eMedicine Specialties > Dermatology > Diseases of the Adnexa

Alopecia Areata: Follow-up

Author: Chantal Bolduc, MD, FRCP(C), Assistant Professor, Department of Dermatology, University of Montreal
Coauthor(s): Harvey Lui, MD, FRCPC, Professor and Head, Department of Dermatology and Skin Science, Vancouver General Hospital, University of British Columbia; Medical Director, The Skin Centre, Lions Laser Skin Centre and Psoriasis and Phototherapy Clinic, Vancouver General Hospital; Jerry Shapiro, MD, FRCP(C), Clinical Associate Professor, Department of Medicine, Division of Dermatology, University of British Columbia, Canada
Contributor Information and Disclosures

Updated: Apr 13, 2009

Follow-up

Deterrence/Prevention

  • Alopecia areata is highly unpredictable. No treatment is effective in preventing or halting progression of the condition. No trigger can be found to explain disease exacerbation in most patients.

Prognosis

  • The natural history of alopecia areata is unpredictable. Most patients have only a few focal areas of alopecia, and spontaneous regrowth usually occurs within 1 year.
  • Estimates indicate less than 10% of patients experience extensive alopecia and less than 1% have alopecia universalis.
  • Patients with extensive longstanding conditions are less likely to experience significant long-lasting regrowth.
  • Adverse prognostic factors include nail abnormalities, atopy, onset at a young age, and severe forms of alopecia areata.

Patient Education

  • Patient education is a key factor in alopecia areata. Inform patients of the chronic relapsing nature of alopecia areata. Reassure patients that the condition is benign and does not threaten their general health.
  • Most patients try to find an explanation about why this is happening to them. Reassure these patients that they have done nothing wrong and that it is not their fault.
  • Inform patients that expectations regarding therapy should be realistic.
  • Support groups are available in many cities; it is strongly recommended that patients be urged to contact the National Alopecia Areata Foundation at 710 C St, Suite 11, San Rafael, CA94901 or view the Web site.
  • Many patients are reluctant to use hairpieces or take part in support groups because, at first, these often are perceived as last-resort options. Take the time to discuss the options with patients because they are of great benefit.

Miscellaneous

Medicolegal Pitfalls

 


More on Alopecia Areata

Overview: Alopecia Areata
Differential Diagnoses & Workup: Alopecia Areata
Treatment & Medication: Alopecia Areata
Follow-up: Alopecia Areata
Multimedia: Alopecia Areata
References
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References

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Further Reading

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Keywords

alopecia areata, hair loss, autoimmune alopecia, baldness

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Contributor Information and Disclosures

Author

Chantal Bolduc, MD, FRCP(C), Assistant Professor, Department of Dermatology, University of Montreal
Disclosure: Nothing to disclose.

Coauthor(s)

Harvey Lui, MD, FRCPC, Professor and Head, Department of Dermatology and Skin Science, Vancouver General Hospital, University of British Columbia; Medical Director, The Skin Centre, Lions Laser Skin Centre and Psoriasis and Phototherapy Clinic, Vancouver General Hospital
Harvey Lui, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Society for Laser Medicine and Surgery, American Society for Photobiology, Canadian Dermatology Association, Canadian Dermatology Foundation, Canadian Medical Association, College of Physicians and Surgeons of British Columbia, Dermatology Foundation, European Academy of Dermatology and Venereology, National Psoriasis Foundation, North American Hair Research Society, and Photomedicine Society
Disclosure: Astellas Consulting fee Review panel membership; Amgen/Wyeth Consulting fee Speaking and teaching; LEO Pharma Honoraria Speaking and teaching; LEO Pharma Grant/research funds Investigator; Serono Grant/research funds Investigator; Galderma Grant/research funds Other

Jerry Shapiro, MD, FRCP(C), Clinical Associate Professor, Department of Medicine, Division of Dermatology, University of British Columbia, Canada
Disclosure: Nothing to disclose.

Medical Editor

Leonard Sperling, MD, Chair, Professor, Department of Dermatology, Uniformed Services University of the Health Sciences
Leonard Sperling, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Lester F Libow, MD, Dermatopathologist, South Texas Dermatopathology Laboratory
Lester F Libow, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Texas Medical Association
Disclosure: Nothing to disclose.

CME Editor

Joel M Gelfand, MD, MSCE, Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania
Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology
Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds None; Genentech Consulting fee Consulting; Centocor Consulting fee Consulting; Centocor Grant/research funds None; Covance Consulting fee Consulting; Shire  Consulting

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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