Alopecia Areata

What is it?
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Alopecia areata is an autoimmune condition that affects 2% of the world’s population
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Autoimmune means that the body’s own immune system is attacking the hair follicles and causing the the hair to fall out.
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The exact cause is unknown. Sometimes it can be associated with viral infections, trauma, hormonal change or emotional stress.
What are the Symptoms?
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The majority of people will develop circular areas of hair loss on the scalp only
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Most people have no symptoms but occasionally people can have nail involvement as well
Do I need to do any tests as part of the diagnosis?
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In most cases the answer is NO as this tends to be a clinical diagnosis
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Occasionally your doctor will order blood tests to determine if you have any easily correctable causes of alopecia areata
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It is rare to have to do a scalp biopsy for diagnosing this condition
What are the treatment options available?
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This condition is self correcting over time thus no treatment is typically needed except reassurance that things will take time to recover. If treatment is warranted there are several options:
1. Topical treatments
• Minoxidil 5% foam (Rogaine)
• Topical corticosteroids
• Anthralin ointment
• Diphenylcyclopropenone (DPCP)
• Bimatoprost solution (Latisse) – more for eyelashes and eyebrows
2. Intralesional corticosteroid injections – Kenalog injections every 4-12 weeks.
3. Oral treatments – typically for severe cases only
• Prednisone (short courses)
• Methotrexate
• Cyclosporine
• JAK inhibitors (Tofacitinib/Ruxolitinib) – mostly experimental currently and costly.