Who Gets Alopecia Areata?
Anyone can have alopecia areata. Men and women get it equally, and it affects all racial and ethnic groups. The onset can be at any age, but most people get it in their teens, twenties, or thirties. When it occurs in children younger than age 10, it tends to be more extensive and progressive.
If you have a close family member with the disease, you may have a higher risk of getting it, but for many people, there is no family history. Scientists have linked a number of genes to the disease, which suggests that genetics play a role in alopecia areata. Many of the genes they have found are important for the functioning of the immune system.
People with certain autoimmune diseases, such as psoriasis, thyroid disease, or vitiligo, are more likely to get alopecia areata, as are those with allergic conditions such as hay fever.
It is possible that emotional stress or an illness can bring on alopecia areata in people who are at risk, but in most cases, there is no obvious trigger.
Symptoms of Alopecia Areata
Alopecia areata primarily affects hair, but in some cases, there are nail changes as well. People with the disease are usually healthy and have no other symptoms.
Hair Changes
Alopecia areata typically begins with sudden loss of round or oval patches of hair on the scalp, but any part of the body may be affected, such as the beard area in men, or the eyebrows or eyelashes. Around the edges of the patch, there are often short broken hairs or “exclamation point” hairs that are narrower at their base than their tip. There is usually no sign of a rash, redness, or scarring on the bare patches. Some people say they feel tingling, burning, or itching on patches of skin right before the hair falls out.
When a bare patch develops, it is hard to predict what will happen next. The possibilities include:
- The hair regrows within a few months. It may look white or gray at first but may regain its natural color over time.
- Additional bare patches develop. Sometimes hair regrows in the first patch while new bare patches are forming.
- Small patches join to form larger ones. In rare cases, hair is eventually lost from the entire scalp, called alopecia totalis.
- There is a progression to complete loss of body hair, a type of the disease called alopecia universalis. This is rare.
In most cases, the hair regrows, but there may be subsequent episodes of hair loss.
The hair tends to regrow on its own more fully in people with:
- Less extensive hair loss.
- Later age of onset.
- No nail changes.
- No family history of the disease.
Nail Changes
Nail changes such as ridges and pits occur in some people, especially those who have more extensive hair loss.
