Alopecia areata is an unusual disease; it causes hair loss in patterns that can be distinct, and in patterns that can mimic almost any other pattern of alopecia (hair loss) including androgenetic alopecia (pattern hair loss). Because of this, most patients have never heard of it and, if they have it, have trouble figuring out what it is. (A good resource for overall information on alopecia areata is the National Alopecia Areata Foundation at naaf.org). Here are five characteristic features of alopecia areata that might help the average patient to recognize if this disease fits their condition.
- Oval or round patches;
- Whole head hair loss; Alopecia totalis, as it is termed medically, involves balding of all the hair on the head. Scalp hair, eyebrows, eyelashes, and beard hair are all lost, either all at once or in stages. It is a dramatic change since facial hair contributes significantly to a person’s overall appearance and self-image. As a matter of fact, hair loss of any kind is strongly linked to symptoms of depression, anxiety and agoraphobia (avoidance of social situations). It is treatable, however, and patients rarely even grow their hair back without treatment of any kind.
- Band-like hair loss; Ophiasis-type alopecia is not common, but very distinctive in pattern. It manifests as a band of loss, like across the nape of the neck. It is treated like other forms of alopecia areata, but it can be a little easier to hide if the hair is worn long.
- Total body hair loss; Alopecia universalis does not seem like it would be as devastating as it actually is – after all, don’t some people pay thousands of dollars to rid themselves of their body hair? While it is true that people feel strongly about removing hair where they do not want it, balding in every area of the body is completely life changing. Besides the obvious aesthetic contribution that hair affords, hair also plays a significant role in temperature regulation.
- Diffuse hair loss; Diffuse alopecia areata resembles many other kinds of diffuse hair loss. Some of these other possible diagnoses include Diffuse Unpatterned Alopecia “DUPA,” telogen effluvium, or senescent hair loss due to old age. Diffuse alopecia arata can thus be difficult to pinpoint without a biopsy, even for experienced physicians. The key is to make sure an accurate diagnosis is obtained before treatment starts, especially if surgery is to be done, since some treatments that might be appropriate for other conditions will not work for diffuse alopecia areata.
Most alopecia areata presents this way and most doctors would recognize this pattern as “classic” alopecia areata. Patients notice small patches, either oval or round that lose all hair. This balding can occur anywhere on the body, but the scalp and the areas of facial hair (beards, brows, lashes, etc.) Patients should know that sometimes the patches can coalesce into a single area, but more importantly and hopefully, the hair often re-grow especially with treatment.
If you have hair loss that you think might fit one of these patterns, get in to see a hair specialist or dermatologist immediately. The sooner an accurate treatment is made, the sooner treatment can start, and early treatment is correlated highly with good response and saving or restoring as much hair as possible.