What is Alopecia Areata?

What is Alopecia Areata?

Alopecia areata is a common autoimmune disorder that commonly results in unpredictable hair loss. It affects 2% of Americans (roughly 6.5 million people) and can affect anyone regardless of age and gender.

In the majority of cases, hair falls out in small patches around the size of a quarter. For most people, hair loss is nothing more than a few patches, though in some cases it can be more extreme. Sometimes it can lead to the complete loss of hair on the scalp (alopecia totalis) or in extreme cases the entire body (alopecia universalis).
Alopecia areata is considered to be an autoimmune disease, where the immune system mistakenly identifies the body’s own cells instead of harmful foreign invaders. In the case of alopecia areata, the immune system attacks the hair follicles which leads to hair loss.

The condition occurs when white blood cells attack the cells in hair follicles, causing them to shrink and dramatically slow down hair production. It is unknown precisely what causes the body’s immune system to target hair follicles in this way.

While scientists are unsure why these changes occur, it seems that genetics are involved as alopecia areata is more likely to occur in a person who has a close family member with the disease. One in five people with the disease has a family member who has also developed alopecia areata.

Other research has found that many people with a family history of alopecia areata also have a personal or family history of other autoimmune disorders, such as atopy.

Despite what many people say, there is very little scientific evidence to support the view that alopecia areata is caused by stress. Extreme cases of stress could potentially trigger alopecia areata, but most recent research points toward a genetic cause.

The most prominent symptom of alopecia areata is patchy hair loss. Coin-sized patches of hair begin to fall out, mainly from the scalp. Any site of hair growth may be affected, however, including the beard and eyelashes.

The loss of hair can be sudden, developing in just a few days. The hair follicles are not destroyed and so hair can re-grow if the inflammation of the follicles subsides. People who experience just a few patches of hair loss often have a spontaneous full recovery without any form of treatment.

About 30% of individuals who develop alopecia areata find that their condition either becomes more extensive or that they experience continuous cycles of hair loss and regrowth.

Health care providers are usually able to diagnose alopecia areata fairly easily by examining the symptoms. They might look at the degree of hair loss and examine hairs from affected areas under a microscope.

If, after an initial clinical examination, the health care provider is not able to make a diagnosis, they can perform a skin biopsy. If they need to rule out other autoimmune diseases, then the health care provider can also perform a blood test.

As the symptoms of alopecia areata are so distinctive, making a diagnosis is usually quick and straightforward.

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