ALOPECIA AREATA: A Closer Look at the Earliest Stages

Early Stages of AA: Broken Hairs and Exclamation Hairs 

Alopecia areata is an autoimmune disease that affects 1.7 % of the world’s population. Patients with alopecia areata may develop defined well demarcated circular or oval shaped areas of hair loss. In the very earliest stages however, hair breakage may be a subtle first feature and possibly some itching may be present in affected areas as well. Hair breakage is due to inflammation beneath the skin (around the hair follicles) that leads to production of weaker hairs. One of these weaker hairs is shown with the arrow and known as an exclamation mark hair. Over time, many patients with alopecia areata develop a coin-shaped area of actual hair loss. A small proportion develop widespread hair loss, including loss of all scalp hair (alopecia totalis) or loss of all scalp and body hair (alopecia universalis).