26/07/10

Exclamation point hair: Exclamation point hair is a key diagnostic finding in a disorder called alopecia areata.

Alopecia areata is patchy baldness (alopecia means baldness and areata means occurring in patches) which
typically begins with patchy hair loss on the scalp and sometimes
progresses to complete baldness and even loss of body hair. The hair
loss tends to be rather rapid and asymmetrical and is different than
male pattern baldness.

Alopecia areata affects both males and females. It tends to occur
most often in children and young adults but older individuals can
also be affected.

The most common pattern of alopecia areata is one or more spots
of hair loss on the scalp. There is also a form with more generalized
thinning. When all of the scalp hair is lost, it is called alopecia totalis.
Loss of all of the hairs on the body is called alopecia universalis.

The cause appears to involve an autoimmune mechanism. The body's
own immune system attacks the hair follicles and disrupts normal hair
formation. Biopsies of affected skin show lymphocytes (one of the
body's immune system cells) inside of hair follicles where
lymphocytes normally are not present. What causes this is unknown.

Alopecia areata is sometimes associated with other
conditions (allergic disorders, thyroid disease, vitiligo, lupus,
rheumatoid arthritis, ulcerative colitis). Some cases occur within
family members and indicate a genetic basis.

The characteristic diagnostic finding of alopecia areata is the
exclamation point hair. These can be found in areas of hair loss and
are short broken off hairs that are narrower closer to the scalp and
therefore mimic an exclamation point. In some cases a biopsy is
necessary for diagnosis.

In about half of cases, the hair regrows within a year without any
treatment. The longer the period of time of hair loss, the less
chance that it will regrow and a variety of treatments can be tied.
Steroid injections and cream to the scalp have been used for many
years. Other drugs include minoxidil, irritants, and topical
immunotherapy which may be used in different combinations.

A study reported in the journal Archives of Dermatology
(Vol 134, 1998;1349-52) showed effectiveness of aromatherapy
essential oils (cedarwood, lavender, thyme, and rosemary oils) in
some patients. As with many disorders for which there is no clear cut
beneficial treatment, a variety of remedies are promoted which in
fact have no benefit.

MedTerms (TM) is the Medical Dictionary of MedicineNet.com.
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