Managing alopecia areata

Alopecia areata is defined as hair loss that leaves discrete, often round, areas of shiny baldness. These areas of shiny baldness can be on the scalp (most common), in the beard area or in any hair-bearing part of the body. Alopecia areata can present as a single patch in any site, or as multiple patches in one or several sites, while diffuse alopecia areata (less common) presents as a generalised profuse thinning involving the whole scalp. In comparison to alopecia areata, alopecia totalis is defined as the complete loss of scalp hair but with no other hair loss, while alopecia universalis is loss of all scalp, face and bodily hair. (Extensive hair loss that does not amount to complete loss can be termed alopecia sub-totalis or sub-universalis.) Nail dystrophy is another feature of alopecia areata and should always be looked for and documented. It takes the form of very fine pitting, much finer than psoriatic nail pitting, and can progress to loss of the nail. As with the hair, spontaneous regrowth is possible. A rare long-term feature is the development of cataracts.