Alopecia areata is an autoimmune disorder that causes your hair to come out, often in clumps the size and shape of a quarter. The amount of hair loss is different in everyone. Some people lose it only in a few spots. Others lose a lot. Sometimes, hair grows back but falls out again later. In others, hair grows back for good.
There are different types of this condition. Alopecia areata is most common in its main form, but there are other, more rare types:
Alopecia areata totalis means you’ve lost all the hair on your head.
Alopecia areata universalis is the loss of hair over your entire body.
Diffuse alopecia areata is a sudden thinning of your hair rather than lost patches.
Ophiasis alopecia areata causes hair loss in a band shape around the sides and back of your head.
Alopecia Symptoms
Alopecia areata (AA) is a chronic, autoimmune disease and while most associate it with temporary and permanent hair loss, it affects the nails in up to 46% of those affected. AA nails may appear pitted with lines, having splitting and/or white spots.
The main and often the only symptom of alopecia is hair loss. You may notice:
Small bald patches on your scalp or other parts of your body
Patches may get larger and grow together into a bald spot
Hair grows back in one spot and falls out in another
You lose a lot of hair over a short time
More hair loss in cold weather
Fingernails and toenails become red, brittle, and pitted
Alopecia areata can’t be cured. But it can be treated and hair can grow back. If you have it, there are several things to try:
Corticosteroids. These are anti-inflammatory drugs that are prescribed for autoimmune diseases. They can be given as an injection into the scalp or other areas. They can also be given as a pill or rubbed on the skin as an ointment, cream, or foam. The downside is that it may take a long time to work.
Topical immunotherapy. This is used when there’s a lot of hair loss or if it happens more than once. Chemicals are applied to the scalp to produce an allergic reaction. If it works, this reaction is actually what makes the hair grow back. It also causes an itchy rash and usually has to be repeated several times to keep the new hair growth.
Minoxidil (Rogaine). This treatment, which is put on the scalp, is already used for pattern baldness. It usually takes about 12 weeks before you see growth, and some users are disappointed in the results. Read more about which types of alopecia are most likely to respond to minoxidil.
Other treatments for alopecia areata include medications that are sometimes used for other autoimmune disorders. These medicines have differing amounts of success in regrowing hair.
Alopecia Diagnosis
If you think you have alopecia areata, you may want to see a skin specialist called a dermatologist. They will:
Talk to you about your symptoms
Take a close look at the areas where you have hair loss
Pull gently on the hairs at the edges of the bald patch to see if they come out easily
Check individual hairs and follicles to see if they’re abnormally shaped
Examine your nails
Rarely, you may have a biopsy, which means a small piece of skin is removed from your scalp and looked at under a microscope.
Many conditions can cause hair loss. So your doctor may test your skin for a fungal infection or give you blood tests to check for thyroid, hormone, or immune system problems.
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