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Many Dermatologist are not that familiar with AA. Yes, the bald spot is smooth but most AA is not scarring alopecia so the follicles are not harmed they just cannot produce hair because the ammunine system tells the body hair is bad. My daughter was without any hair and 5 years later after she started Xeljanz the hair came back. Now that being said, she now has developed a few side effects, not serious ones but enough for her to not take it for now. She grew lashes back and her eyebrows and the hair on her head was not a dense as it was with her own hair. Alopecia is a term disease but you need to see one that is more familiar with it.
Her lashes were the last to fall out, FYI
Losing hair is a natural part of the hair growth cycle. We lose hair so that new hair can replace it.
However, when hair does not grow back as it should, we start to notice thinning hair and a more visible scalp through the hair. In order to understand hair loss, one must understand normal hair growth and shedding cycles.
The hair growth cycle is ongoing, and on an average day, 90% of your hair is in the resting phase while the other 10% is either growing or shedding. Balding occurs when the hair sheds, and no hair re-grows to replace it. Hair is made of keratin, the same material that makes up your nails and the outer layer of your skin. Hair is really a dead structure while the follicular bulb is the growing center. Because the actual strand of hair is not alive, hot curlers, chemical processing, hard plastic combs can cause damage and lead to split ends and fracturing of the shafts.
The hair growth cycle begins with the anagen or growth phase. During this phase cells in the root of the hair divide to add to the hair shaft. Depending on your genetics, the growth phase can last anywhere from 2 to 6 years. As the anagen phase comes to an end, an unknown signal tells the hair to enter the next stage. The hair grows about a fourth of an inch each month, and though it is technically dead, a healthy hair care regimen can keep it looking beautiful while it’s in the anagen phase.
The catagen stage follows the anagen phase and is made up of a 2-3 week transitional period in which the hair is no longer growing. During this stage, a club hair is formed. A club hair occurs when the section of the hair follicle attaches to the hair shaft, cutting the follicle off from its blood supply and the cells that produce new hair. This club hair leads to the next stage of the hair growth and shedding cycle.
The final stage of the hair growth and shedding cycle is the telogen or resting phase. During this two to four month phase, the hair begins to shed at normal levels, and the anagen phase begins again producing new hair.
The average person sheds around 100 telogen-stage hairs a day between brushing the hair, showering, and other activities. High-stress and trauma like high fevers, nutritional deficiencies, pneumonia, and accidents can cause hair to shed in higher than normal amounts. Patterned baldness (androgenetic alopecia) occurs when hair production slows and beings to produce weak, shorter hairs, eventually ceasing to grow completely in some areas.
Men and women often lose hair for different reasons and should be properly diagnosed before beginning any hair restoration treatment. Depending on the cause of your hair loss, there are both surgical and non-surgical treatment options including hair restoration surgery and medications like Propecia®, Rogaine®, and Proscar®.
Source: https://www.griffincenter.com/blog/2011/11/16/the-stages-of-the-hai...
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