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Last reviewed: 21 Apr 2025
Last updated: 23 Sep 2022

Summary

Definition

History and exam

Key diagnostic factors

  • hair loss
  • non-scarring alopecia
  • exclamation mark hairs
  • normal underlying skin in bare areas
  • nail pitting

Risk factors

  • autoimmune disease
  • family history of autoimmune disease

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
  • positive hair pull test

Treatment algorithm

Contributors

Authors

Fong Seng Lim, MBBS, MMed (FM), FAMS

Senior Consultant

Department of Family Medicine

National University Health System

Singapore

Disclosures

FSL declares that he has no competing interests.

Miny Samuel, PhD

Assistant Director

Research Support Unit

Yong Loo Lin School of Medicine

National University of Singapore

Singapore

Disclosures

MS declares that she has no competing interests.

Acknowledgements

Dr Fong Seng Lim and Dr Miny Samuel would like to gratefully acknowledge Dr Richard A. Strick, Dr Jack Green, and Dr Paradi Mirmirani, previous contributors to this topic. RAS is an honorary member of the National Alopecia Areata Foundation (NAAF) clinical scientific advisory board. JG is an author of a reference cited in this topic. PM declares that he has no competing interests.

Peer reviewers

Maria Hordinsky, MD

Professor and Chair

Department of Dermatology

University of Minnesota

Minneapolis

MN

Disclosures

MH declares that she has no competing interests.

Ralph M. Trueb, MD

Associate Professor

Department of Dermatology

University Hospital of Zurich

Zurich

Switzerland

Disclosures

RMT is an author of a number of references cited in this topic.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Olsen EA, Hordinsky MK, Price VH, et al. Alopecia areata investigational assessment guidelines: part II. National Alopecia Areata Foundation. J Am Acad Dermatol. 2004;51:440-447. Abstract

Hordinsky MK. Medical treatment of noncicatricial alopecia. Semin Cutan Med Surg. 2006;25:51-55. Abstract

Messenger AG, McKillop J, Farrant P, et al. British Association of Dermatologists' guidelines for the management of alopecia areata 2012. Br J Dermatol. 2012 May;166(5):916-26.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available here.

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