Signs and Symptoms

Alopecia begins as patchy hair loss in which smooth, unscarred sections of hairless skin stand out from the surrounding area. These patches of smooth skin may be circular or oval in appearance and small or very large. Most commonly, the condition affects the scalp or beard, but in rare cases, loss of some or all of body hair may be included in the manifestation of the disease.

While there is typically no redness, swelling, or rashes with Alopecia, the areas of bare skin can experience a faint tingling or painful sensation. The hair itself may fall out over a very short duration of time, with the hair coming out in clumps rather than a few strands at a time.

Hairs may exhibit what is termed an “exclamation point” shape, in which the hair shaft grows progressively wider the closer it is found to the hair follicle. Close inspection of the bare skin may also reveal destroyed hairs found in the opening of the hair follicles.

Many patients also exhibit signs on their finger- and toenails. A condition called Trachonychia is often present, in which long striations on the nails of the fingers and toes result in a pitted appearance, earning the condition the name of “Sandpapered Nails.” Nails become brittle, opaque and pitted in appearance.

Indications of Alopecia involving finger and toenails were present in 10 to 50 percent of people with the disease.

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