Alopecia areata is a common type of hair loss. It’s an auto-immune disease (when the body attacks itself) which can affect any part of your body.
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Alopecia areata (pronounced a·luh·pee·shee·uh a·ree·uh·tuh) is an autoimmune disease where your body's defence system mistakenly attacks your hair follicles, leading to hair loss. Hair follicles are like little pockets in your skin where hair grows from.
People with alopecia areata are usually healthy and don't have any other symptoms. It usually starts with unexpected hair loss in round or oval patches on the scalp, but it can also affect other areas like the beard, eyebrows and eyelashes.
The course of alopecia areata can vary, with periods of hair loss and regrowth. Some people experience periods of hair loss at different times in their lives, while others may only have one episode.
There are different types of alopecia areata (and all of them have catchy names):
Alopecia areata can affect anyone. It doesn't matter if you're a man or a woman, and it can happen to people of any race or ethnicity. The condition can start at any age, but it's most common in teenagers, people in their twenties, or those in their thirties. When children under the age of 10 experience it, the hair loss tends to be more widespread and may worsen over time.
While we don’t know exactly what causes alopecia areata, scientists believe that genetics may play a role. So if someone in your immediate family has it, you may have a higher chance of developing it too. But for many people, there’s no family history of the condition.
People with other autoimmune diseases like psoriasis, thyroid problems or vitiligo are also more prone to developing alopecia areata. And allergies like hay fever or psychological problems like stress can trigger alopecia areata as well.
Sometimes, alopecia areata can happen after childbirth. This is also known as postpartum alopecia and is due to hormone imbalances caused by pregnancy. This condition is usually only temporary.
Alopecia areata is a common type of hair loss. It's actually the second most common type of non-scarring hair loss (when hair falls out but doesn't leave permanent scars), right after male and female pattern baldness. It's estimated that almost 2% of the general population will experience alopecia areata at some point in their lives.
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When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
We don’t yet know what causes your immune system to attack your hair follicles, but scientists believe that both genetic and environmental triggers may play a role.
Stress from emotions and daily life can contribute to the onset or worsening of alopecia areata. Smoking seems to make you more likely to get it too. And there’s a possibility (though no solid proof) that other triggers like drinking alcohol, being overweight, having an imbalanced diet and not getting enough sleep might also play a role in causing it.
Because low vitamin D levels can occasionally cause other autoimmune diseases like multiple sclerosis or rheumatoid arthritis, scientists looked at this in people with alopecia areata as well. However, they couldn’t draw any conclusions, because they found that some people had low vitamin D levels, but others didn't. So more research is needed to understand its role in alopecia areata.
Alopecia areata can affect both hair and nails, though the latter is less common. But other than that, people with alopecia are usually healthy and have no other symptoms.
In the early stages of the condition, hair loss happens in small, round patches on the scalp. Hair in other body parts like beard, eyebrows or eyelashes may also be affected. Another sign of alopecia areata is usually the appearance of hairs resembling exclamation marks (they’re thicker at the tip and slimmer at the base of the hair). Sometimes you can feel a tingling, burning or itching sensation on the skin right before the hair falls out.
After that, the hair may grow back on its own. It might be grey or white at first and regain its colour over time. Sometimes, hair regrows in the first bare patch while new ones start forming. And these small patches may grow to form larger ones.
In rare cases, called alopecia totalis, hair falls off the entire scalp. And in even rarer cases, hair loss can happen across all your body, called alopecia universalis.
Nail changes can happen in some people and they appear mostly as off-white ridges or pits (similar to the dimples on a thimble) on the surface of the nails. These are more likely to happen to those who experience more extensive hair loss.
If you suffer from alopecia areata you might have a higher risk of developing other autoimmune disorders, including vitiligo, thyroid disease, psoriasis, lupus, irritable bowel syndrome and rheumatoid arthritis. Likewise, if you suffer from these conditions, you might have an increased risk of developing alopecia areata. Alopecia has also been linked to diabetes, anxiety and depression.
The risk of certain types of cancer, like thyroid and bladder, was also found to be higher in patients with alopecia areata than in the general population. Doctors didn’t find any connection between alopecia areata and skin cancer though.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
It's important to know that there is no cure for alopecia areata, but there are treatments that can help your hair grow back. However, not all treatments work the same for everyone, so be patient and give them time to show results. Your dermatologist may recommend different treatment options based on your age and the area affected by alopecia.
Either topical (creams, ointments, solutions, shampoos etc.) or intralesional (injections) corticosteroids are the most common medications used to treat alopecia areata. These medications reduce inflammation, which can help stop hair loss and promote hair growth. Examples include:
A clinical study showed that injections of corticosteroids such as triamcinolone acetonide helped 71% of the participants regrow their hair, compared to 7% of the people treated with a fake treatment (placebo). To help your hair grow back, your dermatologist will inject this medicine into the bald patches every 4 to 8 weeks.
An alternative treatment for alopecia areata is minoxidil, also known by the brand name Regaine (or Rogaine if you live in the USA). It works on the scalp, beard area and eyebrows to promote hair growth. However, it may not be effective for alopecia totalis and alopecia universalis. In these cases, minoxidil can be used alongside other treatments like corticosteroids to help with hair growth.
There are some other treatments that you can apply on the skin as well:
Another option is to take oral medications which include:
If you’ve tried a few medications for alopecia areata and they didn’t work for you, don’t worry, you haven’t run out of options. There are some medical procedures that can help you treat alopecia areata. You could try botox injections, commonly used for reducing wrinkles. Botox can help stimulate hair growth in affected areas.
Another procedure that can be effective is red light therapy. This involves using laser lights to stimulate your hair follicles and hair growth.
Microneedling can also be used for alopecia areata. It involves using a small device with tiny needles to create small punctures in the scalp, which can stimulate your hair follicles to regrow your hair.
Dermarolling is a similar procedure, where a small roller with tiny needles is used to create very small injuries on the scalp, which can ‘reactivate’ your hair follicles to start growing back your hair.
Not always, especially if it's been less than a year since you were diagnosed with alopecia areata. In this case, your dermatologist may suggest that you wait a little and not recommend any treatments right away. This is because everyone's journey is unique and your hair might just decide to come back on its own without any treatment.
How we source info.
When we present you with stats, data, opinion or a consensus, we’ll tell you where this came from. And we’ll only present data as clinically reliable if it’s come from a reputable source, such as a state or government-funded health body, a peer-reviewed medical journal, or a recognised analytics or data body. Read more in our editorial policy.
Have something specific you want to know? Search our info below, or ask our experts a question if you can’t find what you’re looking for.
Alopecia areata. Nature Reviews Disease Primers, 3(1), 17011.
Alopecia Areata. [online] National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Vitamin D deficiency in patients with alopecia areata: A systematic review and meta-analysis. Journal of the American Academy of Dermatology, 78(1), pp.207–209.
Stress and alopecia areata: a psychodermatologic study. Acta Dermato-Venereologica, 77(4), pp.296–298.
Alopecia areata:
What causes it? [online].
Alopecia Areata. [online] National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Cancer risk by the subtype of alopecia. Scientific Reports, 8(1), 9748.
Alopecia areata: a new treatment plan. Clinical, Cosmetic and Investigational Dermatology, 4, pp.107-115.
The Association of Anti-Inflammatory Diet Ingredients and Lifestyle Exercise with Inflammaging. Nutrients, [online] 13(11), p.3696.
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