Alopecia areata, also known as spot baldness, is a condition in which hair is lost from some or all areas of the body. Often it results in a few bald spots on the scalp, each about the size of a coin. Psychological stress may result due to this. People are generally otherwise healthy. In a few cases, all the hair on the scalp or all body hair is lost and loss can be permanent.
Alopecia areata is believed to be an autoimmune disease resulting from a breach in the immune privilege of the hair follicles. Risk factors include a family history of the condition. Among identical twins if one is affected the other has about a 50% chance of also being affected. The underlying mechanism involves failure by the body to recognize its own cells with subsequent immune mediated destruction of the hair follicle.
The condition affects 0.1%–0.2% of the population, and occurs equally in both males and females. Alopecia areata occurs in people who are otherwise healthy and have no other skin disorders. Initial presentation most commonly occurs in the early childhood, late teenage years, or young adulthood, but can happen at any ages. Patients also tend to have a slightly higher incidence of conditions related to the immune system, such as asthma, allergies, atopic dermatitis, and hypothyroidism.
There is no cure for the condition. Efforts may be used to try to speed hair regrowth such as cortisone injections. Sunscreen, head coverings to protect from cold and sun, and glasses if the eyelashes are missing is recommended.
In most cases which begin with a small number of patches of hair loss, hair grows back after a few months to a year. In cases with a greater number of patches, hair can either grow back or progress to alopecia areata totalis or, in rare cases, alopecia areata universalis.
There is no loss of body function, and effects of alopecia areata are psychological (loss of self-image due to hair loss), although these can be severe. Loss of hair also means the scalp burns more easily in the sun. Patients may also have aberrant nail formation because keratin forms both hair and nails.
Hair may grow back and then fall out again later. This may not indicate a recurrence of the condition, but rather a natural cycle of growth-and-shedding from a relatively synchronised start; such a pattern will fade over time. Episodes of alopecia areata before puberty predispose to chronic recurrence of the condition.
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