What Are the Main Causes of Alopecia Areata?

What is alopecia areata?

Alopecia areata is caused by your immune system attacking part of your body. Genetic factors may play a role in alopecia areata.

Alopecia areata is a condition that occurs when the body’s immune system attacks its hair follicles, causing hair loss. The hair loss is patchy and can occur all over the body. The hair may regrow, and it may or may not fall out again.

Dealing with alopecia areata can be frustrating because of the unpredictable nature of the condition and because its symptoms can be very noticeable.

There are many treatment options available for alopecia areata. The hair will often regrow on its own, but people with alopecia areata may experience several recurrences of hair loss throughout their lives.

Signs of alopecia areata

While a loss of hair on the head is the most obvious sign of alopecia areata, the condition can also cause changes to your nails or hair loss on other places of your body. Below are some common signs of alopecia areata:

Round or oval patches of hair loss on your scalp
Round or oval patches of beard hair loss
Band-shaped hair loss on the sides and lower back of your scalp
Loss of eyelashes
Widespread hair loss all over your body
Red, dented, or brittle nails

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It is normal to lose 100-150 hairs per day.
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Types of alopecia areata

There are several types of alopecia areata, including:

Alopecia areata (Patchy)

This is the most common form of alopecia areata and includes one or more coin-sized round or oval patches of hair loss. The hair loss can occur on your scalp or any area of your body where hair grows. This type of alopecia areata may progress into other types of alopecia, or it may stay patchy.

Persistent patchy alopecia areata

In persistent patchy alopecia areata, hair loss continues to be patchy for a long time without ever becoming more extensive.

Alopecia totalis

With alopecia totalis, hair loss occurs over your entire scalp.

Alopecia universalis

Alopecia universalis results in total hair loss on all parts of your body, including your scalp, face, and pubic area.

Diffuse alopecia areata

Diffuse alopecia areata can be confused with other types of hair loss, such as telogen effluvium (a temporary loss of hair in the resting, or telogen, phase caused by trauma, drug use, or a high fever) or male- or female-pattern baldness. It is characterized by a sudden thinning of hair on the scalp.

Ophiasis alopecia

This type of alopecia is present when there is hair loss in the shape of a band around the sides and lower back of the scalp. This type can be resistant to medications.

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Causes of alopecia areata

With alopecia areata, your immune system attacks your hair follicles. It is an autoimmune disease, which is a disease that is caused by your immune system attacking part of your body. Genetic factors may play a role in alopecia areata.

People with the following conditions are at higher risk for developing some form of alopecia areata:

Asthma
Hay fever
Thyroid disease
Pernicious anemia, a type of vitamin deficiency
Down syndrome
Vitiligo, a condition that causes patchy loss of skin color

When to see the doctor for alopecia areata

Many people with alopecia areata will regrow their hair within 12 months or less. For some people, however, the problem becomes more extensive and long-lasting. If you would like treatment for your hair loss, you should see your doctor.

Diagnosing alopecia areata

In most cases, your doctor will probably be able to diagnose your alopecia areata with a physical exam of your hair and nails and by listening to your symptoms.

If further testing is needed, your doctor may do a blood test to check for other immune system diseases. They may also perform a biopsy on your scalp to confirm the diagnosis.

Treatments for alopecia areata

There is no cure for alopecia areata, but there are several treatments that may be effective. The treatment will depend on your age and the amount and location of your hair loss. You may need to try several treatments to find one that works for you.

For Children Under 10

For children younger than 10, topical corticosteroids applied directly to the scalp twice a day can help regrow hair. After the hair starts to regrow, minoxidil may be used to maintain the hair regrowth.

For Adults and Children 10 and Over

For limited, patchy alopecia areata, the most effective initial therapy may be corticosteroids injected directly into the areas of hair loss to suppress the immune system attacks. Other options include high-dose topical corticosteroids, oral corticosteroids, and immunotherapy. Minoxidil may also be used to help with hair regrowth.

There are other medications, such as Anthralin and methotrexate, that your doctor may prescribe if other treatments aren’t working.

Since your hair will often grow back within 12 months even with no treatment, if you have limited symptoms, you may decide to style your hair differently to cover the hair loss or use a wig or hairpiece until your hair starts to grow.

For loss of eyelashes or eyebrows, cosmetic treatments such as makeup and false eyelashes may help disguise hair loss until it regrows. There is also a treatment called dermatography that can help disguise eyebrow loss. It’s performed by injecting dots of pigment into the eyebrow area.