| General
Illness Information |
Common Name: |
ALOPECIA AREATA |
|
Medical
Term:
|
None specified
|
| Description: |
Sudden hair loss in circular
patches on the scalp (in the absence of any other visible skin disorder or systemic disease). Any
hairy area may be involved, the scalp and the beard most frequently. Rarely, all the body
hair may be lost (Alopecia universalis). Alopecia totalis is loss of all scalp
hair and eyebrows. In most cases, the hair grows back in a few months, except in cases with
extensive hair loss, in which case re-growth may not occur. It is a relatively common condition,
usually affecting young adults (under age 25); children are affected more frequently. It
affects males and females equally.
|
| Causes: |
Unknown. Possible association
with auto-immune diseases. Sometimes associated with other auto-immune disorders such as vitiligo,
Hashimoto’s thyroiditis and myasthenia gravis.
|
| Prevention: |
None known.
|
| Signs
& Symptoms |
 |
Sudden hair loss in sharply
defined circular patches; Sometimes hair loss occurs over a period of weeks to months;
Patches of alopecia areata can be stable and often show spontaneous re-growth over a period
of several months, new patches may appear while others resolve.
|
|
No pain
|
|
No itch
|
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Anxiety because of concern about progressive hair loss and balding
|
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Pitting of the nails- looks like hammered brass
|
|
| Risk
Factors |
|
Stress
|
|
Family history
|
|
| Diagnosis
& Treatment |
| General Measures: |
|
Laboratory tests are performed
to rule out other causes of hair loss such as lupus, syphilis and fungal infection
(tinea capitis). No curative treatment is available. Efficacy of treatment is difficult
to assess because of the spontaneous regrowth which, usually occurs in this condition. In
most cases, the most important factor in management of the patient is the psychological support
from the physician, family and support groups.
|
|
Shampoo and bathe as usual; this
is a non-contagious disorder
|
|
Avoid tugging on normal hair close to areas of hair loss
|
|
Use of a hairpiece or wig during the acute phase
|
|
| Medications: |
|
Apply topical steroids
once or twice a day unless otherwise directed. Best applied immediately after bathing
or shampooing, because of ease of spreading and increased penetration. In special cases,
injections of steroids into affected areas and oral cortisone medication may be used.
|
|
Topical minoxidil (a
prescription medication used for hair growth) may help; however, it is very expensive
and not always effective.
|
|
Injections of triamcinolone
into the scalp may help in some cases.
|
|
Photochemotherapy with
PUVA may be recommended. The entire body must be exposed, in that the therapy is believed
to be a form of systemic immunosuppression. Variably effective- response rate about 30%.
|
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| Activity: |
|
No restrictions.
|
|
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|
| Possible
Complications : |
|
Loss of all
hair (alopecia universalis).
|
|
Slow or incomplete hair growth.
|
|
| Prognosis |
|
In about 80% of the patients,
re-growth occurs. However, re-growth may take up-to a year. Recurrences of alopecia are quiet
common. Repeated attacks, nail changes and total alopecia occurring before puberty, are poor
prognostic signs. Confluence of lesions in the occipital region is also a poor prognostic sign.
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