Alopecia areata is a problem with patchy hair loss. Like many other medical conditions that I have talked about recently, it is another “auto-immune” problem. In this case the body’s immune system is attacking its own hair follicles and this causes the hair to fall out. It happens mainly in people in their teens and 20s but can occur in people older than that.

The hair loss in alopecia areata tends to come and go, but less commonly can be permanent. The scalp is the most common part of the body, but the rest of the body can be affected as well. If the hair is going to grow back, it usually takes 6—12 months to do so. Approximately 10% of people with alopecia areata have no hair re-growth at all.

Risk factors leading to permanent hair loss in alopecia areata include a family history of the same problem, having it for more than a year, and being very young when it starts (before puberty). If someone has a lot of allergies or has any other auto-immune problems, they are also at higher risk.

Alopecia areata is diagnosed after a careful history of symptoms and physical examination is done by your doctor. They may do a hair pull and look at the hairs under a microscope. If the hair tapers like an exclamation point at the base, it is likely to be alopecia areata.

Other causes of hair loss include thyroid problems, hormone imbalances, and high levels of the male hormone testosterone. These things should all be checked if they are possible causes before diagnosing alopecia areata.

Treatment of alopecia areata is usually done with cortisone injections every 4—6 weeks with good success. Left untreated, it will often resolve on its own and wigs or hair pieces can be used in the meantime. Unfortunately in those cases where it causes permanent hair loss, i.e. lasting longer than a year, there is no great treatment. A hair transplant is a possible but there is no guarantee that the bald spots will not spread.

Hair loss can be psychologically difficult, but luckily in most cases alopecia areata improves or even resolves. Please see your family doctor if you are experiencing any symptoms of hair loss as it may be a treatable condition.