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Alopecia areata: Signs and symptoms


What are the signs and symptoms of alopecia areata?

While alopecia areata often causes hair loss on the scalp, you can have hair loss on any part of your body. Some people develop hair loss on another area of the body, such as the eyelashes, eyebrows, or beard area (men only). Wherever the hair loss occurs, it happens without any signs of a rash, redness, or scarring.

A common sign of alopecia areata

The first sign of alopecia areata is often a round or oval bald patch on the scalp.


Pictures of alopecia areata

The following pictures show several ways this disease can cause hair loss, and how it can affect your nails. As you look at these pictures, notice that the affected skin often looks like someone shaved the area completely bald.

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.

Alopeica areata can cause a band of hair loss

Some people develop a band or strip of bald skin on their scalp, which is called ophiasis (oh-fee-ah-sis).

Widespread hair loss

Alopecia areata can also cause widespread hair loss, leaving a person with little hair on the head, and some people lose all the hair on their head.

Loss of eyelashes

Alopecia areata can cause partial or complete loss of eyelashes, eyebrows, or both.

Red nails

About 10% to 20% of people who have alopecia areata see changes to their nails, which can include red nails (shown here), pits in the nails, ridges that run the length of the nails, or nails that become so rough they feel like sandpaper.

Brittle nails

People who have a lot of hair loss can develop brittle nails that split.

Alopecia areata rarely causes symptoms

The only sign of alopecia areata is often sudden hair loss. The patches of hair loss can grow larger. Sometimes, the patches grow larger and become one large bald spot.

Other signs that you may have alopecia areata include:

  • Gray and white hairs often remain where you have hair loss

  • Hair starts to regrow on its own where it fell out

  • Hair begins growing in a bald spot and starts falling out in another area

  • Hair loss occurs during a colder month of the year

Cold may be a trigger for alopecia areata. In one study, researchers noticed that people diagnosed with alopecia areata most often had hair loss in November, followed by October and January. Patients had the fewest flare-ups during May and August.

If you have alopecia areata, it generally doesn’t cause pain or other symptoms. However, some people say that right before they lose their hair, they feel tingling, itching, or burning on the skin where the hair will fall out.

If you have alopecia universalis, which causes complete loss of hair everywhere on your body, your nails can become extremely brittle and crack. This can be painful.

While anyone can develop alopecia areata, some people have a higher risk. You can find out if you do at: Alopecia areata: Causes.


Images
1-5,7,8: Images used with permission of Journal of the American Academy of Dermatology: J Am Acad Dermatol. 2018; 78:1-12.

6: Image used with permission of the American Academy of Dermatology National Library of Dermatologic Teaching Slides.

References
Lipner SR, Scher RK. “Letter to the editor: Alopecia areata.” J Am Acad Dermatol 2018;79:e9-e10. Funding sources: None. Conflicts of interest: None disclosed.

Paus R, Olsen EA, et al. “Hair growth disorders.” In: Wolff K, Goldsmith LA, et al. Fitzpatrick’s Dermatology in General Medicine (seventh edition). McGraw Hill Medical, New York, 2008:764.

Putterman E, Castelo-SoccioL L. “Research Letters: Seasonal patterns in alopecia areata, totalis, and universalis. J Am Acad Dermatol 2018;79:974-975. Funding sources: None. Conflicts of interest: None disclosed.

Sperling LC. “Alopcias.” In: Bolognia JL, et al. Dermatology. (second edition). Mosby Elsevier, Spain, 2008:993-3.

Strazzulla LC, Wang EHC, et al. “Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis.” J Am Acad Dermatol 2018;78:1-12.

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