We’ve all had moments or seasons where we seem to be losing a ton of hair. Yet when we look in the mirror, every hair seems to be in place. You may have even had nightmares about losing your hair. While hair loss (alopecia) can occur due to a variety of causes, one form of patchy hair loss called alopecia areata has a distinctive pattern to watch out for.
“During one’s lifetime as many as 2 out of 100 individuals may suffer from alopecia areata, an autoimmune disease that causes patches of hair loss on the scalp,” said Trevor Thompson, MD, a dermatologist with Banner Health Center in Peoria, AZ.
Given that hair, particularly the hair on our heads, has long been a sign of youth and good health, what should you do (and what does it mean?!) if it’s falling out in patches or clumps? Dr. Thompson shared five things to know about alopecia areata—including treatment options.
1. Alopecia areata doesn’t just appear with aging.
While hair loss is typically considered a problem as we get older, alopecia areata is a common condition that can affect anyone at any age. “Alopecia areata impacts children and adults and appears equally among males and females,” Dr. Thompson said.
Alopecia areata can appear during your childhood, disappear for a decade and then reappear.
It develops when your immune system attacks the body's hair follicles (where hair grows from), which can cause hair to fall out. Having a close family member with the disease can increase your risk, but many individuals do not have a family history of it. There may be various triggers that influence the immune system response around hair follicles causing the hair loss. The exact triggers to explain why there and why now for each person are not as fully understood.
2. Alopecia can take many forms.
There are many types of alopecia, with the most common being the predominantly hereditary androgenetic alopecia, also known as male or female pattern baldness. As you may already know, this form of alopecia is the type of hair loss that can lead to baldness at the crown or hairline but usually doesn’t impact hair on the back or sides.
Unlike androgenic alopecia, alopecia areata doesn’t follow a predictable pattern—and not just your head! It can affect any hair on your body.
“While the majority of cases involve coin size patches of hair loss usually on the scalp, a small percentage of individuals can develop more extensive hair loss involving the entire scalp (known as alopecia areata totalis) or the entire body (alopecia areata universalis),” Dr. Thompson said. “The bald patches of skin will feel smooth, with no rash or redness. If you encounter a localized patch or patches of hair loss, this would be worth getting evaluated by your health care provider.”
3. There is no cure for alopecia areata—but it can be treated.
“Fortunately, many people with alopecia areata can see improvement with treatment,” Dr. Thompson said. “For some individuals with mild symptoms of alopecia areata symptoms, hair growth may occur on its own over time with no further issues ever again, while others may have persistent, recurring or challenging cases.”
If your hair isn’t regrowing on its own, there are a variety of treatment options, with topical or intralesional (injected) steroids being the most common form of treatment. “There is additional research into treatments with a class of medication known as JAK (Janus Kinase) inhibitors where people have achieved significant hair regrowth,” Dr. Thompson said.
JAK inhibitors calm overactive immune systems to prevent damage to your joints (or, in this case, your hair follicles). It’s also used to treat other autoimmune conditions like rheumatoid arthritis.
4. Alopecia can take an emotional toll as well.
Hair loss can have a profound effect on your self-esteem, confidence and even your identity—impacting your personal, social and work life—especially when you lose it so abruptly. It can also cause a lot of anxiety and sadness and poorer body image.
There are support groups that have provided help to those with alopecia. Many people find with these groups that they’re not alone, they learn how others cope, what doctors and treatments they’ve tried and what results have been. To find a support group near you, visit the National Alopecia Areata Foundation.
5. Cosmetic approaches may help.
If you’re having trouble coping with hair loss while treatment is ongoing or isn’t working, there are other options that can be helpful.
For women and children, the use of wigs or hairpieces can have a positive effect, enhancing self-esteem and social adjustment. Wigs can be cut and styled according to your preference but can be expensive. There are organizations that offer free or wig subsidies for approved applicants with alopecia.
For men, you may opt to shave your scalp.
Temporary tattooing can be helpful for the loss of eyebrows. False or magnetic eyelashes are an option for patients with hair loss involving the eyelashes.
Alopecia outlook
Alopecia areata isn’t a life-threatening medical condition, but it can cause a lot of stress and anxiety and be very isolating. The good news is there are treatment options available and support groups to help you deal with the psychological effects.
If you notice sudden hair loss, check with your health care provider. There could be other reasons for it besides alopecia areata.
To find a Banner Health provider near you, visit bannerhealth.com.
