Alopecia From The Doctor’s Point Of View

We thought it might be interesting to those of us who are new to the whole “alopecia experience”, to have some idea of what it is that your doctor is thinking (and the process she/he undertakes) when we march into their office, all freaked out, exclaiming “My Hair Is Falling Out! Make It Stop!” So we share with you this piece prepared for the esteemed British Journal of Dermatology by S.P. MacDonald Hull, M.L. Wood, P.E. Hutchinson, M. Sladden, A.G. Messenger and posted on MedLine. It is entitled Guidelines for the Management of Alopecia Areata and was posted the 4th of December in 2003.

We found it to be extremely enlightening and very helpful when visiting our physician. Both to know what to expect from our care, and to understand the limitations of the science available to our doctor. We hope this helps to shed some light onto what can seem to be an overwhelming situation.


These guidelines for management of alopecia areata have been prepared for dermatologists on behalf of the British Association of Dermatologists. They present evidence-based guidance for treatment, with identification of the strength of evidence available at the time of preparation of the guidelines, and a brief overview of epidemiological aspects, diagnosis and investigation.


Alopecia areata is a chronic inflammatory disease which affects the hair follicles and sometimes the nails. The onset may be at any age and there is no known race or sex preponderance. Alopecia areata usually presents as patches of hair loss on the scalp but any hair-bearing skin can be involved. The affected skin may be slightly reddened but otherwise appears normal. Short broken hairs (exclamation mark hairs) are frequently seen around the margins of expanding patches of alopecia areata. The nails are involved in about 10% of patients referred for specialist advice. Data from secondary and tertiary referral centres indicate that 34-50% of patients will recover within 1 year, although almost all will experience more than one episode of the disease, and 14-25% progress to total loss of scalp hair (alopecia totalis, AT) or loss of the entire scalp and body hair (alopecia universalis, AU), from which full recovery is unusual (< 10%). One study from Japan reported that spontaneous remission within 1 year occurred in 80% of patients with a small number of circumscribed patches of hair loss. The prognosis is less favourable when onset occurs during childhood and in ophiasis (alopecia areata of the scalp margin). The concurrence of atopic disease has been reported to be associated with a poor prognosis but this has been disputed.


  1. My 5 year daughter is having alopecia areata since she is 3 years old. She recovered with a naturotherapy but the hair loss in patches have again started .Please suggest a good remedy /cure for the same

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