Symptoms: Recognizing Alopecia Areata by Bald Spots
Usually, you would notice a patchy hair loss on your scalp, that develops over a few weeks. However, it may involve beard, eyebrows, eyelashes, and extremities as well. A key sign of active disease is “exclamation-mark hairs,” which are hairs that are narrower at the base and found at the edges of hair loss patches. Few experience total loss of scalp hair, and 10-15% experience nail changes, including fine pitting, brittle or ridged nails, and discoloration. Interestingly, white hair is often spared, giving an illusion of sudden greying.
Here is a real-life case scenario to help you understand the presentation.
Case 1: I am a 29-year-old male. I’m trying to determine whether I’m exhibiting symptoms of male pattern baldness or just a mature hairline and whether I should be beginning a treatment such as Finasteride if I am I. The early stages. My brother is bald (started at 16 and advanced quickly) and my maternal grandfather was bald. My mom’s brother is bald but my father and his father are not.
Diagnosing Alopecia Areata
Diagnosis is made with the presence of typical clinical history and examination findings described above. Dermoscopy examination and hair pull tests help confirm alopecia areata. Additionally, nail examination gives supportive evidence, as some types of alopecia areata gives rise to nail changes. If the diagnosis still remains unclear, your dermatologist may suggest biopsy, where a small tissue sample will be taken from the skin at the outer edge of the patch of hair loss. It is important to consult a healthcare professional to properly diagnose alopecia areata, so correct treatment can be started early to prevent further hair loss.
Here is a real-life case scenario where a patient underwent significant duress because she was hesitant to consult a healthcare professional early. This highlights the necessity of accurate diagnosis as early as possible.
Case 2: I am a 29-year-old female. I’ve had an itchy scalp for about 8 years now. It usually gets really flaky and smelly. After washing the itching usually reduces but then several hours after the itch comes back. I recently got tired of the itching and shaved my head yesterday with a shaving stick. I have noticed bald patches of the scalp. At some point where the hair just fel off. I suspect that this is some kind of fungal infection. I’m hoping it’s not skin cancer. Now that I’ve shaved my head it only feels sore from the shaving but no itching yet. I’ve ordered some anti-fungal cream online to start applying. I should probably see a dermatologist but these are the steps I’ve taken so far. I hope it’s not scalp cancer.
