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Alopecia Areata

Alopecia areata is a common skin disease. The word alopecia means bald; areata means patchy. The disease causes hair loss on the scalp, face, and sometimes other body areas, like under the arms or on the legs. People with alopecia areata most often lose hair in circular, coin-sized patches on the scalp, but in more severe cases, they may lose all of their hair. Alopecia areata is an autoimmune disease, which means your body’s immune system mistakes your healthy tissues as dangerous and begins attacking them.

Mother with alopecia and child

What Is Alopecia Areata?

Alopecia areata is a common autoimmune skin disease. If you have an autoimmune disease, your body’s immune system mistakes your healthy tissues as dangerous and begins attacking them.

The word alopecia means bald; areata means patchy. The disease causes hair loss on the scalp, face, and sometimes other body areas, like under the arms or on the legs. People with alopecia areata most often lose hair in circular, coin-sized patches on the scalp, but in more severe cases, they may lose all of their hair. About 2% of people across the world will experience alopecia areata at some point in their lifetime.

What does this mean? Nearly 6.7 million people in the U.S. and 160 million worldwide have alopecia areata or have had, or will have it. About 700,000 people in the U.S. currently have some form of alopecia areata.

Who gets it? People of all ages, genders, and racial and ethnic groups are affected by the alopecia areata. The hair loss often first appears during childhood but how and when is different for everyone.

Although alopecia areata can begin at any age, most individuals develop the disease early in life. More than 80% show signs of the disease before age 40, and 40% experience symptoms by age 20. Research suggests that women are more likely to develop alopecia areata than men and people of some races and ethnicities may have a higher chance of developing the disease. Several U.S.-based studies found the odds of developing alopecia areata were higher among Asian, Black,and Hispanic individuals than among whites.

What is alopecia areata? Image of hair structure.

What causes alopecia areata?

Alopecia areata is a polygenic disease, meaning it is related to multiple genetic factors. But not everyone with the genes develops the disease. For example, identical twins share all the same genes, but if one twin has alopecia areata, there is only a 55% chance that the other twin will have it.

The disease is a complex one. Scientists know it is an autoimmune disease, but they aren’t sure why the immune system attacks the healthy hair follicles of people with the gene variations in the first place. About 20% of people with alopecia areata have at least one family member who also has the disease. The risk of alopecia areata increases if you have a close relative with it. And the risk increases even more if that relative lost their hair before age 30.

Another thing researchers aren’t sure about is what triggers the disease. They know that people with alopecia areata have a genetic predisposition (increased likelihood) to it, but how is it triggered? Do the triggers first happen inside the body (from bacteria or a virus), outside the body (environmental), or a combination of both? Many believe it is a combination.

Patchy hair loss is one alopecia areata type It is a mild alopecia areata

Symptoms and Diagnosis

All types of alopecia areata result in some form of hair loss. If you have alopecia areata, there is no way to predict the pattern of hair loss and regrowth or how severe or long-lasting it will be. It’s important to keep in mind that alopecia areata is different for everyone who has it.

That said, there are some common symptoms of alopecia areata that are good to know and recognize. The only way to be sure you have alopecia areata is to make an appointment with a dermatologist for a diagnosis.

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Types of Alopecia Areata

There are a number of different types of alopecia areata that range from mild to more severe hair loss.

Patchy

Totalis

Universalis

Related Conditions

There are more than 80 autoimmune diseases. It’s not uncommon for someone to have more than one at the same time and alopecia areata often occurs with other autoimmune conditions. These include thyroid disease or type 1 diabetes. In addition, people who have alopecia areata often have conditions related to allergies, like asthma and eczema.

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Living with Alopecia Areata

Having alopecia areata can be frustrating and emotionally challenging because hair loss and regrowth are unpredictable. But you are not alone! Learn more about ways to live with alopecia areata, including how to find support.

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Swimming with alopecia

Alopecia Areata in Children

Although alopecia areata can occur at any age, it does start most often during childhood. Parents often wonder if they caused it somehow, if their children developed alopecia areata because of something they did or if they passed on “bad” genes.  Scientists believe that there are multiple factors (both genetic and in the environment) that trigger the disease though. In fact, even if you have alopecia areata yourself, the chances of your child having it are slim.

How your child reacts to having alopecia areata depends on many factors, ranging from age to the kind of support they have from family, friends, and the people around them.

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Treatments for Alopecia Areata

Depending on which type of alopecia areata you or your child has, your age, and the extent of hair loss, there are a variety of treatment options available for disrupting or distracting the immune attack and/or stimulating the hair follicle — especially for those who have milder forms of the disease.

For those who have more severe hair loss on their scalp or other areas of the body, there are oral and injectable medications available. These medications do not work for everyone though. That’s why it’s important to talk with your doctor to discuss the risks and benefits of using any medications.

 

 

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FAQs

What is alopecia areata?

The word alopecia means bald, and areata means patchy. Alopecia areata is an autoimmune disease that causes hair loss on the scalp, face, and elsewhere on the body. The hair loss can be patchy, or it can be over much or all of the body. Learn more about types of alopecia areata ​here.

How common is alopecia areata?

Alopecia areata is a surprisingly common disease. About 2% of people across the world will experience alopecia areata at some point. They either currently have alopecia areata, they have had it, or they will develop it. The disease affects as many as 6.7 million people in the U.S. alone.

How is alopecia areata diagnosed?

Alopecia areata is diagnosed based on your symptoms (hair loss and pattern). In addition, your doctor will want to take a family history and your medical history to rule out other things that could cause hair loss. To learn more about the diagnosis of alopecia areata, click here.

Who treats alopecia areata?

Doctors who specialize in skin conditions, called dermatologists, treat alopecia areata. When looking for a dermatologist, look for one who is board-certified in dermatology. While any doctor can specialize in dermatology, a board-certified dermatologist means the doctor has kept up-to-date on recent developments through continuing education.

Can children get alopecia areata?

Anyone at any age can develop alopecia areata and it does often start in childhood. Parenting a child with the disease can be challenging. To learn about children with alopecia areata and issues related to parenting them, click here.

How will alopecia areata affect my life?

Unlike most autoimmune diseases, alopecia areata does not generally cause physical discomfort or disability. However, hair loss can be difficult for many people. It can have a significant impact on their mental health, affecting how they feel about themselves. Different people have different ways of coping with their hair loss. Some wear wigs or use camouflage techniques to hide the bald areas, while others don’t bother hiding it at all. Click here to learn more about living with alopecia areata, including possible psychological and emotional effects of the disease.