Alopecia Areata

Why Do Patches of Hair Sometimes Fall Out?

Alopecia areata is a hair-loss condition that can affect men, women and children. This type of hair loss is patchy, often comes on suddenly, and can recur frequently.

Alopecia areata is an autoimmune condition which shows up as anything from a single bald patch on the scalp to hair loss all over the body. ‘Autoimmune’ means that the body’s immune system attacks a part of the body instead of protecting it from foreign bodies such as bacteria and viruses. In the case of alopecia areata, the immune system attacks the hair follicles, causing them to fall out. The hair usually grows again, but the condition can be very distressing for the sufferer, causing anxiety and a lack of self-confidence.

There are a number of forms of alopecia areata, but having one form doesn’t mean that the condition will necessarily develop to the more advanced stages.

Dr Simran Deo Medical Editor

Medically reviewed by

Dr Simran Deo

Last reviewed: 16 Apr 2020

What Are the Different Types of Alopecia Areata?

There are different types of alopecia areata which vary in extent and severity.

Alopecia totalis is a more severe form of AA where the sufferer loses all the hair on their scalp.

Alopecia universalis, the most advanced form of AA, leads to complete loss of all body hair, which includes eyelashes, eyebrows and the hair on the arms and legs.

Alopecia barbae only affects the beard area in men, ranging from a lone bald patch to loss of hair all over the beard area.

What Causes it?

Alopecia areata is an autoimmune condition and is thought to be caused by inflammation. The cause of the inflammation is not known but is thought to be caused when the immune system attacks growing hair. It is not known why only hair in certain areas of the body are affected and what causes the hair to begin to grow again in most cases

Genetics factors can affect whether or not a person suffers from alopecia areata. Approximately 20% of people who suffer from AA have close relatives who also suffer from the condition.

People with alopecia areata often have a family history of autoimmune conditions and may even suffer from other conditions themselves. These conditions include asthma, hay fever, eczema, psoriasis, vitiligo, diabetes, rheumatoid arthritis, lupus, and thyroid disease.

Severe stress is thought to sometimes be a trigger for alopecia areata, but this has not yet been proven.

Is There a Cure for it?

There is currently no cure for alopecia areata. However, sufferers of the condition find that their hair does eventually regrow, which can take months or years, but this doesn’t happen in every case.

Those with smaller patches of hair loss are more likely to see full hair regrowth within a year of first losing their hair, with no need for treatment. Those who have lost over 50% of their hair or have alopecia totalis or alopecia universalis are not as likely to see full regrowth.

On occasion the hair that grows back is depigmented or white. Some people will suffer from further episodes of alopecia areata attacks or may not have any re-growth at all.

What Hair Loss Treatments Are There for Alopecia?

There are treatments available for alopecia areata but they are not 100% guaranteed to cause hair regrowth. Many sufferers of mild alopecia will experience the regrowth of their hair within a few months or a year without needing any treatment.

Some hair loss treatments for alopecia areata are designed to stimulate hair regrowth, but none are able to cure the condition or stop it from recurring. Treatments that carry serious risks and side effects should not be used, because although alopecia areata is a distressing condition, it does no harm to physical health.

Available treatments for alopecia areata include:

Topical steroid creams which are applied to the affected area for a limited time can stimulate hair growth. Steroid creams cause the skin to thin so cannot be used for a long time. Steroid injections to small areas of hair loss on the scalp or the eyebrows can also improve the condition. The injections are usually carried out by a dermatologist (a skin specialist) after referral to them by your doctor. It can take a couple of months and a number of sessions for hair to start to regrow, however it can be painful and doesn’t work for everyone.

Minoxidil lotion (also known by the brand name Regaine). This is a solution which is applied to the areas of hair loss. Minoxidil is also used to treat male pattern baldness. It is not recommended for everyone, and is not currently licensed for the treatment of alopecia areata.

Alopecia areata is a condition that can be very upsetting for sufferers, but often the hair will regrow naturally without the need for treatment.

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