Alopecia Areata

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.