Alopecia Areata is a recurrent non-scarring type of hair loss that can affect any hair-bearing area and can manifest in many different patterns. Although this type of hair-loss is benign (not cancerous) and asymptomatic (showing no symptoms), it can cause emotional and psychosocial distress.
Signs & Symptoms
Alopecia Areata most often is asymptomatic, but some patients (14%) experience a burning sensation or pruritus (itching) in the affected area(s). No correlation exists between the number of patches at onset and subsequent severity. Frequency of involvement at particular sites are as follows:
- Scalp – 66.8-95%
- Beard – 28% of males
- Eyebrows – 3.8%
- Extremities – 1.3%
Associated conditions may include:
- Atopic Dermatitis (Eczema)
- Thyroid Disease
- Collagen-Vascular Diseases
- Down Syndrome
- Psychiatric Disorders – Anxiety, personality disorders, depression, and paranoid disorders
- Stressful life events in the 6 months prior to onset
Diagnosis usually can be made on clinical grounds. A scalp biopsy seldom is needed, but it can be helpful when the clinical diagnosis is less certain. Alopecia areata can be classified according to its pattern as follows:
- Reticular – Hair-loss is more extensive and the patches coalesce
- Ophiasis – Hair-loss is localized to the sides and lower back of the scalp
- Sisaipho – (Ophiasis spelled backwars) – Hair-loss spares the sides and back of the head
- Alopecia totalis – 100% hair-loss on the scalp
- Alopecia universalis – Complete loss of hair on all hair-bearing areas
Treatment & Management
Treatment is not mandatory, because the condition is benign, and spontaneous remissions and recurrences are common. Treatment can be systemic or topical.
Corticosteroid therapy injections are usually recommended for Alopecia Areata with less than 50% involvement. Injections are administered intradermally (within the skin) using Triamcinolone Acetonide (Kenalog) administered every 4-6 weeks.
Topical corticosteroid therapy can be useful, especially in children who cannot tolerate multiple injection treatments. Treatment must be continued for a minimum of 3 months before regrowth can be expected and maintenance therapy often is necessary.
Clinical trials, an alternative treatment option, can offer new therapies in the form of new drugs, devices, and/or procedures while also providing continuous, in-depth medical observation by healthcare experts.