Diffuse Hair Loss

(female) Dear Drs,

I was told that I most likely am suffering from Diffuse Areata, the thing that directed my doctor to this diagnosis is diffuse all over hair loss, brow and lash shed and short tapered hairs shedding out. I can find nothing on the subject, nothing on the net and my doctor admitted he did not understand the disorder.

Could you provide me with information regarding the diffuse form leaving no bald spots but diffuse loss all over the head. What is the general prognosis etc?

Thanks for your help

First, I want to tell you that clinical medical science is a descriptive science in many situation. This is important because what we see is what we are reporting when we diagnose diffuse alopecia areata. What doctors are saying is that there is a diffuse form of the disease that mimics classic alopecia areata, except that it is found all over the head. Some doctors question if this is the same disease, but because it looks like the same entity when the skin is biopsied as localized alopecia areata, the conclusion is that the diffuse variant is different in ways that are not understood. Most people believe that it is an autoimmune disease and we see evidence in what we call chronic and diffuse alopecia areata of the microscopic changes seen in autoimmune diseases.

Second, I can point you to some sites of interest so that you can learn more (but hopefully not confuse you):

• National Alopecia Areata Foundation
• Journal of Investigative Dermatology – Role of Cytotoxic T Cells in Chronic Alopecia Areata
• American Journal of Dermatopathology – Diffuse Alopecia With Stem Cell Folliculitis: Chronic Diffuse Alopecia Areata or a Distinct Entity?
• American Journal of Clinical Dermatology – Alopecia Areata: Pathogenesis, Diagnosis, and Therapy