What is Alopecia?
Alopecia is an autoimmune disorder in which the body's immune system sends signals to white blood cells to attack healthy hair follicle cells. This causes the hair follicles to shrink, resulting in varying degrees of visible hair loss on the scalp and sometimes on the face and body. While there is no known cure for alopecia, the condition can resolve spontaneously. Once the immune system stops attacking the healthy cells, it is possible for hair to grow back during the next hair cycle.
The word alopecia derives from Ancient Greek, which translates roughly to "fox disease," because foxes shed their fur twice a year. The word areata means “occurring in patches or circumscribed areas.
Stats and Facts About Alopecia:
Alopecia affects an estimated 6.6 million people in the U.S. and 147 million people worldwide.
Alopecia can affect people of all ages, but often begins during childhood.
About 60% of individuals develop the disease prior to age 20, with peak incidence occurring at ages 15 to 29.
About 90% of patients with less than one-quarter scalp involvement experience spontaneous regrowth within 2 years.
In an estimated 20% of cases, hair loss recurs or becomes permanent.
Nail involvement (mainly the fingernails) affects 6.8-49.4% of patients, most commonly in severe cases.
Symptoms of Alopecia
The most obvious symptom of alopecia is patchy hair loss. Coin-sized patches of hair begin to fall out, mainly on the scalp. Alopecia can impact facial hair including the beard, mustache, eyebrows, and eyelashes, as well as body hair. The loss of hair can be sudden, developing in just a few days. No correlation exists between the number of patches at onset and subsequent severity. Changes to the fingernails and toenails may be the first sign that alopecia is developing before it affects the hair. As with the hair, alopecia-related nail issues can resolve over time and the nails can return to their normal form. The constantly cycling cell growth in nails is suppressed, which can lead to several signs, as follows:
- Pinpoint dents
- White spots and ridges/lines
- Loss of shininess
- Thinning and brittleness
Localized Hair Loss
- Single Patch: 80%
- Two Patches: 12.5%
- Multiple patches: 7.7%
- Scalp: 66.8 - 95%
- Beard: 28% (males)
- Eyebrows: 3.8%
- Extremities: 1.3%
Diagnosis of Alopecia
Diagnosis of alopecia is typically straightforward because the symptoms are quite distinctive. Hair loss with alopecia usually presents as patchy areas of hair that begin to rapidly and randomly fall out. The site(s) and extensiveness of hair loss determines the type of alopecia, with the three primary forms as follows:
Alopecia Areata Patchy
- The most common variation, this results in patchy hair loss that is mainly on the scalp or any areas of the body with hair.
Alopecia Areata Totalis
- This refers to cases in which complete hair loss affects the scalp
Alopecia Areata Universalis
- A rare form, this affects the entire scalp, face, and body, resulting in complete hair loss.
To learn more about the different types of alopecia, visit our Types of Alopecia Resource page.
Causes of Alopecia
For many years, it was thought that stress was the primary cause of alopecia. While extreme stress can trigger alopecia in some people, more recent research points toward a genetic cause. One in five people with alopecia have a family member with the condition. However, even in identical twins who share all the same genes, there is only a 55% chance that the other twin will develop alopecia. This indicates that other factors besides genetics are required to activate the disease, although the exact triggers are unknown. Experts do know that people who are predisposed to or already suffer from other autoimmune disorders such as vitiligo, thyroid disease, lupus, type 1 diabetes, rheumatoid arthritis, pernicious anemia, or Addison’s disease have a higher risk of developing alopecia.
Treatment of Alopecia
Treatment varies depending on the severity of the hair loss, the area where the loss occurs, and an individual's general health. Treatments include corticosteroid injections, topically applied medicated ointments and creams, and light therapy. These treatments cannot turn off the signals that cause the cells to be attacked. However, they can stimulate the follicles to produce healthy cell growth in the next growth cycle if and when the autoimmune system returns to normal. There have been many small research studies analyzing the potential use of experimental treatments. To date, a universal alopecia therapy has not been developed that works for everyone.
Coping with Alopecia
Alopecia affects every person differently. Coping with this disorder can often be challenging for the individual, as well as for friends and family members of the affected person. The physical symptoms of alopecia can cause some individuals to feel uncomfortable about the way they look. Wearing scarves, hats, or hairpieces can reduce feelings of self-consciousness about physical appearance, thereby allaying some of the negative emotions associated with hair loss. Many people with alopecia also wear wigs, false eyebrows, and fake eyelashes, which can help boost confidence when interacting with others on a day-to-day basis.
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I FEEL BAD ABOUT WOMEN WHO LOSES HER HAIR .I AM BALD BY CHOICE AND I'VE GOTTEN TO REALLY LOVE IT. MY HUSBAND LOVE S IT THIS WAY HE SAYS I'M HAPPIER. I HAD THIN AND UNCONTROLLABLE HAIR I HATED IT. SO I STARTED TO WEAR WIGS SHAVING MY HEAD THE WIGS FIT BETTER AND ARE MORE COMFORTABLE.I DON'T PLAN ON HAVING MY OLD HAIR BACK.. BALD IS BEAUTIFUL.. AND REMEBER YOU ARE STILL A BEAUTIFUL WOMAN EVEN IF YOU DO'T HAVE HAIR .. BOLD/BALD&BEAUTIFUL.. BY THE WAY I AM A 69 YEAR YOUNG WOMAN.. (Posted on 08/06/2019)
Hello, I was diagnosed with scarring alopecia - Lichen Planopilaris. You don't mention scarring alopecias so I wanted to bring it to your attention. Although it is rare, incidences of scarring alopecias are on the rise. Experts do not know why. Scarring alopecias result in scarring of the hair follicles that eventually never grow back. So while non-scarring alopecias can result in regrowth, scarring alopecias do not. We should be included in the alopecias you mention. Thank you. (Posted on 05/15/2019)
Hello (Posted on 10/18/2018)
I would have to say , Elizabeth, your story is similar to mine. Stress induced. Was married 24yrs , lost my only son over it, too. This bites . I too find myself a homebody any more, nothing like my old self. Strength in numbers, ladies. Much love and understanding to all. ?? (Posted on 09/22/2017)
My current journey with alopecia been only 3 months. I had a small bald spot of hair gone years ago but it greward back. I did not know then that it was alopecia. Just thought it was stress. Now I do not leave the house without a hat or scarfs or one of my two wigs on. The only place I have hair (but it's thinning hair) is on the crown of my head. Have considered shaving it all off but my husband worries about what that will do to my mood. I have suffered from terrible depression before I ever had any hair loss. I have become very much home bound. Since I am 57 and do not work it's just created a sinaro where I do not go out much. Maybe every other weekend my husband insists that we go to a movie, out to eat or out to the mall ... and he really dislikes malls. At first I embraced the whole idea and got me the wigs deciding I might as well have fun with what is ahead of me. I have bought me hats that doctors and nurses use. I find them to be light weight and pretty, for those days too hot to put hair on. I have a visor I place over the head caps that helps hold ithe in place when I have ventured outside. I am a bit worried that I have become accustomed to staying in my house and the depression that is created by that might turn ugly. I have been told my hair may grow back, maybe? Frustrated and depressed, for now. Not sure what happened to my fun embracing attitude. Could be the cost of wigs. It's hard to justify when I do not work. Atleast for me my husband will buy me anything to make me smile or help me feel better. He is awesome! 37 years together. (Posted on 09/08/2017)
Just FYI: There are other types of hair loss as well that has nothing to do with alopecia. I have hair loss and dermatologists are calling it "stress induced" because of loss of husband and only adult child, leaving me alone with no family in my area and friends who have deserted me because of my loss and depression. BTW, I love your website. Thank you. One more question. Are there any websites that sell used head wraps, hats, etc.? (Posted on 12/01/2016)
I have battled alopecia for 18 years. Two years ago, I lost enough that I had to shave my head. My eyebrows are now gone, as well as almost all my eyelashes. The hair on my legs is practically non-existent. And well, now...you know. I am almost completely hairless. I love being bald, I do! But after 35 years of having hair, walking around bald in public has lead to some serious anxiety. But there are support groups out there that are super awesome, and I have been blessed with a compassionate workplace and loving husband. It's tough, but it could always be worse, ya know? Thanks for making this info available to your visitors. Bald can be beautiful! Love ya! (Posted on 10/04/2016)
I've had alopecia for 20 years and it has not been easy. Thank you for your part in bringing awareness to this issue. (Posted on 09/19/2016)