I just turned 38 and I've been dealing with AA now since Jan 2009.. It started with a small dime sized spot on my chin in January and by June the chin was completely bald. In June I started to lose my moustach and eyebrows; at this point the mustach is gone and the eyebrows are fading quickly but still hanging in there even if barely. About six weeks ago I started to get spots in my scalp and now there are seven. Luckily I can cover them by growing my hair a bit longer and by using an eyebrow pencil. No one has commented about it, even if they have noticed. I'm actually amazed at how well I can keep both eyebrows and scalp hair loss hidden and you don't notice the facial hair.

I've had three rounds of injections, my last one a week ago. The scalp seems to be coming in a bit but I'll have to wait a few more weeks to be sure. The eyebrows have started to come a few weeks after the second injection but are localized to "tufts" at each injectin site, about a half centimer wide. If they keep growing, I have a good chance of regrowing them over several months with multiple injections . At least there is progress.

I'll continue to update you all on how things go.

As we all know, the worst part of dealing with this is the fear of what will happen. So, I have compiled the following to help me feel better, and I 'm sharing it with you all. It's really geared towards those of us with mild AA, although I do not want to segregate anyone on this site; we are all brothers and sisters and some of us have AT and AU. We're all in this together. I do however feel a certain cameraderie with those facing the same situation as me, patchy AA, so the following list is here to help you feel better about what is happening to us and that there is a light at the end of this long, dark tunnel.


Alopecia Areata –The Good News!

Having had AA now for the better part of a year, I find myself being down about it. It really wears on me over time. I find it helps me to be as objective as possible about it, and I have scoured the net and books for some kind of indication about how long it lasts for most people. Although each individual person will have a different experience with AA in terms of duration and severity, it calms me to remind myself that I will likely have the same experience as most; the exception is not the rule in AA, just like in every other facet of life. For example, I could have a car accident when driving, some people do, but I still drive to work because on average the chances are low, and if it happens it will likely be a fender bender, not a car wreck. Same with AA; the worst is possible, but not likely.

Although different sources quote different statistics, the general consensus is that mild patchy AA enters remission on its own within about a year or so in 50% to 80% of cases; 50% being the most pessimistic study I’ve read and 80% being the most positive, so it is probably somewhere in between. If it lasts longer than a year statistics indicate that it will still go away on its own in 67% to 90% of cases, again different sources are more or less optimistic, so again it probably is somewhere in between. The conclusion however is that the chances are good for remission, far better than not having remission.

More good news is that although treatments don’t alter the underlying course of the condition (like an aspirin does not cause a sprained ankle to heal, it does so on its own in its own good time), there is almost always one or more treatments that can be used bring some, most, or all of the hair back temporarily until it goes into remission on its own. Treatments need to be continued until that time, which in my mind is a small price to pay for regrowth.

I have cut and paste quotations from websites and books on AA . This list is repetitive and not a summary, and that's on purpose. When you look at the various quotes you can see a pattern that is very optimistic.

Here goes:

• Ikeda Classification System for AA (from a 1950 study)
Type I: 83% - patchy, no history of atopy (auto-immune conditions), good prognosis
Type II:10% -ophiasis or large patches, history of atopy, ¾ develop AT or AA, long lasting, seasonal recurrences
Type III: 4% -reticular (net like pattern) 40% develop AU
Type IV: 3% -, long-lasting
The Ikeda study concludes that 80% of mild cases resolve in a year. This is the most optimistic study I have seem on AA.
• The good news is most patients will only experience a mild 'patchy' form of the disease that comes and goes. Research shows one third of all patients with AA experience total re-growth within six months, with or without treatment, while a further third will achieve total re-growth within a year
• The course of AA is usually characterized by phases of acute hair loss followed by spontaneous hair regrowth
• In most cases hair growth occurs spontaneously without any treatment in a few months. So “wait and watch” is a non expensive, safer alternative!
• Approximately 80 percent of people with mild alopecia areata recover within a year
• About 65% of people who have alopecia areata have just one or two patches of hair loss which usually enter remission after 6 months to 2 years from first diagnosis with or without treatment
• When alopecia areata results in patches of hair loss, the hair usually grows back in 6 months to 1 year.
• In 90% of cases, the hair will ultimately grow back
• For most people small amounts of hair fall out then regrow in months
• The follicles usually resume normal hair growth within a year
• If untreated, regrowth tends to occur within 6–12 months. When it does regrow, the hair is often white initially
• Regrowth in untreated patients occurs in the vast majority by 1 year
• Most patients have only a few focal areas of alopecia, and spontaneous regrowth usually occurs within 1 year
• Usually, the bald patches appear suddenly and affect only a limited area. The hair grows back within 12 months or less
• In more than 90% of cases, hair grows back and fills the bald spot within one year, even without treatment. Only about 7 percent of people develop severe, long-term forms of the illness that produce large areas of hair loss with little hair regrowth.
• The initial strategy may be no treatment as regrowth, particularly in paucilesional first episode alopecia areata, is common in 2-6 months.
• A 9 year old girl and her mother visited a doctor, concerned about two patches of hair loss. For a mild case like this (two bald patches 4cm x 4cm) in which the hair loss can be hidden, the best treatment is reassurance and observation. The physician explained the natural history of the disease, including the fact that regrowth will take at least 3 months for any single patch. Therapeutic options were also discussed. The mother and child were reassured that the hair is likely to grow in on its own. Neither of them wanted intralesional injections or topical therapies. One year later during a well-child check, it was noted that the girl’s hair had fully regrown

I hope this list of quotations helps you feel more optimistic. You can see the optimistic trend, so fearing the worst, although a human tendency, is not really realistic or helpful. When I feel a bit down and start focusing on the worst case scenario I remind myself that the worst case is not very likely to happen.

If you know of anyone on AW that would benefit from seeing this list, please refer them to it. Thanks

Stephen