Introduction

Alopecia areata is a presumed autoimmune condition causing localised, well demarcated patches of hair loss.

Epidemiology

  • Incidence: 21.00 cases per 100,000 person-years
  • Peak incidence: 20-30 years
  • Sex ratio: 1:1
<1 1-5 6+ 16+ 30+ 40+ 50+ 60+ 70+ 80+

Clinical features

Well-demarcated, coin-like areas of hair loss on the scalp or beard.

At the edge of the hair loss, there may be small, broken 'exclamation mark' hairs

Management

Hair will regrow in 50% of patients by 1 year, and in 80-90% eventually. Careful explanation is therefore sufficient in many patients. Other treatment options include:
  • topical or intralesional corticosteroids
  • topical minoxidil
  • phototherapy
  • dithranol
  • contact immunotherapy
  • wigs