Alopecia Areata Questions & Answers

Updated: Jun 13, 2022
  • Author: Chantal Bolduc, MD, FRCPC; Chief Editor: Dirk M Elston, MD  more...
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Questions & Answers

Overview

What is alopecia areata?

How is alopecia areata diagnosed?

What are the signs and symptoms of alopecia areata?

Which hair-bearing sites are affected by alopecia areata?

Which clinical conditions are associated with alopecia areata?

What are the classifications of alopecia areata?

Which nail abnormalities may be present in alopecia areata?

What are the treatment options for alopecia areata?

How are corticosteroids administered for the treatment of alopecia areata?

How are topical corticosteroids administered for the treatment of alopecia areata?

What is the role of systemic corticosteroids in the treatment of alopecia areata?

Which immunotherapy agents are used to treat alopecia areata?

How is anthralin used to treat alopecia areata?

What is the role of minoxidil in the treatment of alopecia areata?

How is psoralen plus UV-A used to treat alopecia areata?

What are some less commonly used agents for treatment of alopecia areata?

What are cosmetic treatment options for alopecia areata?

What is alopecia areata?

What is the pathophysiology of alopecia areata?

What is the proposed autoimmune pathophysiology of alopecia areata?

What evidence supports the hypothesis of an autoimmune pathophysiology for alopecia areata?

What clinical evidence supports an autoimmune pathophysiology of alopecia areata?

What is the role of genetics in the etiology of alopecia areata?

Which genes have been identified in the pathophysiology of alopecia areata?

What is the role of cytokines in the pathophysiology of alopecia areata?

What is the role of innervation in the pathophysiology of alopecia areata?

What is the role of vasodilatation in the pathophysiology of alopecia areata?

What is the role of infectious agents in the pathophysiology of alopecia areata?

What causes alopecia areata?

What are the risk factors for alopecia areata?

What is the role of stressful events in the etiology of alopecia areata?

What is the prevalence of alopecia areata?

What are the racial predilections for alopecia areata?

How does the incidence of alopecia areata vary by sex?

How does the incidence of alopecia areata vary by age?

What is the prognosis of alopecia areata?

What is the natural history of alopecia areata?

What are adverse prognostic factors for alopecia areata?

What is included in the patient education information for alopecia areata?

Presentation

What are the signs and symptoms of alopecia areata?

What are the clinical manifestations of extensive alopecia areata?

When does spontaneous regrowth occur in patients with alopecia areata?

Why is there limited data on comorbidities of alopecia areata?

What is the prevalence of atopic dermatitis in alopecia areata?

What is the prevalence of vitiligo in alopecia areata?

What is the prevalence of thyroid disease in alopecia areata?

What is the prevalence of collagen-vascular diseases in alopecia areata?

What is the prevalence of diabetes mellitus in alopecia areata?

What is the prevalence of alopecia areata in Down syndrome?

What is the prevalence of psychiatric disorders and alopecia areata?

How frequently do major stress factors precede episodes of alopecia areata?

What are less common comorbidities of alopecia areata?

How frequently is a precipitating factors identified in alopecia areata?

What are the physical findings characteristic of alopecia areata?

How is alopecia areata classified?

How is a reticular pattern of alopecia areata characterized?

What is alopecia totalis?

What is alopecia universalis?

What is the role of dermoscopy in the evaluation of alopecia areata?

What is the significance of a finding of yellow dots on dermoscopy during the evaluation of alopecia areata?

What are the dermoscopic signs of alopecia areata?

How frequently are nail abnormalities present in alopecia areata?

DDX

Which conditions should be included in the differential diagnosis of alopecia areata?

What are the differential diagnoses for Alopecia Areata?

Workup

What is the role of biopsy in the diagnosis of alopecia areata?

How is alopecia areata diagnosed histologically?

What is the most characteristic histologic feature in alopecia areata?

Treatment

What is the treatment algorithm for alopecia areata?

What is the basis for treatment selection in alopecia areata?

What is the efficacy of treatment for alopecia areata?

What are the rates of spontaneous remission in alopecia areata?

What is the prognosis of alopecia areata?

What is the role of immunomodulators in the treatment of alopecia areata?

How are corticosteroids administered in the treatment of alopecia areata?

What is the role of intralesional steroids in the treatment of alopecia areata?

What is the efficacy of intralesional steroids for hair regrowth in alopecia areata?

What is the role of triamcinolone acetonide (Kenalog) in the treatment of alopecia areata?

What are the adverse effects of intralesional steroids in the treatment of alopecia areata?

How frequently are steroid injections administered in the treatment of alopecia areata?

What is the efficacy of triamcinolone acetonide in the treatment of alopecia areata?

What is the efficacy of topical steroids for the treatment of alopecia areata?

What is the efficacy of fluocinolone acetonide for the topical treatment of alopecia areata?

What is the efficacy of betamethasone dipropionate cream for the treatment of alopecia areata?

What is the efficacy of clobetasol propionate for treatment of alopecia areata?

What is the durations of topical steroid treatment for alopecia areata?

What are the benefits of topical steroid treatment for alopecia areata?

What is the most common adverse effect of topical steroids for the treatment of alopecia areata?

What is topical immunotherapy for the treatment of alopecia areata?

What are commonly used immunotherapy agents for the treatment of alopecia areata?

What is the efficacy of topical immunotherapy for the treatment of alopecia areata?

How does age affect the prognosis of alopecia areata treated with topical immunotherapy?

What is the median time to significant regrowth from topical immunotherapy treatment of alopecia areata?

What is the efficacy of diphencyprone (DPCP) for the treatment of alopecia areata?

Which factors predict a lower response rate to treatment for alopecia areata?

What are the serious adverse effects of topical immunotherapy for alopecia areata?

What is the most common side effect of topical immunotherapy for alopecia areata?

What are adverse effects of topical immunotherapy for alopecia areata?

What is the mechanism of action of topical immunotherapy for the treatment of alopecia areata?

Why is approval of an ethics review board suggested prior to beginning topical immunotherapy for alopecia areata?

What are the efficacies of squaric acid dibutylester (SADBE) and diphencyprone (DPCP) in the treatment of alopecia areata?

What is the treatment regimen for topical immunotherapy for alopecia areata?

Why is only half the head initially treated with topical immunotherapy for alopecia areata?

What should be avoided during topical immunotherapy for alopecia areata?

When should regrowth be seen following treatment of alopecia areata with topical immunotherapy?

What is the efficacy of anthralin in the treatment of alopecia areata?

What is the relationship between contact dermatitis and anthralin in the treatment of alopecia areata?

What is the response rate for anthralin in the treatment of alopecia areata?

What are the adverse effects of anthralin in the treatment of alopecia areata?

What is the mechanism of action for anthralin in the treatment of alopecia areata?

What is the efficacy of combination therapy of diphencyprone (DPCP) and anthralin for the treatment of alopecia areata?

What is the efficacy of minoxidil for the treatment of alopecia areata?

What is the regimen for minoxidil for the treatment of alopecia areata?

What are the adverse effects of minoxidil for the treatment of alopecia areata?

What is the mechanism of action for minoxidil in the treatment of alopecia areata?

What is the role of prostaglandin analogs in the treatment of alopecia areata?

What is the efficacy of psoralen plus UV-A (PUVA) for the treatment of alopecia areata?

What are the different forms of psoralen plus UV-A (PUVA) for the treatment of alopecia areata?

How many psoralen plus UV-A (PUVA) treatments are needed for regrowth in alopecia areata?

What is the response rate for psoralen plus UV-A (PUVA) for the treatment of alopecia areata?

What is the role of prednisone in the treatment of alopecia areata?

What are the benefits of using prednisone for treatment of alopecia areata?

What are the adverse effects of systemic therapy for alopecia areata?

What is the mechanism of action for systemic steroids in the treatment of alopecia areata?

What are the limitations of prednisone for the treatment of alopecia areata?

Why is systemic prednisone not a treatment drug of choice for alopecia areata?

What is the role of methylprednisolone for treatment of alopecia areata?

How is cyclosporin A (CsA) administered for the treatment of alopecia areata?

What is the efficacy of topical cyclosporin A (CsA) in the treatment of alopecia areata?

What is the efficacy of oral cyclosporin A (CsA) in the treatment of alopecia areata?

What is the mechanism of action of cyclosporin A (CsA) for the treatment of alopecia areata?

What is the role of cyclosporin A (CsA) for the treatment of alopecia areata?

What is the role of tacrolimus for the treatment of alopecia areata?

What is the role of interferon in the treatment of alopecia areata?

What is the efficacy of dapsone for the treatment of alopecia areata?

What is the efficacy of methotrexate for the treatment of alopecia areata?

Which treatments have limited evidence of efficacy for alopecia areata?

Which biological agents are used to treat alopecia areata?

What is the role of simvastatin/ezetimibe in the treatment of alopecia areata?

What is the role of platelet-rich plasma (PRP) in the treatment of alopecia areata?

What is the role of stem cell therapy or zinc in the treatment of alopecia areata?

What are nonpharmacologic treatments for alopecia areata?

What is the role of surgery in the treatment of alopecia areata?

How is alopecia areata prevented?

Medications

Which medications are most commonly used to treat alopecia areata?

What are the treatment options for patients younger than 10 years old with alopecia areata?

Which medications in the drug class Vasodilators are used in the treatment of Alopecia Areata?

Which medications in the drug class Glucocorticoids are used in the treatment of Alopecia Areata?

Which medications in the drug class Immunomodulators are used in the treatment of Alopecia Areata?