University of Iowa Health Science Relations and
Mary Stone, MD
Associate Professor of Dermatology and Pathology
First Published: November 2000
Last Revised: August 2003
Peer Review Status: Internally Peer Reviewed

Janie noticed the pea-sized, smooth patch of skin on her scalp, but gave it little thought. She thought it would go away. A few months later, she found large amounts of hair in the shower drain, and noticed that the once tiny spot had grown and two others were forming.

"If your hair is falling out, leaving round smooth patches on your skin, you may have a condition called alopecia areata," says Dr. Mary Stone, associate professor of dermatology and pathology at the University of Iowa College of Medicine and UI Hospitals and Clinics staff physician.

"It is a fairly common condition affecting about one in 100 people. Alopecia areata occurs among men, women, and children," Stone says. The scalp is the most commonly affected part of the body, but men's beards or any hair-bearing part of the body can also be affected.

"Alopecia areata likely is an autoimmune disease, where the body's defenses attack the body's cells. It appears that your body actually fights off your hair," Stone says.

Hair normally grows about six inches per year. People with alopecia areata have follicles that produce abnormal hairs that break close to the surface of the scalp, she explains. "During this time, no hair is visible. It can last for several months, even years," Stone says.

The hair follicles are not permanently destroyed and can resume normal growth, Stone says. "The less hair that's been lost, the more likely it will grow back. In more severe cases, hair sometimes doesn't grow back. If you have lost large amounts of body hair, there's no safe, effective treatment, although the condition may reverse on its own," Stone says.

"Though the cause of alopecia areata is not known, some people report that hair loss worsens under stress, but this hasn't been scientifically proven," she adds.

Heredity may also play a part in the disease. According to the National Alopecia Areata Foundation, one of five persons with the disease has a family member that has had the same condition.

Alopecia areata is not physically disabling. "In fact, people with alopecia areata are usually healthy and physically fit," Stone says, "but it can be emotionally troubling.

"Although there are no cures, we have treatment options, which vary with the person's age and extent of hair loss. People with a few patchy areas usually receive cortisone injections--the most common treatment--into the affected areas," Stone says. Other treatments include applying an anthralin cream or ointment, cortisone creams, or a minoxidil solution.

If you think you may have alopecia areata, see your physician.