With alopecia areata, inflammation develops around the hair roots. Attacking hair loss (baldness) is usually the only symptom of this hair follicle inflammation (folliculitis). A few patients experience burning and itching or feeling on the head. Pain, a feeling of sickness or other symptoms do not normally occur with alopecia areata. Usually one or two hair bunches first fall out, often on the scalp. Sometimes this also occurs in the beard, in the eyebrows, under the armpits, on the genitals (pubic hair) or on the arms or legs. The hair patches that have fallen off the head are smooth, round or oval in shape and peach. The hair roots are still present and visible in the bare hair areas. At the edges of a bald spot there are hairs that have the appearance of an exclamation mark. With alopecia totalis, total hair loss often occurs within six months after the first symptoms have started.
Also nail anomalies sometimes occur. For example, a patient with Alopecia areata sometimes experiences to leukonychie (white nails), or to well nails (pitting of the nails).
A blood test excludes other disorders
Often the hair disease can be clearly identified on the basis of the external characteristics. If the doctor doubts, he performs a scalp biopsy. He then removes a piece of tissue from the scalp and has it examined microscopically to ensure that the patient does not suffer from another hair disorder. In addition, various blood tests are possible. This is necessary to detect any autoimmune disorders and thyroid abnormalities.
The hair often grows back within a few months without treatment. This does not apply when the hair loss is very widespread. The doctor may prescribe medication that the patient applies to the skin. Another treatment consists of a steroid injection under the skin surface. Corticosteroids are, after all, strong, anti-inflammatory drugs that suppress the inflammation of the hair roots. Furthermore, ultraviolet light therapy is a solution for some patients. Other patients benefit from a wig to hide the areas of hair loss.
Prognosis is usually good
Normally the hair grows back completely after the inflammation has disappeared, but it is possible that this is then in the form of white or gray hairis. Often it takes several months before the hair starts to grow back. But in about 10% of patients, hair growth does not happen again. This is especially the case in patients where the condition has started at a very young age, when the alopecia is chronic, when the condition is very widespread and also when the patient is suffering from eczema. Patients with abnormal color, shape, texture, or thickness of fingernails or toenails also have poorer prospects for hair regrowth. In addition to the physical characteristics of the disease, alopecia areata sometimes leads to social isolation, shame and an unattractive feeling.
The head hair sometimes falls out completely. The hair condition sometimes also comes back, with or without treatment. This is unpredictable.