Circular hair loss: What do bald spots do?


When bald spots suddenly appear in dense hair, it is a great shock. The disease behind it, the circular hair loss, however, has nothing to do with the hereditary hair loss around which many myths rang.

About 1.4 million people in Germany are affected by the bald spots. ” The Alopecia areata (AA) is an inflammatory hair loss disease and is considered as an autoimmune phenomenon according to current research. Its distinctive appearance makes it quite easy to recognize, “explains Uwe Schwichtenberg, President of the National Association of German Dermatologists in Bremen. Thus, the hairless circles appearing usually had a diameter of two to six centimeters and were sharply demarcated.

The course of the disease is very different. This already begins with the number and size of the bald spots: “Some have only one or two small spots, others quite a few, which are expanding ever more. And in a few cases, there is also complete hair loss, “says Anita Macionga-Knauer, who has been affected for more than 30 years.

Affected women feel unattractive

Irrespective of its extent, circular hair loss is fundamentally not accompanied by physical pain or, as with a headache skin, by itching. In the case of women in general, however, the psychological pain that the disease entails, says Macionga-Knauer: “It is very difficult to get rid of the loss of the hair. One feels unattractive and unfortunately often also faces negative reactions on the part of the environment. ”

The overall risk of developing is two percent. “Unlike a lot of other hair loss diseases, it is reversible, so the features can re-form,” explains Hans Christian Hennies of the University of Cologne. The main reason for this is that AA does not lead to a destruction of the hair root, but only to a local inflammation, which interferes with the growth of the hair.

The reason is probably a misdirected immune reaction, which is often regulated by itself: “In fact, more than 50 percent of those affected have spontaneous healing within one year, and the hair can begin to sprout again, either by itself or by itself Through a treatment, “says Schwichtenberg. However, regression may occur.

The exact causes of the disease are hitherto unknown. There are many factors that may also interact: such as severe stress conditions, allergies, the existence of thyroid gland or autoimmune diseases. “The presence of a genetic predisposition is certain, since Alopecia Areata is a family-based disease,” explains Hennies. If these individual genes were to be assigned, targeted therapies could be developed.

Only nonspecific treatment

As long as the origin is not clear, only unspecific treatment is possible. The application of the cream and the under-spraying of the affected areas with cortisone as well as a special light therapy – the cream-puva treatment – are also common. However, cortisone is not uncontroversial. “Immunotherapy with the chemical diphenylcyclopropenone has the highest success rate”, explains Schwichtenberg. When applied regularly for a longer period of time, it produces an allergic reaction and can lead to the immune cells ceasing with the misguided “hair-control”.


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