Exclamation Mark Hairs in Alopecia Areata

Exclamation Hairs in AA

Exclamation hairs are short hairs that are thick at the top and thin at the bottom. They are commonly seen in acute (recent) alopecia areata.  Exclamation hairs occur because the area of the follicle that is responsible for making a hair fiber stops working at full function. The result is a tiny thin fiber that usually just breaks off at the level of the scalp.

Exclamation mark hairs in a patient with alopecia areata.

This photo captures a fairly long exclamation mark hair with an extremely thin fiber emerging from the scalp. This delicate fiber will likely be broken or washed away with the next shampoo. With treatment of the alopecia areata, the hope is that a brand new thick fiber emerges from the scalp. Treatments for alopecia areata include about 27 possibilities beginning with topical steroids, steroid injections and minoxidil for the vast majority.