Bahr Dermatology


What Us Alopecia Areata?

Alopecia areata is an autoimmune disease that causes hair loss in children, women, and men. It usually begins with a few bald Spots or areas on the scalp. It is possible to lose hair anywhere on your body, though. Some people have noticeable hair loss on their eyebrows and/or eyelashes. Men also can have noticeable loss of facial hair that causes patches of bare skin in the beard area.

Why Do People Lose Their Hair?

Alopecia areata causes the person's immune system to mistakenly attack the body‘s hair follicles, as it would germs. This causes the hair in those follicles to fall out and stop growing.

Does The Hair Grow Back?

This varies from person to person. It is likely that your hair will regrow but it also may fall out again. This cycle of hair loss and regrowth is unpredictable. Some people develop a few bald patches. After their hair regrows, they never may experience more hair loss. While others may lose most of their hair.

No matter how much hair a person loses, hair regrowth is usually possible. When the hair regrows, it may grow in white or blonde and finer than before. This is usually temporary. With time, the person's natural hair color and texture often return.

Are There Other Signs & Symptoms?

Aside from hair loss, people with alopecia areata also may notice:

  • Nail changes: Dents, white spots, roughness, thinning, or splitting
  • Itching or other minor discomfort: On skin where hair loss will soon begin or has already occurred
  • Sinus or eye irritation: If eyebrows or eyelashes are lost

Is Alopecia Areata A Sign Of Something Serious?

The majority of individuals who develop alopecia are otherwise healthy and do not
develop other autoimmune diseases.

Having an autoimmune disease like alopecia areata may increase an individual's risk of developing another. Examples include thyroid disease or vitiligo, which is a condition that causes pigment loss in the skin. Individuals with alopecia areata may also have a higher risk of developing an allergic condition such as eczema, asthma, or nasal allergies.

Who Gets Alopecia Areata?

Many people have Alopecia Areata- nearly 6.5 million people in the United States. Alopecia Areata usually appears with children and teenagers, but it can actually start at any age. Alopecia Areata can appear in individuals of of all races and sexes. About 1/5 of individuals with Alopecia have a blood relative who also has it.

How Does A Dermatologists Diagnose Alopecia Areata?

Dr. Bahr can identify alopecia areata by simply observing the areas with hair loss. Occasionally he will need to collect a few hairs or perform a biopsy of the affected area, then examining it under a microscope.

Dr. Bahr may be assign one of the following diagnoses: 

  • Alopecia Areata: Patches of hair loss 
  • Alopecia Totalis: Loss of all hair on the scalp
  • Alopecia Universalis: Loss of all hair on the body 


What Treatment Is Available For Alopecia Areata?

Many people find that their hair regrows without treatment. Hair regrowth can be slow. Though, some people do not see the hair regrowth they expect.

Dermatologists can treat patients affected by alopecia areata. If you have patches of hair loss on the scalp or elsewhere, the treatment plan may include one or more of the following treatments:

    This medicine calms the immune system which can prevent it from attacking the hair follicles. When treating alopecia areata, our dermatologist will either prescribe a topical steroid to apply to the skin or will inject the corticosteroid into the bald area.

    If you are prescribed topical steroids. The steroids need to be applied daily to the areas of hair loss. Hair regrowth may begin after three to four months of treatment. If you receive injections of corticosteroids, you will need several shots every three to six weeks. When effective, patients usually see signs of hair regrowth about four weeks after receiving the first injection.

    Our dermatologist may prescribe an oral (taken by mouth) corticosteroid pill if a patient has extensive hair loss. Not every patient with extensive hair loss receives this treatment. The risks and benefits should be considered carefully before starting oral corticosteroids particularly in children.

    People use this popular treatment to regrow hair. Our dermatologist may prescribe topical minoxidil as an agent that can help hair growth in many hair loss conditions. including alopecia areata. Topical minoxidil comes in various strengths with the 5% formula being most effective for alopecia areata. Minoxidil must be applied twice a day to areas where you want to see hair regrowth. When effective, you will see signs of hair growth in about 12 weeks.

    This tar-like substance calms the immune system. Patients apply anthralin daily to areas where they want to see hair regrowth. It is left on the skin for 15-20 minutes. Patients can add more time if the treatment does not irritate the skin. When effective, a patient usually sees some hair growth in the treated areas in three to four months.

When a patient has extensive hair loss a treatment plan may include:

    These are chemicals such as squaric acid dibutyl ester or diphencyprone, which when applied to the skin, may cause what looks like an allergic reaction. The skin will appear red, may swell and can itch. This allergic reaction causes the body to trigger the hair follicles awake, often resulting in hair regrowth. If hair regrowth occurs, it can take three months. As with other topical treatments for alopecia areata, patients need to continue applying the medicine until the disease stops causing hair loss.

  • ORAL TREATMENTS Our dermatologist may recommend an oral treatment. This could include methotrexate, cyclosporine or other immunomodulators. These medications have serious side effects that you should discuss with your dermatologist.

Alternatives To Medicine

Some patients want to avoid medicine. Others have trouble coping with the hair loss while treatment is going on, or if treatment has failed. For these patients, the following options can be helpful:

    Covering your head does not interfere with hair regrowth. This option may help some people feel more comfortable in public, at work, or at school.

    Coping with hair loss can be difficult. Joining a support group can help restore self-esteem. Many people feel inspired when they connect with others.
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