Alopecia Areata
Symptoms
Alopecia areata causes sudden, well‑circumscribed patches of hair loss on the scalp, beard, or other hair‑bearing areas. Skin within patches appears smooth and normal. Exclamation‑point hairs—short broken hairs tapered proximally—line the margins. Nail pitting or ridging may accompany hair loss. Regrowth may be white or fine initially.
Cause
An autoimmune attack targets the hair follicle bulb, interrupting the growth cycle. Genetic predisposition and environmental triggers such as stress or infection play roles. Association exists with other autoimmune diseases like thyroiditis or vitiligo.
Treatment
Intralesional corticosteroid injections stimulate regrowth in patchy disease. Topical corticosteroids, minoxidil, or contact immunotherapy (DPCP) are additional options. Systemic corticosteroids or JAK inhibitors treat extensive or rapidly progressive alopecia areata. Psychological support and cosmetic aids (wigs, scalp micropigmentation) help cope with appearance changes. Early intervention may improve outcome.
Dr. Beth Schulz-Butulis
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