Alopecia Areata

Alopecia areata is an autoimmune disorder in which the immune system mistakenly attacks hair follicles, resulting in sudden, patchy hair loss on the scalp, face, and sometimes other areas of the body. It can begin at any age and often appears suddenly, with no prior symptoms.

Small, round, smooth patches of hair loss primarily on the scalp; Tingling or burning in the affected area (less common); Nail abnormalities: pitting, ridging, or brittleness; Regrowth of white or fine hair in affected areas; In more severe forms, complete loss of scalp hair (Alopecia Totalis) or all body hair (Alopecia Universalis).

The immune system mistakenly attacks the hair follicles. Contributing factors include genetic predisposition (family history of alopecia or autoimmune conditions), environmental triggers (virus, stress, hormonal changes, medications, or skin injury), and co-occurrence with other autoimmune conditions like thyroid disease, vitiligo, type 1 diabetes, lupus, or rheumatoid arthritis.

Clinical evaluation of the hair loss pattern; Pull test to see how easily hair comes out; Dermatoscopy to examine the scalp; Scalp biopsy (if uncertain); Blood tests to rule out other autoimmune conditions or thyroid dysfunction.

No cure, but treatments may promote hair regrowth or reduce the immune response: Topical corticosteroids or intralesional steroid injections; Topical immunotherapy (e.g., diphenylcyclopropenone); Minoxidil (Rogaine) to stimulate hair growth; JAK inhibitors (e.g., baricitinib) - FDA approved for severe cases in adults; Oral corticosteroids (short-term); Supportive treatments: wigs, cosmetic camouflage, and counseling.

Many cases resolve spontaneously within 12 months, especially milder cases. Recurrence is common and regrowth may be temporary. Severe cases (e.g., total scalp or body hair loss) are less likely to fully recover. Emotional and psychological support is important.

Affects approximately 1 in 500 to 1 in 1,000 people worldwide. Lifetime risk estimated at 2%. Affects males and females equally. Most common onset is before age 30.