Alopecia Areata

Alopecia areata is a disease that affects the hair follicles, which are part of the skin from which hairs grow. In most cases, hair falls out in small, round patches about the size of a quarter. Many people with the disease get only a few bare patches. Some people may lose more hair. Rarely, the disease causes total loss of hair on the head or complete loss of hair on the head, face, and body.

Who Gets Alopecia Areata?

Anyone can have alopecia areata. It often begins in childhood. There is a slightly increased risk of having the disease if you have a close family member with the disease.
What Causes Alopecia Areata?

Alopecia areata is an autoimmune disease. Normally the immune system protects the body against infection and disease. In an autoimmune disease, the body's immune system mistakenly attacks some part of your own body. In alopecia areata, the immune system attacks the hair follicles.

The cause is not known. Scientists think that a person's genes may play a role. For people whose genes put them at risk for the disease, some type of trigger starts the attack on the hair follicles. The triggers may be a virus or something in the person's environment.
Will My Hair Ever Grow Back?

There is every chance that your hair will grow back, but it may fall out again. No one can tell you when it might fall out or grow back. You may lose more hair, or your hair loss may stop. The hair you have lost may or may not grow back. Even a person who has lost all of his hair may grow all of his hair back. The disease varies from person to person.
How Is Alopecia Areata Treated?

There is no cure for alopecia areata. There are no drugs approved to treat it. Doctors may use medicines approved for other diseases to help hair grow back. Talk to your doctor about the treatment that is best for you.

The following are some treatments for alopecia areata. They may help hair grow back, but none of them prevent new patches of hair loss or cure the disease.

Corticosteroids:

Corticosteroids are drugs that reduce swelling and pain. They also affect the immune system. Corticosteroids may be given in three ways for alopecia areata:

* Injected in the skin
* Swallowed as pills
* Rubbed on the skin as a cream or ointment.

Drugs that are rubbed on the skin as a cream or lotion include:

* Minoxidil (5%)
* Anthralin
* Squaric acid dibutyl ester (SADBE) and diphenylcyclopropenone (DPCP).

Drugs that affect the immune system include:

* Sulfasalazine
* Cyclosporine.

Photochemotherapy:

In photochemotherapy, a person is given a drug called a psoralen, which is affected by light. The drug can be swallowed or rubbed on the skin. Once the drug is taken or applied, the area with hair loss is exposed to an ultraviolet light source. This combined treatment is called PUVA.

Alternative therapies:

Some people with alopecia areata try other treatments. These alternatives include acupuncture, aroma therapy, evening primrose oil, zinc and vitamin supplements, and Chinese herbs. Because many alternative therapies have not been studied in clinical trials, they may or may not help hair grow back. In fact, some may cause more hair loss. Talk with your doctor before you try alternative therapies.
How Will Alopecia Areata Affect My Life?

Alopecia areata does not make you feel pain and does not make you feel sick. You can't give it to others. People who have the disease are, for the most part, healthy in other ways. Alopecia areata will not shorten your life, and it should not affect activities such as going to school, working, marrying, raising a family, playing sports, and exercising.
How Can I Cope With the Effects of This Disease

Living with hair loss can be hard. There are many things you can do to cope with the effects of this disease, including:

* Learning as much as you can about the disease.
* Talking with others who are dealing with the disease.
* Learning to value yourself for who you are, not for how much hair you have or don't have.
* Talking with a counselor, if necessary, to help build a positive self-image.

Here are some things you can use to reduce the physical dangers or discomforts of lost hair:

* Use sunscreens for the scalp, face, and all exposed skin.
* Wear eyeglasses (or sunglasses) to protect eyes from sun, and from dust and debris, when eyebrows or eyelashes are missing.
* Wear wigs, caps, or scarves to protect the scalp from the sun and keep the head warm.
* Apply antibiotic ointment inside the nostrils to help keep germs out of the nose when nostril hair is missing.

Here are some things you can do to reduce the disease's effects on your looks:

* Try wearing a wig, hairpiece, scarf, or cap.
* Use a hair-colored powder, cream, or crayon applied to the scalp for small patches of hair loss to make the hair loss less obvious.
* Use an eyebrow pencil to mask missing eyebrows.