Alopecia natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD
Overview
Patients with alopecia are at increased risk of psychosocial complications such as anxiety and depression. In addition, these patients need to be evaluated for other medical conditions. Outcomes vary with the type of alopecia.
Alopecia natural history, complications and prognosis
Natural History
The progression of alopecia depends on the type of alopecia an individual has. In some cases, it is irreversible as in alopecia mucinosa, alopecia neoplastica, and long-standing cases of tinea capitis; other cases, it is reversible such as in anagen effluvium. In males with androgenetic alopecia, the hairline regression occurs mostly at the temporal areas bilaterally and vertex balding is also seen. In females with androgenetic alopecia, there is a frontal hairline is largely unaffected while in other areas, there is hair thinning [1] [2]. In telogen effluvium, it could take as much as 6 months for hair to begin growing again, and it often takes more time for the hair growth to be perceptible to the patient.
Complications
Prognosis
- In telogen effluvium, recovery is usually good.
- In majority of anagen effluvium cases, cessation of chemotherapy often leads to hair regrowth. However, it could take up as much as a few years to achieve a full recovery of hair. Less commonly, full recovery does not occur.
- In alopecia areata, the degree of hair loss and age of the patient at initial diagnosis may play a role in the outcome of the disease, with onset in childhood being associated with a poorer prognosis compared to a later age. [3] Patients with a positive family history of alopecia areata, presence of accompanying autoimmune disease and personal history of atopic diseases may also indicate poorer outcomes. [4]
References
- ↑ Ludwig E (1977). "Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex". Br J Dermatol. 97 (3): 247–54. doi:10.1111/j.1365-2133.1977.tb15179.x. PMID 921894.
- ↑ Levy LL, Emer JJ (2013). "Female pattern alopecia: current perspectives". Int J Womens Health. 5: 541–56. doi:10.2147/IJWH.S49337. PMC 3769411. PMID 24039457.
- ↑ Pratt CH, King LE, Messenger AG, Christiano AM, Sundberg JP (2017) Alopecia areata. Nat Rev Dis Primers 3 ():17011. DOI:10.1038/nrdp.2017.11 PMID: 28300084
- ↑ Madani S, Shapiro J (2000). "Alopecia areata update". J Am Acad Dermatol. 42 (4): 549–66, quiz 567-70. PMID 10727299.