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Ask the Medical Expert Archives 2000-2004

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Facial Hair
November 2000

Q. Recently, there are spots on my face where I cannot grow facial hair. It's so smooth that it feels like hair NEVER used to grow there. What could cause this?

A. The condition you describe is likely alopecia areata, in which there are discrete areas of hair loss, usually occurring in a circular pattern, while the surrounding hair seems quite normal. Such hair loss areas can occur on the scalp, face, or anywhere else. The cause is usually not known, and it is thought to represent an autoimmune reaction, meaning the body's immune system has formed antibodies against some of it's own tissue.

In the majority of cases, the patient is in generally good health, and the alopecia is not associated with any underlying condition. Alopecia affects about 1-2% of the general population. It can be a frustrating and unpredictable condition which can subside and later recur without apparent cause.

Treatment can be tried with topical medication such as minoxidil (Rogaine) or with topical cortisone preparations. Sometimes injection of cortisone medication into the affected areas will lead to hair regrowth. All of these treatments should be directed by your doctor or a dermatologist.

HELPFUL WEBSITES:

http://www.dermnet.org.nz/index.html

http://www.alopeciaareata.com/

MEDICAL REFERENCES (usually available through the library of your local hospital):

Shapiro J, Madani S: Alopecia areata: diagnosis and management. Int J Dermatol 38 (suppl 1):19, 1999

Shapiro J, Price VH: Hair regrowth: therapeutic agents. Dermatol Clin 16:341, 1998

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