Circular hair loss (alopecia areata)

Cir­cu­lar hair loss, medi­cal­ly known as alo­pe­cia area­ta, is a com­mon form of hair loss in which cir­cu­lar bald patches form on one or more are­as of the head. Around one to two per­cent of the popu­la­ti­on are affec­ted in the cour­se of their lives. The con­di­ti­on can occur at any age, but often beg­ins in child­hood or young adulthood.

Cau­ses

Men and women are affec­ted equal­ly often. The cau­se is an auto­im­mu­ne reac­tion in which the body­’s own immu­ne sys­tem mista­ken­ly attacks the hair roots and cau­ses inflamm­a­ti­on. The hair falls out, but the hair roots remain int­act so that the hair can, in prin­ci­ple, grow back. Why the immu­ne sys­tem is mis­di­rec­ted is not ful­ly unders­tood. Gene­tic fac­tors play a role, as the dise­a­se runs in fami­lies. Psy­cho­lo­gi­cal stress is also dis­cus­sed as a pos­si­ble trigger.

Sym­ptoms

The dise­a­se mani­fests its­elf in the form of sud­den­ly appearing, usual­ly cir­cu­lar bald patches on the head. The skin in the­se are­as is smooth, not red­den­ed or sca­ly. At the edge of the bald patches the­re are often so-cal­led excla­ma­ti­on mark hairs, which beco­me thin­ner towards the end. In seve­re cases, all the hair on the head may fall out or even the enti­re body hair. The fin­ger­nails can also be affec­ted and show pits or grooves.

The dia­gno­sis is made cli­ni­cal­ly based on the typi­cal appearance. A hair-pul­ling test can be car­ri­ed out, in which hair can be easi­ly pul­led out from the edges of the bald patches. In unclear cases, a scalp bio­psy can be performed.

Tre­at­ment

Tre­at­ment is dif­fi­cult as the­re is no the­ra­py with gua­ran­teed suc­cess. Small are­as can be trea­ted with a wait-and-see approach, as the hair often grows back on its own. Solu­ti­ons or creams con­tai­ning cor­ti­so­ne can be appli­ed local­ly. In the case of exten­si­ve infe­sta­ti­on, cor­ti­so­ne injec­tions into the scalp or sys­te­mic cor­ti­so­ne the­ra­py can be con­side­red. The pro­gno­sis varies great­ly: for many suf­fe­rers, the hair grows back within a year, for others the dise­a­se is chro­nic with recur­ring relapses.

Rela­ted tre­at­ment at Swiss Der­ma Cli­nic: Hair loss treatment