Alopecia Areata Relapses May Decrease with Age

The autoimmune disorder Alopecia Areata can affect men, women and children, causing everything from small bald spots on the scalp only, to complete hairless-ness from head to toe.

Whilst its mildest form may, to some, appear less to worry about, it can still be an incredibly difficult condition to come to terms with, given its unpredictability.

Little is known about its epidemiology, but what is known is that hair regrowth may spontaneously recur at any time. However, if it does, the sudden hair loss may also recur again later.

A study published on 19th March 2019 in the Journal of the European Academy of Dermatology and Venereology may have some encouraging news for those worried by this 'unknowable' aspect; researchers have now found that the likelihood of Alopecia Areata relapses may decrease with age.

Frequency of relapses declined over time

A team from the Department of Dermatology at Chaim Sheba Medical Centre in Tel Hashomer, Israel, explored the long-term course of Alopecia Areata by investigating its prevalence in different age groups.

After carrying out a retrospective evaluation of 104 cases of Alopecia Areata - 31 of which started in childhood, 63 were adult-onset and 10 were referred to as 'late-onset' - from diagnosis through at least 7 years of follow-up, the team published their findings.

"At first episode, 88.5% of patients had mild, 3.8% moderate and 7.7% severe AA. Full or significant re‐growth was observed in 74%, 94% and 100% of childhood‐onset, adult‐onset and late‐onset AA patients, respectively. There was no re‐growth in 13%, 3% and 0% of childhood‐onset, adult‐onset and late‐onset patients, respectively," write the study's authors.

"The duration of the initial episode and the disease‐free interval negatively correlated with age... The frequency of relapses was high overall (52%, 44% and 30% in childhood‐onset, adult‐onset and late‐onset, respectively), but significantly declined over time with a majority (79%) occurring within the first 4 years."

Researchers confirmed they found no correlation between the relapse rate and gender, how severe the hair loss was, or whether any - or which - treatment was used during the initial bout.

The report concluded that the long-term course of Alopecia Areata appeared to be more positive in older age, stating, "The prevalence of severe disease, duration of an initial episode and the rate of relapses decreased with an older age at onset. In addition, the outcome and the disease‐free interval improved with age at onset. The frequency of relapses declined over time and most appear early on."

Alopecia Areata hair regrowth

In many cases where Alopecia Areata causes patchy hair loss of the scalp only, hair regrowth will resume naturally within 12 months.

When this hair grows back, it may be paler, white or silver-looking - this is normal and the usual hair colour tends to reappear within a few hair growth cycles.

This spontaneous recovery does not always happen, however, and for those wanting advice on regrowing hair, a consultation with a hair loss specialist can be beneficial.

At Belgravia personalised courses of Alopecia Areata treatment are available to suitable adults; these involve topical high strength minoxidil hair loss solutions which can be used at home.

For children, or those with the more extensive forms of autoimmune alopecia which affect areas other than the scalp, a dermatologist or GP will be able to advise on the best options from potential treatments to emotional and peer support.