Alopecia Areata

DESCRIPTION
* Alopecia areata causes development of bald patches on the scalp. Although it is a relatively uncommon cause of hair loss in children, about half of the people who do develop alopecia areata do so before their 20th birthday.
* A less common form of the disease, "alopecia totalis," results in loss of all the hair on the head.

SYMPTOMS
* Hair loss, usually in patchy, localized areas
* Scalp in the areas of hair loss is smooth, without irritation, itching, or rash.
* Sudden development of hair loss, without slow spreading of the affected area
* Hairs that do grow in the affected area are shaped like "exclamation points" (narrow at the base and wider at the tips).

CAUSE
* The cause of alopecia areata is not known. It is thought to be an "autoimmune" disease. This means that the body confuses the hair follicle with an infecting or foreign object, and begins to attack it, much like it would fight an infection.

RISK FACTORS
* People with family members with the disease are at a higher risk of developing alopecia areata, leading many to conclude there is an unidentified gene that makes certain people more likely to develop the disease.

TREATMENT
* Because of the complexity of the therapy, most children with this disorder are treated by a dermatologist, who helps select the most appropriate therapy.
* There are several therapies for alopecia areata, but none are effective for all patients. Some of these treatments include:

1. Local injections of steroid medications, to decrease the immune response in the affected area
2. Use of topical medications that increase hair growth, such as Minoxidil
3. Use of topical anti-immune agents

* In more severe cases, use of oral steroids might be considered.
* Psychological counseling is also appropriate, since the hair loss can be very traumatic and embarrassing for children and (especially) teenagers.
* In most cases, alopecia areata will resolve itself, if given enough time. This can take several years to occur, and is less likely in children than in adults.

IF YOU SUSPECT THIS CONDITION
* See your pediatrician for more information.