Early Alopecia Areata: Subtle Findings

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Subtle Findings

Alopecia areata is an autoimmune disease that affects 2 % of the world. Most people develop small round or oval patches of hair loss when the disease first occurs. In the very earliest stages however, the clinical findings may be more subtle until sufficient time has elapsed for the actual circles of hair loss to form.

The earliest stages of alopecia areata may be associated with increased shedding of hair compared to the normal rate of shedding. Some shed hairs may be broken as well. Many patients with alopecia areata are asymptomatic although a proportion will note the presence of burning or itching prior to the hair loss.

Up close dermatoscopic examination, as shown here, may reveal reduced density as well as exclamation mark hairs (blue arrows), tapered hairs or black dots. Over time, the more classic findings typically emerge making the diagnosis much easier. 


Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887



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