This is a condition where patients present with sudden localised or generalised hair loss with no evidence of scarring.
What is the cause?
- The exact cause of this condition is unknown.
- It is thought that it is most likely an organ-specific autoimmune disorder where the body is able to target the pigment cells in the hair follicle.
What are the clinical presentations of this condition?
Patients usually present with round to oval sharply circumscribed smooth areas of hair loss. It usually starts as a single lesion and may expand and develop new patches. Common sites include the scalp, beard , eyebrows and eyelashes.
Can the hair regrow with this condition?
Yes, the hair can spontaneously regrow with this condition. However, regrowth depends on the duration of the condition. The longer the duration, the poorer the chance of hair growth. When hair growth does occur, it usually occurs with a white tuft of hair.
What are the treatment options available?
- Topical steroids –to apply on the lesions
- Topical irritants eg. DNCB or dithranol cream to the affected area
- Topical stimulants eg Minoxidil (Regaine) solution/spray
- Intralesional steroids –eg celestone soluspan into the affected area
- Pulse systemic steroids eg prednisone
- Turban PUVA therapy /narrowband UVB –targeted to the areas of alopecia
- Systemic agents eg Azathioprine, Cyclosporine, Cellcept or Sulphasalazine
- Excimer laser –for localised alopecia areata –used 2x week for 24 weeks