Alopecia areata is a form of hair loss that occurs in children and adults. It is non-scarring, which means that the hair follicle is not destroyed and that it has the ability to regrow hair. It is considered an autoimmune condition that results in inflammation and loss of hair. While hair is lost most commonly on the scalp, hair anywhere on the body may be affected. Alopecia areata only affects the hair and nails and does not cause any other body-wide problems.
Alopecia areata frequently presents as the sudden onset of smooth, round, hairless patches on the scalp. The affected areas are usually skin-colored but may have a peach color. Occasionally, there are scattered short colored or white hairs within the hairless patch.
In alopecia areata, there is no redness or scaling on the surface of the skin. Children usually first present with one to several small patches on the scalp, but occasionally experience with more rapid hair loss involving nearly the entire scalp, eyebrows, eyelashes and body hair. Your child’s nails may show small pits in the surface.
Alopecia areata has two peaks of onset – one in childhood and one in adulthood – though it has been reported in all ages. As with other autoimmune conditions, there is likely a genetic basis to alopecia areata with unknown triggers that result in the loss of hair. Associated conditions in the patient or family that might represent increased risk include Type 1 diabetes, celiac disease, rheumatoid arthritis, vitiligo, thyroid disease, multiple sclerosis and inflammatory bowel disease.
In half of patients with alopecia areata, individual episodes of hair loss last less than one year, and hair grows back without treatment. These patients may experience recurrent episodes of hair loss that spontaneously regrow or respond quickly to treatments.
Other patients have a progressive course with more stubborn hair loss that does not grow back on its own and may not respond to different treatments.
At this time, there are no means to predict which patients will have limited and brief involvement and which patients will have extensive hair loss of a longer duration.
Some patches of hair loss will spontaneously regrow hair without treatment.
Most patients and families, however, are interested in trying treatment to speed up hair regrowth. Selection of treatment depends on the age of the patient, how widespread the hair loss is, how long the hair loss has been present and other medical problems.
Pediatric dermatologists at Nationwide Children’s may recommend the following treatment options: topical steroids, injections of steroids, topical minoxidil (Rogaine), topical irritants and immunotherapy, or pills that turn down the immune system.