Alopecia areata is a disease of localized hair loss. It begins as small areas of complete hair loss with sharp margins. There is no associated itching or discomfort. Sometimes these patches of hair loss are only discovered by accident, often by a hairdresser. The scalp is most commonly affected, but these bald patches can also appear anywhere that hair grows, including the beard region, eyebrows or eyelashes.
The cause for alopecia areata is not known. Cells of the immune system can be found clustered around the roots of affected hairs, so most experts view this condition as a manifestation of autoimmunity, wherein the immune system inappropriately attacks normal body structures. However, the vast majority of people with alopecia areata are otherwise perfectly healthy with no known other diseases, so this process seems to be quite selective for hair.
Alopecia areata is not caused by food, is not infectious or contagious, and only rarely is inherited. Stress or nervousness can precipitate flares of this condition but are not strictly speaking the cause of this disease. Many people with significant emotional events never get this problem. One first has to be predisposed to alopecia areata, after which stress may provoke flare-ups.
The usual course of this disease is gradual spontaneous regrowth of the bald patches after several weeks or months, only to have new patches appear months or years later. It seems that the tendency to develop bald patches never completely goes away though there can be prolonged periods of inactivity of this disease over many years.
Onset in early childhood is often associated with a more severe pattern of involvement with frequent exacerbations and more resistance to treatment.
Many different therapies are available to treat alopecia areata. Small patches of hair loss usually respond to injections of cortisone directed at the roots of the hairs. Potent cortisone creams or ointments are also helpful. Creams containing anthralin can be useful but sometimes stain hair or clothing. Minoxidil solution (Rogaine) has also shown benefit for this condition, even though this drug is marketed only for patterned baldness. In extreme cases, cortisone pills or shots are required to prevent significant hair loss, but this involves greater risk of harmful side effects.
Alopecia areata, while not a dangerous condition, is nonetheless an extremely distressful affliction. The National Alopecia Areata Foundation provides a central resource of information on research, new treatments and other support for people who are similarly affected. The Foundation may be contacted at 710 C Street 11, San Rafael, CA 94901, by telephone at (415) 456-4644, or at their website at http://www.alopeciaareata.com.
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