Alopecia areata

Alopecia areata is a condition which affects the scalp or the beard area, causing clear-cut smooth patches of hair loss.

The cause is not completely understood, but it is probably associated with an altered immune response to parts of your body, in this case your scalp.

It usually starts in the teens or early twenties. Both men and women are affected, women slightly more so. It might be set off by a sudden stress or shock.

Alopecia is completely painless. The first sign may be excessive hair loss noticed when you brush your hair, or when you wash your hair. You may notice one or more smooth-edged bald patches in your hair or beard, which get bigger and then join together. The skin underneath will be smooth and not inflamed in any way.

At the edge of the bald patch, you may notice small hairs which are thicker and darker at the end, rather than near the scalp. These are called exclamation mark hairs.

White hairs are not affected, so you may notice that when you first start to lose hair, you are left with white patches where all the pigmented hairs have fallen out. Your hair will usually begin to grow back over the next 3 - 6 months and to begin with, the hair that grows back will be fine and white.

Rarely, you may lose all the hair on your head (alopecia totalis) or over your whole body (alopecia universalis).

Mild alopecia areata often settles quickly on its own and does not mean you have a serious underlying illness. If you have lost enough hair to make it very noticeable, or embarrassing you may wish to discuss it with your GP.

If you see a doctor, they will look at your scalp to rule out any other scalp disorders and arrange some blood tests, to rule out anaemia and to check your thyroid function. If these tests are normal often no treatment is necessary - or effective. As long as you are not too troubled by it, your GP may suggest that you wear hats, or maybe a wig, until the hair starts to grow again. Sometimes it might be appropriate for you to be referred to a dermatologist. Treatment however is often not very successful.

Unless you have another condition associated with your alopecia, it is unlikely that you will need to do anything in the long-term. In most cases your hair will grow back quite normally.

Occasionally the condition recurs, in which case you may need referral

Further information

DermNet NZ

Hairline International

This article published on
01 July 2005

Next review date 7/1/2013


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