Alopecia Areata (cont.)

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What are the different patterns of alopecia areata?

The most common pattern is one or more well-defined spots of hair loss on the scalp. There is also a form of more generalized thinning of hair referred to as diffuse alopecia areata throughout the scalp. Occasionally, all of the scalp hair is lost, a condition referred to as alopecia totalis. Less frequently, the loss of all of the hairs on the entire body, called alopecia universalis, occurs.

Who is affected by alopecia areata?

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.

Reviewed by William C. Shiel Jr., MD, FACP, FACR on 10/17/2011

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