Alopecia Areata

Alopecia areata is an autoimmune condition in which the immune system attacks hair follicles, causing sudden, often patchy hair loss. It most commonly affects the scalp but can involve any hair-bearing area of the body.

• Sudden appearance of one or more smooth, round patches of hair loss, most commonly on the scalp
• The skin in the affected area usually appears normal, without redness, scaling, or scarring
• Nail changes, such as pitting, occur in some people
• In more extensive cases, hair loss can affect the entire scalp (alopecia totalis) or the whole body (alopecia universalis)

• Results from an autoimmune process in which the immune system attacks hair follicles, though the exact trigger is not fully understood.
• Family history of alopecia areata or other autoimmune conditions increases risk.
• Stress is sometimes reported as a trigger for onset or flares, though it is not considered the underlying cause.

• Diagnosed clinically based on the characteristic pattern of sudden, well-defined patches of hair loss with normal-appearing underlying skin.
• A scalp examination, sometimes with magnification, can reveal characteristic hair changes at the edges of patches.
• Other causes of hair loss, such as fungal infection or scarring alopecia, are considered and excluded based on the clinical picture.

Many mild cases, particularly single small patches, may regrow hair spontaneously within months without treatment.

A topical or injected corticosteroid into the affected patches can help stimulate regrowth for more persistent or larger patches.

More extensive or refractory cases may be referred to a specialist for other treatment options.

Hair often regrows over time in many people, though the course is unpredictable and can include recurrence.

Psychological support can be valuable, given the potential impact on self-esteem and body image, particularly with more extensive hair loss.

• Seek early assessment for sudden patches of hair loss to confirm the diagnosis and discuss treatment options.
• Manage stress through relaxation techniques or other approaches, as it may play a role in some flares.
• Seek support from family, friends, or counselling if hair loss is affecting emotional wellbeing.
• There is no proven way to prevent alopecia areata, given its autoimmune basis.