What is alopecia areata?

There is no cure for alopecia areata, but there are treatments available that some people find beneficial.
There is no cure for alopecia areata, but there are treatments available that some people find beneficial.

Many people experience an autoimmune disorder of the skin that causes hair loss on the scalp, face, and other areas of the body. This disease is called alopecia areata. It affects nearly 6.8 million people in the United States with a lifetime risk of 2.1%. 

Alopecia areata is an autoimmune skin disease in which your body mistakes normal cells in your body for foreign invaders. This causes hair loss on the scalp, face, and other areas of the body as your immune system attacks healthy hair follicles. These attacks cause follicles to grow smaller, slower, and/or to even stop producing hair. This causes hair loss and difficulty regrowing hair in different parts of the body. 

The three different types of alopecia areata include:

  • Alopecia areata: patchy, coin-sized patches of hair loss on the scalp or other parts of the body
  • Alopecia totalis: total hair loss on the scalp
  • Alopecia universalis: total hair loss of the scalp and all other parts of the body

Diagnosis for alopecia areata

Only a licensed dermatologist can diagnose alopecia areata. It's important to know what's causing your hair loss so that your doctor can provide you with the right treatment. The examination may include:
 

  • Using a tool called a dermascope (a medical instrument similar to a microscope) to inspect the area where hair loss has occurred
  • A series of questions about how hair loss is affecting your life
  • Blood tests to look for signs of an autoimmune disorder

Treatments for alopecia areata

There is no cure for alopecia areata, but there are treatments available that some people find beneficial.

The main goal of an alopecia areata treatment is to block the attack from the body's immune system and help regrow hair. Different treatments may help different individuals. There is no single treatment that is effective for everyone. Working with a dermatologist can help you find the treatment option that will work best for you and your type of alopecia areata.

Intralesional corticosteroid injections

This common type of treatment for alopecia areata uses corticosteroids injected into the skin with a needle. The injections are given every four to six weeks and can help generate new hair growth.

Topical minoxidil

With this treatment, topical minoxidil (medicine for hair loss) is applied to the skin once or twice a day to help stimulate hair regrowth. To achieve the best results when treating alopecia areata, topical minoxidil is usually combined with intralesional corticosteroid injections, where corticosteroids are injected into a skin lesion or just beneath it.

Anthralin cream or ointment

Anthralin cream or ointment is a medicine used to treat inflammation at the bottom of the hair follicles. Anthralin is normally applied to hairless patches of skin for several minutes or sometimes hours before it is washed off. If this form of treatment is successful, you can expect to see new hair growth in eight to twelve weeks.

Topical corticosteroids

Topical corticosteroids, also known as steroid hormones, are used to treat alopecia areata by decreasing inflammation around the hair follicle. This treatment comes in various forms, such as solutions, lotions, foams, creams, or ointments. Studies have shown that these steroids help reduce hair loss and improve hair regrowth.

In cases where more extensive hair loss has occurred, a dermatologist may recommend other treatment options including:

  • Oral Corticosteroids: Medication is taken in the form of a pill to treat hair loss.
  • Topical Immunotherapy: A dermatologist applies chemicals to the scalp, which causes a skin rash that alters the body's immune response. Some people see hair regrowth after six months of this type of treatment.
  • Immunomodulatory Drugs: This is a new type of therapy being tested to treat severe hair loss due to alopecia areata. This has not yet been approved by the FDA. It is undergoing clinical trials in the United States.

QUESTION

It is normal to lose 100-150 hairs per day. See Answer

Possible complications and side effects

Depending on the type of treatment your dermatologist recommends, you may possibly experience some complications and side effects. Here are some of the most common:

  • Corticosteroid injections may cause pain or tingling where the needle is injected into the skin and temporary depressions in the skin from the injections. 
  • Anthralin cream or ointment might irritate the skin and cause it to temporarily turn a brownish color.
  • Topical corticosteroids' effectiveness is limited by how much of the medicine is absorbed by the scalp.
  • Corticosteroid pills taken by mouth may cause pressure in the eyes, fluid retention, high blood pressure, mood swings, or weight gain

Other medications may have different side effects. Consult your healthcare provider about possible complications of any medications you might take for alopecia areata.

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Medically Reviewed on 1/25/2021
References
American Academy of Dermatology Association: “HAIR LOSS TYPES: ALOPECIA AREATA DIAGNOSIS AND TREATMENT.”

Mayo Clinic: “Prednisone and other corticosteroids.”

National Alopecia Areata Foundation: “Alopecia Areata.”