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It is possible for alopecia areata to be inherited. However, most children with alopecia areata do not have a parent with the disease, and the vast majority of parents with alopecia areata do not pass it along to their children.
Alopecia areata is not like some genetic diseases in which a child has a 50–50 chance of developing the disease if one parent has it. Scientists believe that there may be a number of genes that predispose certain people to the disease. It is highly unlikely that a child would inherit all of the genes needed to predispose him or her to the disease.
Even with the right (or wrong) combination of genes, alopecia areata is not a certainty. In identical twins, who share all of the same genes, the concordance rate is only 55 percent. In other words, if one twin has the disease, there is only a 55-percent chance that the other twin will have it as well. This shows that other factors besides genetics are required to trigger the disease.
To learn more about the genes and other factors involved in alopecia areata risk, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) sponsored the development of an alopecia areata registry. (For more information about the registry, see “What Are Some Promising Areas of Research?”)
This is a common question, particularly for children, teens, and young adults who are beginning to form lifelong goals and who may live with the effects of alopecia areata for many years. The comforting news is that alopecia areata is not a painful disease and does not make people feel sick physically. It is not contagious, and people who have the disease are generally healthy otherwise. It does not reduce life expectancy and it should not interfere with going to school, playing sports and exercising, pursuing any career, working, marrying, and raising a family.
The emotional aspects of living with hair loss, however, can be challenging. Many people cope by learning as much as they can about the disease, speaking with others who are facing the same problem, and, if necessary, seeking counseling to help build a positive self-image.
Q. I've heard that chemicals can be painted on the scalp to make the hair grow but that we can't get them in this country. Why is this?
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Photo courtesy Derm Atlas
Living with hair loss can be difficult, especially in a culture that views hair as a sign of youth and good health. Even so, most people with alopecia areata are well-adjusted, contented people living full lives.
The key to coping is valuing yourself for who you are, not for how much hair you have or don’t have. Many people learning to cope with alopecia areata find it helpful to talk with other people who are dealing with the same problems. Nearly 2 percent of Americans have this disease at some point in their lives, so you are not alone. If you would like to be in touch with others with the disease, the National Alopecia Areata Foundation (NAAF) can help through its pen pal program, message boards, annual conference, and support groups that meet in various locations nationwide. To find contact information for NAAF and other organizations that can help people with alopecia areata, see “Where Can People Find More Information About Alopecia Areata?”
Another way to cope with the disease is to minimize its effects on your appearance. If you have extensive hair loss, a wig or hairpiece can look natural and stylish. For small patches of hair loss, a hair-colored powder, cream, or crayon applied to the scalp can make hair loss less obvious by eliminating the contrast between the hair and the scalp. Skillfully applied eyebrow pencil can mask missing eyebrows.
Children with alopecia areata may prefer to wear bandanas or caps. There are many styles available to suit a child’s interest and mood. It is often helpful if a parent informs teachers, coaches, and others that the child has alopecia areata, that it is not contagious, and that the child is healthy.
For women, attractive scarves can hide patchy hair loss, and proper makeup can camouflage the effects of lost facial hair. If you would like to learn more about camouflaging the cosmetic aspects of alopecia areata, ask your doctor or members of your local support group to recommend a cosmetologist who specializes in working with people whose appearance is affected by medical conditions.
Q. I have alopecia areata and have heard that there is new NIH sponsored research on alopecia areata. Can you tell me how I can participate?