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Alopecia Areata

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What is it?

  • Alopecia areata is an autoimmune condition that affects 2% of the world’s population

  • Autoimmune means that the body’s own immune system is attacking the hair follicles and causing the the hair to fall out.   

  • The exact cause is unknown.  Sometimes it can be associated with viral infections, trauma, hormonal change or emotional stress.


What are the Symptoms?

  • The majority of people will develop circular areas of hair loss on the scalp only

  • 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?

  • In most cases the answer is NO as this tends to be a clinical diagnosis

  • Occasionally your doctor will order blood tests to determine if you have any easily correctable causes of alopecia areata

  • It is rare to have to do a scalp biopsy for diagnosing this condition


What are the treatment options available?

  • 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.

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