Why patchy hair loss

Alopecia areata is an autoimmune condition. An autoimmune condition develops when the immune system mistakes healthy cells for foreign substances. Normally, the immune system defends your body against foreign invaders, such as viruses and bacteria. If you have alopecia areata, however, your immune system mistakenly attacks your hair follicles. Hair follicles are the structures from which hairs grow.

The follicles become smaller and stop producing hair, leading to hair loss. However, it most often occurs in people who have a family history of other autoimmune conditions, such as type 1 diabetes or rheumatoid arthritis.

This is why some scientists suspect that genetics may contribute to the development of alopecia areata. They also believe that certain factors in the environment are needed to trigger alopecia areata in people who are genetically predisposed to it. The main symptom of alopecia areata is hair loss. Hair usually falls out in small patches on the scalp. These patches are often several centimeters or less.

Hair loss might also occur on other parts of the face, like the eyebrows, eyelashes, and beard, as well as other parts of the body. Some people lose hair in a few places. Others lose it in a lot of spots. You may first notice clumps of hair on your pillow or in the shower.

If the spots are on the back of your head, someone may bring it to your attention. However, other health conditions can also cause hair to fall out in a similar pattern. In rare cases, some people may experience more extensive hair loss. This is usually an indication of another type of alopecia, such as:. The hair loss associated with alopecia areata is unpredictable and, as far as doctors and researchers can tell, appears to be spontaneous.

The hair may grow back at any time and then may fall out again. The extent of hair loss and regrowth varies greatly from person to person. Alopecia areata occurs in both men and women, but the loss of hair is likely to be more significant in men. Men are also more likely to have a family history of the hair loss condition. Men may experience hair loss in their facial hair, as well as their scalp, chest, and back hair.

Compared to male-pattern baldness, which is a gradual thinning of hair all over, hair loss from this condition causes patchy hair loss.

The hair loss can occur on the scalp, as well as the eyebrows and lashes. Unlike female-pattern hair loss , which is a gradual thinning of hair that covers a large area, alopecia areata may be confined to a small area. Funding sources: None. Conflicts of interest: None disclosed.

Paus R, Olsen EA, et al. J Am Acad Dermatol ; Sperling LC. Mosby Elsevier, Spain, Types of hair loss Alopecia areata Female pattern hair loss Frontal fibrosing alopecia. Treatment for hair loss Hair loss treatment Treating alopecia areata Hair transplant What you can do. Insider secrets Alopecia areata: Self care Hair loss or shedding? Early signs of hair loss New moms: Tips Scalp psoriasis Stop damaging your hair.

A common sign of alopecia areata The first sign of alopecia areata is often a round or oval bald patch on the scalp. Beard affected by alopecia areata Men who have alopecia areata may develop one or more bald patches in their beard area. Hair loss due to alopecia areata While hair loss on the scalp often causes round or oval bald patches, hair loss can take any shape. Guidelines for the management of tinea capitis in children. Pediatr Dermatol. Goodheart HP.

Philadelphia, Pa. The child and adolescent trichotillomania impact project: descriptive psychopathology, comorbidity, functional impairment, and treatment utilization. J Dev Behav Pediatr. A placebo-controlled trial of cognitive-behavioral therapy and clomipramine in trichotillomania.

J Clin Psychiatry. Diseases of the skin appendages. Evaluation and diagnosis of the hair loss patient: part I. History and clinical examination. J Am Acad Dermatol. Trichorrhexis nodosa secondary to argininosuccinicaciduria. Trichorrhexis nodosa: a manifestation of hypothyroidism. Chemotherapy-induced alopecia. Semin Cutan Med Surg. Kanwar AJ, Narang T. Anagen effluvium.

Indian J Dermatol Venereol Leprol. Psychological sequelae and alopecia among women with cancer. Cancer Pract. Changes in self-concept and body image during alopecia induced cancer chemotherapy.

Support Care Cancer. Common hair loss disorders. Thiedke CC. Alopecia in women. This content is owned by the AAFP.

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Read the Issue. Sign Up Now. Sep 15, Issue. Hair Loss: Common Causes and Treatment. Author disclosure: No relevant financial affiliations. B 5 Alopecia areata can be treated with intralesional corticosteroids. B 11 Oral terbinafine Lamisil , itraconazole Sporanox , fluconazole Diflucan , or griseofulvin is recommended for treatment of children with tinea capitis caused by Trichophyton infections. B 2 Cognitive behavior therapy is effective for the treatment of trichotillomania, and medical therapy may be more effective when combined with cognitive behavior therapy.

Enlarge Print Table 2 Common Findings, Related Diagnoses, and Workup for Hair Loss Common findings Related diagnosis Diagnostic workup and comments Abrupt onset of hair loss Telogen effluvium related to a specific event Inquire about inciting event Gradual onset of hair loss Alopecia areata History and physical examination findings are diagnostic Pull test: increased telogen-to-anagen ratio greater than the normal ratio of Androgenetic alopecia Family history and specific patterns are important Scarring alopecias Refer if scarring is suspected Diffuse hair loss Alopecia totalis if more than scalp is involved Consider referral Systemic disease e.

Table 2 Common Findings, Related Diagnoses, and Workup for Hair Loss Common findings Related diagnosis Diagnostic workup and comments Abrupt onset of hair loss Telogen effluvium related to a specific event Inquire about inciting event Gradual onset of hair loss Alopecia areata History and physical examination findings are diagnostic Pull test: increased telogen-to-anagen ratio greater than the normal ratio of Androgenetic alopecia Family history and specific patterns are important Scarring alopecias Refer if scarring is suspected Diffuse hair loss Alopecia totalis if more than scalp is involved Consider referral Systemic disease e.

Enlarge Print Figure 1 Male pattern hair loss. Figure 1 Male pattern hair loss. Enlarge Print Figure 2 Female pattern hair loss. Figure 2 Female pattern hair loss. Enlarge Print Figure 3 Alopecia areata. Figure 3 Alopecia areata. Enlarge Print Figure 4 Exclamation point hair showing distal broken end of shaft and proximal club-shaped hair root.

Figure 4 Exclamation point hair showing distal broken end of shaft and proximal club-shaped hair root. Enlarge Print Figure 5 Hair loss from tinea capitis. Figure 5 Hair loss from tinea capitis. Enlarge Print Figure 6 Hair loss from trichotillomania. Figure 6 Hair loss from trichotillomania. Enlarge Print Figure 7 Hair loss from trichorrhexis nodosa. Figure 7 Hair loss from trichorrhexis nodosa. Read the full article. Get immediate access, anytime, anywhere. Choose a single article, issue, or full-access subscription.

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Navigate this Article. Alopecia areata can be treated with intralesional corticosteroids. Intralesional triamcinolone acetonide injected intradermally. With this treatment, the medicine that is applied to your scalp irritates your skin, making it red and scaly. It could take as long as three months to see hair growth if this treatment works. Contact immunotherapy does have side effects, including a severe rash and swollen lymph nodes in your neck.

It affects social interaction and self-confidence, as people are embarrassed to let others see their hair loss. It can also be frustrating to not know if your hair is going to grow back or fall out again. Consider joining a patient support group for people who have alopecia areata. Support groups give you a chance to talk about your condition. They help you realize you are not alone in your frustration with alopecia areata.

A support group can be a good resource for practical tips to deal with the condition. Hairstyling techniques or hair care products can help to cover bare patches on your head.

But some products can be harsh on your hair. This could cause additional damage and loss. You might want to talk with your doctor about what products to avoid. People who have alopecia areata are encouraged to be creative with hats, scarves, and wigs. Losing your eyelashes, eyebrows, and the hair in your nose and ears also can be a problem. Hair protects your eyes, nose, and ears from the irritation of dust, germs, and small, foreign particles.

Wear eyeglasses or sunglasses to protect your eyes. You can use antibiotic ointment inside your nose to help keep germs out. Be sure to cover areas of exposed scalp with a hat or sunscreen to reduce your risk of sunburn and skin cancer. American Academy of Dermatology, Alopecia areata. This article was contributed by: familydoctor. This information provides a general overview and may not apply to everyone.

Talk to your family doctor to find out if this information applies to you and to get more information on this subject. It is normal to shed some hair each day as part of this cycle. However, some people may experience….