Alopecia areata affects one out of every 100 people, causing loss of scalp hair in well-demarcated patches, usually in a circular pattern.

Most doctors feel that alopecia areata is an autoimmune disease caused by a person's immunity that is supposed to be killing gems attacking the hair follicles and causing the hair to fall out. It is associated with other autoimmune diseases such as diabetes, vitiligo or white patches on the skin, certain types of thyroid disease, and pernicious anemia. The vast majority of people who get alopecia areata are healthy and do not need blood tests or further medical evaluation.

Since the hair follicles are not damaged, hair loss is never permanent and a short course of any cortisone-type drugs can bring back all of the lost hair. However, immediately after a person stops taking cortisones, the hair starts to fall out again. Since cortisones do not cure the hair loss and they can have serous side effects, most doctors prescribe cortisone pills only when there is a serious need to bring the hair back temporarily. Cortisone injections into the bald spots bring the hair back only temporarily. Another treatment is to apply chemicals that act like poison ivy in causing blisters. When the blisters heal, the hair often returns. Available drugs for baldness such as monoxidil, called Rogaine, and Propecia are not very effective. Aldara may help to treat alopecia areata. Tacrolimus (brand names Protopics and Eladil)were promising treatments but doctors no longer prescribe them because of possible serious side effects. Check with your doctor.

Gabe Mirkin, M.D.

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in Sports Medicine and three other specialties.

Dr. Mirkin's daily features on fitness have been heard on CBS Radio News stations since the 1970's. He has written 16 books including The Sportsmedicine Book, the best-selling book on the subject that has been translated into many languages. His latest book is The Healthy Heart Miracle, published by HarperCollins.

Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. A Boston native, Dr. Mirkin did his residency at the Massachusetts General Hospital. He has served as a Teaching Fellow at Johns Hopkins Medical School, Assistant Professor at the University of Maryland, and Associate Clinical Professor in Pediatrics at the Georgetown University School of Medicine. He has run more than forty marathons and is now a serious tandem bicycle rider with his wife, nutritionist Diana Mirkin.