Alopecia Areata

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Medical Author:

Gary W. Cole, MD, FAAD

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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• Alopecia areata is a hair-loss condition which usually affects the scalp.
• Alopecia areata typically causes one or more patches of hair loss.
• Alopecia areata affects both genders.
• An autoimmune disorder, in which the immune system attacks hair follicles, is believed to cause alopecia areata.
• For most patients, the condition resolves without treatment within a year, but hair loss is sometimes permanent.
• A number of treatments are known to aid in hair regrowth. Multiple treatments may be necessary, and none consistently works for all patients.
• Many treatments are promoted which have not proven to be of benefit.

Alopecia areata is an acquired skin disease that can affect all hair-bearing skin and is characterized by localized areas of non-scarring hair loss. Alopecia areata, as a rule, is rarely associated with any other external or internal medical problems. Most often these bald areas regrow their hair spontaneously.

Alopecia areata is rare before the age of 3. There seems to be a significant tendency to inherit alopecia areata from ancestors.

Current evidence suggests that alopecia areata is caused by an abnormality in the immune system. This particular abnormality leads to autoimmunity, a misguided immune system that tends to attack its own body. As a result, the immune system attacks particular tissues of the body. In alopecia areata, for unknown reasons, the body's own immune system attacks the hair follicles and disrupts normal hair formation. Biopsies of affected skin show immune lymphocytes penetrating into the hair bulb of the hair follicles. Alopecia areata is occasionally associated with other autoimmune conditions such as allergic disorders, thyroid disease, vitiligo, lupus, rheumatoid arthritis, and ulcerative colitis. The diagnosis or treatment of these diseases is unlikely to affect the course of alopecia areata. Sometimes, alopecia areata occurs within family members, suggesting a role of genes.