Alopecia areata is a type of hair loss affecting around 15 in 10,000 in the UK. Affecting men and women equally, it typically begins as a small patch of baldness but it can progress, in some cases, to total baldness. The hair loss is temporary in many cases, re-growing after several months, but occasionally the hair loss is permanent. While you can get alopecia areata at any age, it tends to develop first when people are children or teenagers. Furthermore, there is an inherited factor with about 1 in 5 people having a close relative also affected. How do I know I have alopecia areata?The initial symptoms of alopecia areata are the appearance of one or more small and round bald patches on the scalp. men can also experience these patches in the area where their beard normally grows. Hair loss aside, the scalp usually looks healthy although in some cases you might experience mild burning and redness, or for the bald patches to feel slightly itchy. What causes it? The thinking around alopecia areata is that it is an autoimmune disease, where the body’s immune system mistakes parts of the body as foreign and sets about attacking it, damaging healthy cells. In people with alopecia areata, the affected hair roots are mistaken as foreign; the gathering of white blood cells at these follicles causes mild inflammation, weakening the hair which then falls out. Why only certain areas of the scalp are affected is not known. What is the prognosis? The outlook varies greatly, with mild cases often getting better without treatment within a few months, although it is probable that you will have one or more recurrences of alopecia areata throughout your life. In other cases, patchy baldness may come and go, but with more severe cases, regrowth is less likely. What are my treatment options? In mild cases, many doctors will advise leaving the bald patches alone at first; alopecia areata is an unpredictable condition and does often heal itself with hair starting to re-grow from three months. Steroid injections are an option, an often effective treatment that is performed by a skin specialist. These injections suppress the local immune reaction thereby allowing the hair follicles to resume their normal function but it is not considered suitable for larger patches of baldness. Topical immunotherapy, also to be performed by a specialist and requiring a referral, is considered the most effective treatment for those with extensive alopecia areata. Other treatment options include topical steroid creams and gels and minoxidil lotion which is available on private prescription. Is it possible to camouflage alopecia areata? Scalp micropigementation, known as SMP, can cosmetically camouflage patches of hair loss as a result of alopecia areata. One of the major benefits is that it has no impact on the hair follicles and will not prevent hair from growing back. For more information on SMP, available at HisHair Clinic, book your free consultation.