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AARP is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age. Get instant access to members-only products and hundreds of discounts, a free second membership, and a subscription to AARP the Magazine. Hair loss can affect quality of life and can be mentally and emotionally damaging. Loss of eyelashes usually develops on both eyes, causing some eyelashes on both the upper and lower eyelids to fall out. However, the psychological impact can be significant, therefore warranting treatment.
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Ultimately, the cause of alopecia areata is likely multifactorial, says Dr. Costello. It is common for people to get confused about the types of alopecia, says Collin M. Costello, M.D., a Mayo Clinic dermatologist who specializes in treating all types of alopecia. But excessive hair shedding, particularly in patches on the scalp, could be a sign of alopecia areata. This is one of those conditions where the body's immune system, which usually fights off germs, accidentally attacks itself.
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A doctor may also order blood tests to check for another disease or condition that may cause hair loss, such as iron deficiency or thyroid disease. According to the NAAF, children ages 5 years and younger typically don’t experience much of an emotional impact from alopecia. However, after age 5, hair loss can be traumatizing for children as they start noticing differences in their hair compared with others.
Symptoms and Diagnosis
Most people with alopecia areata will have only one or a few circular patches of hair loss involving the scalp, eyebrows, eyelashes, and/or body. Others, however, experience extensive, and sometimes total, hair loss. Spontaneous hair regrowth and recovery may occur and is common in some reports. Relapse is also common, however, and patients may have several phases of hair loss and subsequent regrowth. The risk of progression to alopecia totalis or alopecia universalis is approximately 5–10%, from which recovery is unlikely.
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What is the outcome for alopecia areata?
Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include Micromedex (updated 1 Apr 2024), Cerner Multum™ (updated 21 Apr 2024), ASHP (updated 10 Apr 2024) and others. People with certain diseases, such as psoriasis, and those with allergic conditions such as hay fever are more likely to get alopecia areata. How your child reacts to having alopecia areata depends on many factors, ranging from age to the kind of support they have from family, friends, and the people around them.
“Opt for hairstyles that minimize tension on the hair follicles, such as loose braids, buns or ponytails,” advises Gaboardi. “Avoid tight hairstyles and hair accessories that pull on the hair and handle your hair with care to minimise breakage and damage. Female pattern baldness often results in thinning all over the scalp and might look like widening or thinning around the part. It typically occurs after age 65 but, for some females, it can begin early in their lives.
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Vitamins are essential nutrients that play a crucial role in hair health and getting the adequate amount is important. Newer treatments that are also being explored include some forms of laser therapy, microneedling with PRP, as well as other oral medications. Many of these treatments are still in the early testing phases though, and more research will be necessary. If they suspect an autoimmune or skin condition, they might take a biopsy of the skin on your scalp. This involves carefully removing several small sections of skin for laboratory testing. Because so many things can cause hair loss, it’s best to schedule an appointment with a medical professional if you notice any changes in your hair.
The condition tends to be milder if it comes on at an older age. In the UK, alopecia areata is estimated to affect about 15 in 10,000 people. Many other therapies can be tried if corticosteroids or topical treatments have not provided the desired improvements. Examples include a short course of oral corticosteroids (such as prednisone) and immunotherapy (such as baricitinib or ritlecitinib). In most cases, the hair regrows, but more hair loss may follow.
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Increasing strengths of this substance are placed on the affected skin once a week over several weeks until the skin looks like it has mild dermatitis (eczema). The skin reaction seems to affect the process involved in causing alopecia areata in some way to allow hair to regrow. It is thought that topical immunotherapy is the most effective option for people with extensive alopecia areata. This is a very specialised treatment that is only available in some hospitals.
Doctors aren’t sure what causes alopecia areata, but they think it’s linked to certain genes and environmental triggers. Some people notice the hairs around the patches are short and broken. They may have the shape of an exclamation point, with a narrow base and thin tip.
However, a negative test result does not necessarily exclude those conditions. Doctors often prescribe oral medications to be used along with topical minoxidil because studies show the combination boosts hair production. Low-dose oral minoxidil (prescribed off-label) has been found to be effective and safe for most patients, Mirmirani says. Other oft-used drugs include finasteride (Propecia) and spironolactone. By contrast, scarring alopecia, another autoimmune disease that causes hair loss, is often accompanied by itchiness, tenderness and scaling of the scalp. Scarring alopecia is the most devastating type of hair loss, Mirmirani says, because it permanently destroys the hair follicles.
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