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Back to Dermatology Diseases

Alopecia areata

Alopecia Areata ("baldness in spots") is a form of hair loss from areas of the body, usually from the scalp. Because it causes bald spots on the head especially in the first stages, it is also called ?spot baldness?. Hair loss can extend to eyebrows, eyelashes, facial and nasal hair and create more bald spots elsewhere in the body. Alopecia monolocularis describes baldness in only one spot, alopecia multilocularis refers to multiple areas of hair loss. In Alopecia totalis, the patient is totally bald. If all body hair, including pubic hair, is lost, the diagnosis is alopecia universalis. The disease may also be limited only to the beard (alopecia barbae).

Alopecia is thought to be a minor autoimmune disease that makes the body to treat its hair follicles as foreign tissue and suppress or stop hair growth. It is not contagious but may be hereditary - there are a few recorded cases of babies being born with congenital alopecia. Whether it is stress-related or not is controversial.

First symptoms are small, soft, round bald patches of just about any shape. This usually happens in late teens but alopecia has been observed with people of all ages. There may be different skin areas with hair loss and regrowth in the same body at the same time. It may go into remission for a time or permanently. The longer the hair loss persists, the smaller the chance that it will grow back.

Effects of alopecia are mainly psychological (loss of self image due to hair loss). However, patients also tend to have a slightly higher incidence of asthma, allergies and atopic dermal ailments and even hypothyroidism. Loss of hair also means that the scalp burns more easily in the sun. Loss of nasal hair increases severity of hay fever and similar allergic conditions. They may also have aberrant nail formation because keratin forms both hair and nails.

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Episodes of alopecia areata before puberty predispose to recurrent episodes after puberty. Pitting of the fingernails can hint at a more severe or prolonged course.

It has been shown that zinc intake can support regrowth. Initial stages may be kept from increasing by applying topical corticosteroids. However, since the exact mechanisms are not ultimately understood, there is no known cure to date. Hair implants may help covering bald spots, but cannot guarantee satisfactory outcome, since the bald areas might expand. Wigs should be prescribed if patients, especially female patients, mention social discomfort.

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