Alopecia

Expert Answers on Alopecia

In today’s Science Times, Claudia Dreifus interviews Angela Christiano, a researcher who began studying hair loss after a hairdresser discovered a bald spot at the back of her head. She has since discovered several genes that contribute to alopecia areata, a fairly common condition that causes hair loss, either in discrete patches or all over the body.

Dozens of readers had questions about alopecia areata when it was featured earlier this year in an installment of the Patient Voices multimedia seriesand in Science Times, “A ‘Forest Fire of Hair Loss’ and Its Scars.” This week, Dr. Wilma F. Bergfeld, a dermatologist at the Cleveland Clinic and an expert on hair disorders, joins the Consults blog to answer many of these questions. Dr. Bergfeld serves as director of the dermatopathology fellowship and professor of dermatology and pathology at the Cleveland Clinic Educational Foundation and is also an asssociate clinical professor in the department of dermatology at Case Western Reserve University. See her responses below.

Is Alopecia a Lifelong Condition?

Q.

When my daughter was 9 she was diagnosed with alopecia areata and eventually lost about 90 percent of the hair on her head. She tried many treatments, including steroids and other topical treatments, including daily application of men’s Rogaine, but none appeared to work. At age 13, she entered puberty and spontaneously began to grow her hair back, and now at age 17, she has more hair on her head than anyone I know.

I am wondering if there is a time after which she can have some assurance that she will not lose her hair again? If she goes, say, five years with no signs of bald patches, is there a greater chance that she will not lose her hair again? Are there any warning signs, other than the appearance of a bald patch, that she may be about to lose her hair ?
cf, New York

A.

Dr. Bergfeld responds:

Alopecia areata is a lifelong disorder. Most individuals have patches of hair loss that come and go with triggers: stress, metabolic or endocrine disorders, and even nutritional deficiencies. Alopecia totalis, which involves loss of all the hair on the scalp, accounts for about 20 percent of all cases of alopecia areata. Once alopecia totalis occurs, there is a heightened tendency for it to recur. It is prudent to treat even patchy alopecia areata in these types of patients.





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