Tips on Management of Alopecia
Questions and answers regarding medical hair loss.
What is the cause of alopecia areata?
The cause is unknown but is thought to have an autoimmune basis.
What other diseases is alopecia areata sometimes associated with?
Organ-specific autoimmune disorders like Hashimoto's thyroiditis, pernicious anaemia, and also Down's syndrome.
What is the commonest age of onset?
Early adult life.
Alopecia totalis and alopecia universalis are two forms of alopecia areata - what is the difference between the two?
Totalis is when there is complete hair loss affecting the scalp and beard areas, whereas universalis involves the whole body.
When the patches of alopecia areata are examined what is seen?
Normal skin with normal texture, with the presence of `exclamation mark' hairs.
What is the normal course of alopecia areata?
The condition normally resolves completely within nine months of onset.
What are the indicators of a poor prognosis?
Early age of onset, speed of hair loss and area affected. Universalis rarely recovers.
What changes may occur to nails in association with alopecia?
Pitting and ridging may occur.
What is the treatment of alopecia areata?
No treatment is particularly effective, but the following are often tried: intralesional steroids, UV light, PUVA, or topical irritants such as dinitrochlorobenzene.
What are the differential diagnoses of alopecia areata?
Tinea capitis, psoriasis, pityriasis capitis, pityriasis amiantacea, trichotillomania, lichen simplex.
* Du Vivier A. Atlas of clinical dermatology. London: Churchill Livingstone, 1997
* Hunter J et al. Clinical dermatology (2nd edition). Oxford: Blackwell Science, 1994
* Leppard B, Ashton R. Treatment in dermatology. Oxford: Radcliffe Medical Press, 1993
Compiled by Nigel Stollery, a GP in Kibworth, Leicestershire, and a clinical assistant in dermatology.
Copyright Miller Freeman plc Jan 14, 2002