Alopecia Areata
Introduction
Alopecia areata (a-luh-pee-shee-uh a- ree-uh- tuh) is a patchy hair loss condition that most commonly involves the scalp, and sometimes other body areas containing hair, such as the eyebrows and eyelashes. The amount of hair loss varies from child to child, with some children having only a few patches of hair loss, and others experiencing complete loss of scalp or body hair.
.png)
Child with patchy scalp hair loss in alopecia areata with some regrowth
Who gets it?
Approximately 1 in 50 people will develop this condition over their lifetime. It most commonly starts in childhood or adolescence, although it can occur in any age. This condition affects both boys and girls equally.
What causes it?
Alopecia areata is thought to arise from an abnormal immune response to our growing hairs. This immune response causes the hair to shed at a faster rate than expected. The hair follicle (where hair is produced) is not affected during this process, and so hair regrowth is possible. Children who have a family member affected by alopecia areata or other immune related disorders (known as autoimmune disorders) are at a higher risk of developing this condition. Episodes of hair loss in alopecia areata may be triggered by:
Infections
Certain medications
Trauma
Physical or emotional stress
Children who have alopecia areata are also at a higher risk of having other autoimmune conditions like vitiligo (a skin condition that causes white skin) or thyroid problems.
What does it look and feel like?
Looks like...
Single or multiple patches of hair loss (known as alopecia areata)
Loss of all scalp hair (known as alopecia areata totalis)
Loss of all hair on the body (known as alopecia areata universalis)
Hair that regrows in areas of previous hair loss
White hairs in patches of hair loss
Normal appearing skin in the areas of hair loss
Small indentations on the nails
Feels like...
This condition is not painful or itchy
What tests might be needed?
Often no testing is required to identify and treat alopecia areata. If your doctor is concerned that another condition may be causing your child's hair loss, they may perform some blood tests or take a small sample of your child's skin (biopsy) to look under the microscope.
What treatments are available?
A doctor or dermatologist can provide a range of medical or non-medical treatment options for managing your child's alopecia areata. This may include arranging professional mental support to help cope with this condition.
What can I do?
If there are large parts of the scalp with hair missing children may find that hair wigs and hair pieces are an excellent way of covering areas of scalp hair loss. If the eyelashes are affected, artificial eyelashes can be attached with the help of special glues. If the eyebrows are affected, artificial eyebrows can be attached. Other options include using an eyebrow pencil, where the eyebrows can be coloured in, or having a tattoo to provide permanent eyebrow colour when the child is a bit older to tolerate these procedures.
Medical therapies
In general, the earlier treatment is started the better the outcome for regrowing your child's hair. It is important to remember that not all treatments work in all children and sometimes it is a matter of trialling the simplest, safest treatments first before escalating to stronger options. The dermatolgist may prescribe one or more of these treatments:
Steroid creams to apply on areas of hair loss
Minoxidil solution or foam
Anthralin cream or DCP cream
Steroid injections to affected hair loss areas (to help promote hair regrowth)
Ultraviolet light treatment to affected areas shortly after applying a cream or taking a tablet
Steroid tablets to take for a short period of time
Immune modifying medicines in children who have larger areas of hair loss or are rapidly losing hair. These are oral tablets that interact with the immune system to help promote hair regrowth
What happens after treatment?
Most children with alopecia areata can expect some hair regrowth over time. Children who have one or multiple patches of hair loss may find that these patches will have some hair growth within 6 months to a year, even without any treatments. Unfortunately, one third of children with this condition will experience ongoing hair loss. However, the treatment for alopecia areata is constantly evolving, with some new experimental medications showing promising results.
What support is available?
The National Alopecia Areata Foundation is an organisation that is dedicated to supporting and informing children and their families about alopecia areata. They are able to assist in:
Becoming involved in a local community support group
Organising mentorship as part of the Youth Mentor Program
Joining their online community network with other people who are also affected by alopecia areata
Providing an information package about the condition
Providing guides on using cosmetic treatments for alopecia areata
To sign up for any of these features, or to find out more about this foundation, please visit their website on https://www.naaf.org/
Authors/Reviewers:
Author: Dr Akshay Flora
Paediatric Reviewer: Dr Mayuri Sivagnanam
Editor in Chief: Dr Tevi Wain
