“I have small round ball spots – what’s going on?!” My friend, it sounds like you have Alopecia areata.

Alopecia areata, also known as spot baldness, is an autoimmune disorder that causes a patch of hair to fall out on the body. This is most commonly seen on the scalp, and can be about the size of a coin. While ‘uncommon’ amongst the majority of the population, it affects about 4.7 million people in the United states –to men and women equally, and it’s causes are unknown, though can be triggered by illness or stress.

First of all, is alopecia areata permanent?

The good news is that alopecia areata is usually not permanent, and that hair can eventually grow back for some people. However, just because you suffer from it once does not mean that it will not reoccur again. The disease varies from person to person and it is very difficult to predict when, and if, the disease will strike again.

For some unlucky people, the bald patches are permanent and the hair doesn’t grow back, no matter how many oils you rub on the spot. You’re more likely for the condition to be permanent if:

• There is a family history of the condition
• The condition occurs for more than one year, or arises before puberty.
• You have extensive hair loss
• There is abnormalities to your fingernails or toenails, including colour, shape, texture or thickness
• You are prone to allergies
• You have other autoimmune diseases

Where does alopecia occur on the body? 

While the hair loss is most noticeable on the head, it can occur anywhere on the body, from your legs, arms, back, chest or beard. The hair loss associated with alopecia areata can be unpredictable and random. The size and extent of the hair loss can vary from person-to-person and can be difficult to predict where and when it will occur next.

What causes alopecia areata?

The condition is triggered by an abnormality in the immune system that results in autoimmunity, when the immune system mistakes healthy cells for foreign substances. Normally, your immune system defends your body against viruses and bacteria, however with alopecia areata, the immune system mistakenly attacks hair follicles, making them become smaller and stop producing hair leading to hair loss and bald patches. The disease is not contagious.

The exact cause of this condition is still not known, however certain factors can increase the likelihood of you contracting this disease. This includes:

• Those who have a family history of autoimmune diseases (eg diabetes or arthritis)
• Those who have affected family members (suggesting the heredity may be a factor)

Alopecia areata is rare before the age of 3 years, but can affect all age groups, occurring most often in adults between 30 – 60 years of age. In fact, 50% of people who suffer from alopecia areata develop their first episode of hair loss before the age of 18.

How do I know if I have alopecia areata?

The signs and symptoms of alopecia areata are small, circle areas of hairless skin. They can be the size of small coins and you may start with one or two bare patches where hair once was. While most often seen on the scalp, it can occur wherever there is hair on the body; the beard, eyebrows, even eyelashes.

Bald patches are not the only way to diagnose the condition. Other signs to look out for are fractures hairs, short, thin hairs, grey hairs in bald areas, and yellow areas of skin deposition at the follicular orifice. Often, a medical professional will want to perform a biopsy on the scalp to confirm the diagnosis.

 What is the treatment for alopecia areata?

There are a variety of treatments for this condition, however none of the treatments can accurately predict or impact the course of the disease. Some options are steroid injections, which can be helpful in restarting the hair growth cycle in affected areas, or steroid creams, lotions and shampoos.

What can I do to hide my bald spots?

As the emotional effect of balding spots due to alopecia areata can be significant in both men and women, one of the best ways to manage alopecia areata is to camouflage the area. Here are some things you can do to reduce the effect on your looks:

• Try wearing a wig, hairpiece, hat or scarf
• Use hair coloured crayon, cream, or powder and apply to the scalp to make the hair loss less obvious

Physical dangers associated to alopecia areata

If you suffer from bald spots, there are considerations you’ll need to make to ensure you reduce your discomfort or physical dangers you may encounter. These include:

• If your eyelashes or eyebrows are missing, wear sunglasses to protect your eyes from dust, debris and sun.
• If your nostril hair is missing, apply antibiotic ointment inside your nostrils to keep the germs out.
• Use sunscreen to protect the exposed skin on your scalp and face.
• Wear scarves, hats or wigs to protect your scalp from the sun or keep your head warm in cool weather.