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Understanding Alopecia Areata Prognosis: Insights for St. Louis Residents

Updated: May 27, 2023


A man with patches of hair loss of alopecia areata.
Alopecia Areata St. Louis

Introduction

At Mid-County Dermatology in St. Louis, MO we treat many patients with alopecia areata. Alopecia areata is a long-lasting condition that causes unpredictable hair loss. It can be quite challenging as the course of the disease varies, with periods of hair loss, recovery, and relapse. While treatments may not have a significant impact on the long-term outcome of AA, it's important to understand the factors that affect the prognosis to effectively manage the condition.


The Course of Alopecia Areata

Around half of the patients with AA experience spontaneous hair regrowth within a year after the initial episode. However, it's important to note that the chance of the condition returning is quite high, especially over a longer period. The severity of the hair loss is a key factor in determining the prognosis. Certain signs, such as complete hair loss on the scalp (alopecia totalis), total hair loss on the entire body (alopecia universalis), or hair loss in a specific pattern (ophiasis pattern), can indicate a poorer outlook for regrowth. Involvement of the nails is also a sign that the condition may worsen.


Factors Influencing Prognosis

The age at which alopecia areata starts can affect its severity and prognosis. If it begins at a young age, it tends to be more severe. On the other hand, if it starts later in life, it's often less severe and more likely to improve over time. Other factors that can impact the prognosis include resistance to treatment, delays in seeking treatment, and ongoing hair loss. Additionally, having a family history of AA, other autoimmune or atopic diseases, or Down's syndrome can also contribute to a poorer prognosis.


Different Types of AA and Prognosis

There are different types of alopecia areata, including patchy, diffuse, and alopecia areata incognita. Generally, diffuse and incognita types have a more positive prognosis compared to patchy alopecia areata. They tend to have lower rates of relapse and respond better to treatment. Interestingly, patients with diffuse and incognita alopecia areata rarely develop the typical circular patches of hair loss. Notably, recovery from diffuse alopecia areata has been reported within six months, regardless of the treatment used. Although the potential for full remission decreases over time, the hair follicles still retain their ability to regenerate, offering hope for hair regrowth once the inflammation subsides.


Conclusion

Alopecia areata, a long-lasting condition that leads to unpredictable hair loss, affects individuals in St. Louis and beyond. While there is no perfect treatment that exists, it is crucial to grasp the factors that influence the prognosis for effective management. Factors such as the severity of hair loss, age of onset, specific signs, and related health conditions all play pivotal roles in determining the outlook for individuals dealing with alopecia areata.


In St. Louis, individuals facing alopecia areata are encouraged to seek support from a trusted dermatologist specializing in hair disorders. Dr. Feigenbaum is a board-certified dermatologist and hair transplant surgeon that specializes in hair loss conditions. To take control of your journey and explore available options, reach out to our St. Louis dermatology team. Together, we can create a personalized plan that empowers you to manage your hair loss and embrace life with confidence.


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