What is alopecia areata?
Alopecia areata is an autoimmune disorder in which your own body's immune system attacks hair follicles, resulting in chronic, patchy hair loss. The degree of hair loss experienced can range from a small patch on the scalp to the loss of all hair on the head including facial hair (alopecia totalis), and sometimes even the whole body (alopecia universalis).
What causes alopecia areata?
The cause of alopecia areata is not fully understood. The immune system sees certain hair follicles as foreign and attacks them, effectively halting the life cycle of those hairs, causing them to fall out in patches. Alopecia areata is not contagious or "caught". Presently, research has not found a cause or a predictable pattern for alopecia areata.
How do we treat alopecia areata?
Treatment begins with an in-depth consultation and physical examination of your hair loss condition, along with any specific testing necessary to determine an accurate diagnosis. Alopecia areata treatment aims to stimulate hair follicles to grow hair again. These treatments can include:
- Corticosteroid injections: One common treatment is cortisone injections to areas of hair loss. These injections are administered in the office about once every four to six weeks, and are generally well tolerated.
- Topical drops or ointments: Immunomodulator medications such as tacrolimus can be applied at home to areas of hair loss. These work by weakening the immune response at the site of hair loss.
- Topical immunotherapy: Another method of treatment involves producing an antibodies to an irritating medication, so that applying this irritant to the skin causes the body to attack the medication instead of the hair, allowing the hair to grow.
Why don't traditional hair loss medications and treatments work on alopecia areata?
Treatments meant for male pattern hair loss and female pattern hair loss are typically "anti-androgens" aimed at blocking the hormone dihydrotestosterone (DHT), which is responsible for this type of hair loss. DHT does not cause alopecia areata; therefore these medications are ineffective at treating alopecia areata.
What can I expect?
Treatment for alopecia areata is very individualized and results are often unpredictable, so there can be no guarantees of specific results. While some individuals achieve complete re-growth, it is possible that one may not respond to treatments. No matter what the degree of hair loss, the hair follicles remain alive, supporting the possibility of a spontaneous remission.
Have a question about your treatment?
We have a dedicated triage nurse (RN) who answers patient questions during office hours. If you have a problem or question about a procedure or a prescribed medication, please call our office and ask to speak to our nurse. If she is unable to answer your question, she will consult with your practitioner and return your call.