Alopecia areata
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Alopecia areata, also known as spot baldness, is a condition in which hair is lost from some or all areas of the body.[12][1] It often results in a few bald spots on the scalp, each about the size of a coin.[7] Psychological stress and illness are possible factors in bringing on alopecia areata in individuals at risk, but in most cases there is no obvious trigger.[7] People are generally otherwise healthy.[7] In a few cases, all the hair on the scalp is lost (alopecia totalis), or all body hair is lost (alopecia universalis). Hair loss can be permanent, or temporary.[7][1]
Alopecia areata | |
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Other names | Alopecia Celsi, vitiligo capitis, Jonston's alopecia[1] |
Alopecia areata seen on the back of the scalp | |
Pronunciation | |
Specialty | Dermatology Immunology[6] |
Symptoms | Areas of hair loss, usually on the scalp[7] |
Usual onset | Childhood[7] |
Causes | Autoimmune[7] |
Risk factors | Family history, female sex, rheumatoid arthritis, type 1 diabetes, celiac disease[7][8][9] |
Differential diagnosis | Trichotillomania, alopecia mucinosa, postpartum alopecia[1] |
Treatment | Sunscreen, head coverings to protect from sun and cold[7] |
Medication | topical minoxidil[10] and triamcinolone injections[11] |
Prognosis | Does not affect life expectancy[7][1] |
Frequency | ~2% (US)[7] |
Alopecia areata is believed to be an autoimmune disease resulting from a breach in the immune privilege of the hair follicles.[12][13] Risk factors include a family history of the condition.[7] Among identical twins, if one is affected, the other has about a 50% chance of also being affected.[7] The underlying mechanism involves failure by the body to recognize its own cells, with subsequent immune-mediated destruction of the hair follicle.[7]
No cure for the condition is known.[7] Some treatments, particularly triamcinolone injections and 5% minoxidil topical creams,[11][10] are effective in speeding hair regrowth.[7][1] Sunscreen, head coverings to protect from cold and sun, and glasses, if the eyelashes are missing, are also recommended.[7] In more than 50% of cases of sudden-onset localized "patchy" disease, hair regrows within a year.[14][15][7] In patients with only one or two patches, this one-year recovery will occur in up to 80%.[16][17] However, many people will have more than one episode over the course of a lifetime.[15] In many patients, hair loss and regrowth occurs simultaneously over the course of several years.[7] Among those in whom all body hair is lost, fewer than 10% recover.[18]
About 0.15% of people are affected at any one time, and 2% of people are affected at some point in time.[7][18] Onset is usually in childhood.[7] Females are affected at higher rates than males.[9]