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Alopecia Areata

Treatment at Auro Skin Clinic

The treatment options available for Alopecia Areata Treatment at Auro Skin Clinic are:

  • Diagnosis for alopecia areata is made clinically and with help of Dermatoscope- Dermlite DN3, Dinoscope- video dermascope. 

  • Serial photographs of alopecia patches are taken for result monitoring. 

  • Medical line of treatment is always the first choice for alopecia areata.

  • Intralesional steroids is the other option for faster recovery in alopecia areata.

  • We provide Phototherapy in the form of Excimer Laser light treatment, for Alopecia areata, which is done once a week. This gives excellent results, especially in patients who are not willing for injections, or had side effects due to topical steroids.

  • If needed PRP- Platelet rich plasma procedure can also be added to the treatment for extensive patches.

What is Alopecia areata?

  • Herpes zoster is a skin rash which occurs when a virus (varicella-zoster virus) in the nerve cells becomes active again later in life.

  • The varicella-zoster virus is the same virus that causes chickenpox. Once you have had chickenpox, varicella-zoster virus remains in your body's nerve tissues and never really goes away. It can be reactivated later in life causing Herpes zoster.

What are the causes of Alopecia areata?

  • Alopecia areata is considered to be an autoimmune disease. This occurs when the body’s own immune system damages its healthy cells. 

  • In Alopecia areata, white blood cells gather around the affected hair roots (hair follicles). This causes inflammation which leads to hair loss.

  • Genetics, stress, atopy and environmental factors play a role. 

  • It is not a hereditary condition.

How does Alopecia areata manifest?

  • It typically occurs as one or more round bald patches, in the size of a coin on the scalp. It can affect any hairy area of the body. Hair loss may be seen on the scalp,

  • Beard, mustache, eyebrows, eyelashes or body hair may also be lost. 

  • In 90% patients- scalp is the commonest site. Apart from the bald patches, the scalp usually looks healthy and there is no scarring. 

  • In nails- sometimes pits, ridges can be seen.

What is the course of the disease?

  • It is difficult to predict the progress of a bald patch of Alopecia areata. 

  • Usually the hair regrows within a few months. Initially it is grey or white in color and normal color returns after several months.

  • At times, one or more bald patches develop a few weeks after the first one. Large bald patches can also develop. 

  • Patches of body hair, beard, eyebrows or eyelashes may be affected in some cases.

  • Sometimes, the entire scalp hair is lost. This is called Alopecia totalis. 

  • In a small number of cases, all body hair including- scalp, body, beard, eyebrows and eyelashes are lost. This is called Alopecia universalis.

What should one do if he/ she gets Alopecia areata?

  • Consult a dermatologist since it can be easily diagnosed by the dermatologist by the clinical appearance of the lesion.

  • Appropriate counseling, topical therapy and medications will be recommended by the dermatologist as per the needs.

Are there any tests to diagnose Alopecia areata?

  • Usually no tests are required. The diagnosis is usually confirmed by clinical examination and it is based on the typical appearance of the bald patches. A dermatoscopy may aid the clinical diagnosis.

  • Blood tests may be advised to check for other auto-immune diseases and a skin scraping or biopsy may be done to rule out other causes of hair loss.

What are the treatment options in Alopecia areata?

  • Alopecia areata is a very unpredictable condition. In many cases, bald patches regrow by themselves without treatment. If the hair loss becomes more extensive then the decision on whether to treat may be considered.

  • Injections of steroid (Triamcinolone acetonide) into the bald patches of the scalp suppress the local immune reaction that occurs in Alopecia areata and allows the regrowth. This treatment may be an option for one or more small- to medium-sized bald patches. 

  • This treatment should only be done by a skin specialist.

  • Large bald areas are not suitable for steroid injections.

  • Injections are repeated every 4-6 weeks. 

  • There is no guarantee that any hair re-grown during treatment will persist.

  • Steroid cream, gel, etc, can be used but these are not as effective as steroid injections. Topical steroids are to be strictly used under medical supervision and prolonged use should be avoided. 

  • Topical corticosteroid sparing agents such as tacrolimus can be used in sites such as eyebrows

  • Applied to the bald patches and has been shown to promote hair re-growth in some cases.

  • Topical immunotherapy is the most effective option for people with extensive Alopecia areata.

  • Substances like diphenylcyclopropenone (DPCP) is applied on affected skin to make the skin react like an allergy or dermatitis (eczema). The skin reaction affects the process involved in causing Alopecia areata to regrow hair.

  • Phototherapy has been used with limited success with either psoralen combined with ultraviolet A (PUVA) or narrow band UVB therapy.

  • Systemic steroids are used for rapidly progressive and extensive involvement as long term or short term treatment. Immunosuppressive drugs such as cyclosporine, azathioprine or methotrexate may be used. 

  • Wigs are considered in resistant cases.

  • Tattooing can be considered in case of eyebrow hair loss for cosmetic reasons.

Can Alopecia patches progress from one bald patch to extensive involvement?

  • Bald patches are commonly localized to the scalp and can grow spontaneously or improve with treatment.

  • Progression to extensive involvement is common if:

  • The bald patches start in childhood. 

  • If there is history of atopic eczema(A type of skin allergy). 

  • If there is a family history of Alopecia areata.

  • The initial bout of hair loss affects more than half of scalp area. 

  • When eyelashes and/or eyebrows are involved. Hair loss is around the scalp margin. 

  • Nail changes are present. 

  • Underlying autoimmune disease like vitiligo, lichen planus, thyroid disorders or diabetes mellitus may be present

Can Alopecia areata reoccur?

  • Spontaneous regrowth is usually seen in 80% of cases, without treatment within a few months to a year.

  • The course of disease is unpredictable and recurrence may occur in few cases.


The above clinical content is published by The Indian Association of Dermatologists, Venereologists and Leprologists (IADVL) for circulation amongst patients for their education purposes.


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