In addition to these medical treatments, some people with alopecia areata have found that wearing wigs or using makeup can help them feel more confident about their appearance. It is also important that people with alopecia areata continue to attend regular doctor appointments so they can watch for the development of other health conditions or other types of alopecia. It is also recommended that people with alopecia areata consider talking to a mental health professional, as stress can trigger the condition in some cases.