Alopecia Areata

Alopecia areata (hair loss in patches).

Alopecia Totalis (lose all hair on the scalp).

Alopecia Universalis (lose all hair on the body).

Patchy hair loss: The problem often begins with 1 or more coin-sized, round, smooth, bare patches where hair once was. You may first notice the problem when you see clumps of hair on your pillow or in the shower.
Hair loss occurs mostly on the scalp. But it can involve eyebrows, eyelashes, beards — any hair-bearing site. Patches vary in size.

“Exclamation mark” hairs: Often, a few short hairs occur in or at the edges of the bare spots. These hairs get narrower at the bottom, like an exclamation mark.

Widespread hair loss: With time, some patients go bald. Some lose all their body hair, too. This is not common. Also uncommon is a band of hair loss at the back of the scalp.
Alopecia areata: Nails can have dents, white spots, and roughness.

Nail problems: Alopecia areata also can affect your fingernails and toenails. Nails can have tiny pinpoint dents (pitting). They also can have white spots or lines, be rough, lose their shine, or become thin and split. Rarely nails change shape or fall off.
Sometimes nail changes are the first sign of alopecia areata.

Sometimes a dermatologist can diagnose alopecia areata by looking at the hair loss.

If the patch of hair loss is expanding, the doctor may pull out a few hairs. These hairs will be looked at under a microscope.

Sometimes the dermatologist will perform a skin biopsy to confirm that the disease is alopecia areata. To perform a skin biopsy, the dermatologist removes a small piece of skin so that it can be studied under a microscope.

Blood tests may be necessary if the dermatologist thinks the patient might have another autoimmune disease.