What is alopecia areata?

Alopecia means hair loss, and there are several types. Alopecia areata is one of the most common hair loss disorders characterized by loss of hair in round patches, usually on the scalp.

WHAT CAUSES ALOPECIA AREATA?

The exact cause of alopecia areata is unknown, but it seems to be caused by the immune system attacking the hair follicles by mistake. The hair follicle is the pocket at the base of the skin that grows and holds the hair. When the follicle is attacked, this causes the hair to fall out just below the surface of the skin. The scalp itself is usually perfectly normal. Occasionally, the scalp itches slightly, but usually there are no associated symptoms.

WHAT ARE THE DIFFERENT TYPES OF ALOPECIA?

There are three distinct forms of alopecia areata. The type depends on how much hair is lost:

  • ALOPECIA AREATA: this is the most common type. People with alopecia areata have round, well-defined patches of hair loss, sometimes only one or few spots.
  • ALOPECIA TOTALIS: loss of all hair on the scalp.
  • ALOPECIA UNIVERSALIS: loss of all scalp and body hair.

HOW IS THE DIAGNOSIS OF ALOPECIA MADE?

Your child’s doctor will diagnose alopecia areata by examining your child and talking to your family. Testing is not usually needed to make the diagnosis. Most children with alopecia areata are otherwise healthy. In some children with alopecia areata, the immune system may also attack other organs of the body, such as the thyroid. Your doctor may order some tests to see if other organs of the body are affected.

WHAT CAN I EXPECT FROM TREATMENT OF ALOPECIA AREATA?

Your doctor may decide not to give your child any treatment for alopecia areata at first. Sometimes the hair can grow back on its own. A “wait and see” approach may be the best option in some children.

Other times, your doctor might decide to treat. Some treatments for alopecia areata include:

  • topical steroid creams or ointments
  • steroid injections into the bald patches
  • contact sensitizers, such as squaric acid or DPCP
  • other topical medications, like anthralin or minoxidil

These treatments are helpful in some patients, but not all children respond to therapy. Even with a good response to treatment, the hair may fall out again in the future. Treatment may help treat the bald patches that already exist, but these treatments do not prevent new ones from forming.

HOW CAN I HELP SUPPORT MY CHILD WITH ALOPECIA AREATA?

  • Educate your child about alopecia areata. Be open and honest and support your child.
  • Discuss the diagnosis with your child’s teacher and principal. If they know what your child has, they will be better able to support your child in the school setting as well. Give your child the option of informing classmates.
  • Help your child learn what to say if someone asks about the hair loss. This can be a simple answer such as “I have alopecia” or anything they are comfortable responding. Having a prepared response helps some children to handle questions more easily.
  • Children and adults are often curious about whether alopecia areata is contagious and whether it is a sign of cancer. You and your child can tell them that it is neither contagious, nor a sign of cancer.
  • Provide your child with positive messages and praise. Your outlook has a great impact on how your child feels about himself. Self-esteem is crucial.
  • Model good problem-solving and ways to cope. This means that it is alright to show and share your feelings. If you or your child have a hard time coping and it affects your everyday life, you may want to consider speaking with a counselor.
  • Listen to your child. It is important that your child has someone that they trust and talk to. This person can be a friend, family member, or counselor.
  • Encourage your child to pursue things she loves and guide her toward activities that help her feel good about herself.
  • Give your child the choice to interact with other children who have alopecia. This allows them to share their experiences and know they are not alone.
  • Another way to cope with this disease is to minimize the effect on the child’s appearance. Your child may want to wear a wig, hat or bandana.

WHAT OTHER RESOURCES ARE THERE FOR FAMILIES?

There are several resources to provide support and education for families with alopecia:

National Alopecia Areata Foundation
P.O. Box 150760
San Rafael, CA 94915-0760
Phone: (415) 472-3780
Fax: (415) 472-5343
Website: www.naaf.org
E-mail: info@naaf.org

The Childrens Alopecia Project
childrensalopeciaproject.org

National Alopecia Areata Registry
The National Alopecia Areata Registry collects patient information in an effort to identify the cause(s) of alopecia areata.
Toll-free number: (866) 837-1050

© 2016 The Society for Pediatric Dermatology