Alopecia areata or spot baldness as it's also known, occurs when hair is lost in small round spots. It usually occurs on the scalp but can involve other areas of the body as well. It's an autoimmune disease in that the body attacks the hair follicles. The cause of alopecia areata is unknown but appears to be genetically transmitted.
This form of alopecia affects as much as 2% of the population during some point in their lives. It can vary in its severity, and terms used to describe it are dependent upon the extent of hair loss. Alopecia areata totalis describes the condition of a person who has lost hair over his or her entire scalp. Alopecia universalis occurs when a person loses hair over the entire body, including eyebrows, lashes, and pubic hair. Alopecia areata monolocularis describes hair loss in one spot only. And alopecia areata multilocularis is hair loss over multiple areas of the body.
This disorder usually starts out with the development of small round bald patches - usually on the scalp - but that can turn up anywhere on the body where there is hair. It can show up in beards, mustaches, pubic areas or other hair bearing parts of the body. In some cases the hair will re-grow and in others the disease can go into remission, but this is not always the case. And in some cases, the hair that regrows can then fall out again. Sometimes, the fingernails are affected as well, developing denting and pitting. This is an unpredictable illness as each case differs from others. There is always the chance that complete regrowth will occur, but no way to know beforehand. It can be a one time occurrence that corrects itself, or a pattern of loss and regrowth that continues for years.
While alopecia areata is not considered a serious disease, there does seem to be a higher incidence of some other illnesses in sufferers, such as other autoimmune disease, and allergies. But for alopecia areata itself, there usually are no serious symptoms, other than the occasional mild irritation and itchiness in the bald patches it causes.
Since there are other disorders that can cause the loss of hair in spots, a diagnosis must include the elimination of other diseases. Some of these illnesses are treatable so it's important to rule them out before the determination of alopecia areata is made. Diagnosis may include a scalp or skin biopsy, or the doctor may gently tug on the hair around a patch. Hair that easily comes out from this pull may indicate that this is alopecia areata.
There are no known cures for alopecia areata. In some cases with small affected areas, the hair grows back by itself, and so no other treatment is needed. For other cases, there are treatments available, such as:
Minoxidil - a 5% solution of minoxidil applied twice daily to affected areas may regrow hair in those areas. Minoxidil can be used by both adults and children to treat alopecia areata. Results, if any, should be apparent within 3 months.
Corticosteroids -are immune system suppressing anti-inflammatory drugs that are delivered topically, orally or by injection. They are either injected directly into affected areas or rubbed onto those areas. Oral corticosteroids are prescribed less often as it can have side effects. Hair that results from this treatment should appear in about a month.
For those with extensive scalp hair loss, hairpieces and head covers (hats, scarves, etc.) can be used to cover up the loss. Covering the head in no way interferes with regrowth and it may allay any self-consciousness the sufferer may have, if this is a problem.
The most significant effect that alopecia areata has on some patients may be psychological, or emotional. For many of us, hair is a very important part of how we see ourselves, and the loss of it can have quite an impact. Fortunately, this disease tends to leave those who have it healthy otherwise, and able to live a normal life.
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