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.
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.
Alopecia areata tends to occur most often in adults 30 to 60 years of age. However, it can also affect older individuals and rarely toddlers. Alopecia areata in not contagious. It should
be distinguished from hair shedding that may occur following the discontinuation of hormonal estrogen and progesterone therapies for birth control or the hair shedding associated with the end of pregnancy. There are a number of treatable conditions that could be confused with alopecia areata.
How is alopecia areata diagnosed?
The characteristic finding of alopecia areata is a well-circumscribed area or areas of normal hairless skin in an area of normal hair growth. Occasionally, it may be necessary to biopsy the scalp to support the diagnosis. Other findings that may be helpful are the appearance of short hairs that presumably represent fractured hairs, yellow areas of skin deposition at the follicular orifice, short thin hairs, and grey hair all present in a bald area. Other causes of hair loss are generally excluded from the consideration by history and clinical evaluation.
What is the treatment for alopecia areata?
The course of typical alopecia areata is not predictable with a high
likelihood of spontaneous remission. The longer the period of time of hair loss
and the larger the area involved, the less likely the hair will regrow.
Therefore, there are a variety of treatments, but none of these can confidently
be predicted to impact the course of this disease. Steroid injections, creams,
and shampoos (such as
clobetasol [Clobex] or fluocinonide [Lidex]) for the scalp have been used for many years.
As with many chronic disorders for which there is no single treatment, a
variety of remedies are promoted which in fact have no benefit. There is no
known effective method of prevention, although the elimination of emotional
stress
is felt to be helpful. No drugs or hair-care products have been associated
with the onset of alopecia areata. Much research remains to be completed on this
complex condition.
Although not precisely a treatment, the cosmetic camouflage of alopecia
areata is certainly an important consideration in patient management. The
damaging emotional effect of significant hair loss for both women and men can be
considerable.
Previous contributing author: Zoe Diana Draelos, MD, PA
There are many causes of scalp hair loss. This featured article covers the common ones such as patchy hair loss (alopecia areata, trichotillomania, and tinea capitis), telogen effluvium, and androgenetic alopecia (male-pattern baldness, female-pattern baldness).
Vitiligo is a condition in which the skin turns white due to the loss of pigment from the melanocytes, cells that produce the pigment melanin that gives the skin color.
Leprosy (Hansen's disease) is a disfiguring disease caused by infection with Mycobacterium leprae bacteria. The disease is spread from person to person through nasal secretions or droplets. Symptoms and signs of leprosy include numbness, loss of temperature sensation, painless ulcers, eye damage, loss of digits, and facial disfigurement. Leprosy is treated with antibiotics and the dosage and length of time of administration depends upon which form of leprosy the patient has.
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