These are usually circular, and are often about the size of a coin, although they can be larger. Alopecia areata is widely accepted to be an autoimmune disorder.
The good news is that hair loss caused by alopecia areata is most often temporary. Around 98% of cases that we treat in the Philip Kingsley Clinics result in complete regrowth, with no permanent loss. However, alopecia areata is an unpredictable condition: while many people find that their hair grows back spontaneously within a few months to a year, some do not see an improvement.
Alopecia areata can also affect other areas of your body, such as eyebrows, eyelashes and body hair, as well as beard hair in men. In very rare cases, alopecia areata can lead to a complete loss of scalp hair (alopecia totalis) or a universal loss of hair over your entire body (alopecia universalis).
How Common Is Alopecia Areata?
Alopecia areata affects approximately 4% of the population (90,000 in the UK alone). Around 98% of those diagnosed recover with no permanent hair loss.
There are several treatments available to help suppress alopecia areata. However, there is currently no cure, and symptoms can recur. Unfortunately, it is not possible to predict when or where this will happen.
Alopecia areata can affect all ethnic groups and ages, but is most likely to occur in young children, or between the ages of 20 and 50. It occurs equally in both men and women.
What are the Symptoms of Alopecia Areata?
The main diagnostic feature of alopecia areata is the presence of bald patches, which are usually circular, and can range in size from a few millimetres to several centimetres or more.
In the active stage, these bald patches are surrounded by little ‘exclamation mark hairs’, which are thicker at the top and taper to a thinner end at the root. They are visible to the naked eye, but are best identified by a specialist, such as a Trichologist or GP.
The number of exclamation mark hairs you have can indicate how active your alopecia areata is. In general, the more there are, the more rapid its progression.
Alopecia areata also causes inflammation at the lower end of the hair follicle — but this is not painful, and you are unlikely to notice it. Very rarely, small patches of alopecia areata can grow, overlap and progress to total baldness, or alopecia totalis.
Alopecia areata can also cause brittleness and pitting in your fingernails, similar in appearance to the dimples on a sewing thimble.
Does Alopecia Areata Hurt?
There are usually no symptoms that accompany alopecia areata. However, some people report itching, tingling or burning in the area preceding the formation of a patch.
What is the Main Cause of Alopecia Areata?
Alopecia areata is widely accepted to be an autoimmune disorder, where your body sees certain hair cells as foreign enemies and attacks them. What triggers this response is not entirely understood, but 90% of cases are associated with stress, shock, bereavement, illness, or an accident.
There is also often a genetic predisposition for alopecia areata. There are, in fact, several reported cases of alopecia areata occurring in twins.
Alopecia areata is more common in people who suffer from other autoimmune conditions such as eczema, Addison’s disease, pernicious anaemia, rheumatoid arthritis, ulcerative colitis, lichen planus, diabetes mellitus, vitiligo, lupus and thyroid conditions.
What is the Best Treatment for Alopecia Areata?
In many cases, alopecia areata spontaneously resolves itself within a year.
There are also several treatments available to help bring about remission and encourage your hair to grow back. However, there is currently no cure for alopecia areata, and symptoms can recur. Unfortunately, it is not possible to predict when or where this will happen.
At Philip Kingsley, our world-renowned Trichologists have a wealth of knowledge and experience consulting to clients with alopecia areata. Around 98% of those treated in our Clinics recover with no permanent hair loss.
We find that the treatments listed below have good success rates — but, with such an unpredictable condition, we can never guarantee results. Our Trichologists will discuss all the options with our clients before deciding on a course of action.
Steroids work by decreasing inflammation, and reducing the activity of your immune system to stop it attacking your hair follicles. Steroids can be used to help treat alopecia areata either through injections, or creams and gels that are applied topically to your skin.
Corticosteroid injections are thought to be the most effective treatment for alopecia areata, especially when used on small patches. They are administered by a GP or dermatologist every few weeks, and can be used to treat bald areas on your scalp, eyebrows and body. They work by suppressing your body’s immune system, so that it no longer attacks your hair follicles. Side effects may include pain at the injection site and thinning of the skin.
Topical corticosteroids (creams and gels applied to your skin) work in the same way as steroid injections, but they are neither as strong, nor as targeted. Studies on their effectiveness are so far inconclusive, but some benefits have been reported. These creams and gels are available on prescription from your GP (weaker strengths are available over-the-counter, but Philip Kingsley Trichologists do not recommend you use them without consulting your doctor). They are applied daily to the affected scalp areas. Topical creams and gels include: betamethasone, hydrocortisone and mometasone. Side effects may include acne and thinning of the skin.
UV treatment, or phototherapy, works in the opposite way to steroids. It increases inflammation at the affected site, in the hope that this will trick your body into recognising your hair follicles as ‘friendly’ cells so it stops attacking them. At Philip Kingsley, the use of UV rays is carefully monitored by your Trichologist and is given in safe, small doses, which are far lower than you would experience, for example, by visiting a sun-bed. Only a limited number of UV treatments can be administered per person over a lifetime, and we stay well within these boundaries.
Alopecia areata is linked to stress. At Philip Kingsley, we take a holistic approach to hair care, and we consider stress management an important part of any alopecia areata treatment plan. During Consultations, our Trichologists are happy to discuss hair-healthy lifestyle choices with our clients.
At Philip Kingsley, we do not recommend transplants for people with alopecia areata. Although transplants are a temporary cosmetic fix, alopecia areata can recur, and affect transplanted hairs as well as non-transplanted ones. This may cause even more emotional (not to mention financial) distress to an already upsetting condition.
If you are worried about any form of hair loss, our Clinics in London and New York specialise in all aspects of hair and scalp health, and will be happy to welcome you.