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Expert Q&A

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How can we treat my boyfriend's unusual balding?

Asked by Tracy, Fort Wayne, Indiana

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Hi. My boyfriend is 27 years old. Over the past two or three months, he has had an odd pattern of baldness. It started as a very small area (pencil eraser size) above his left ear, but it quickly spread upward as well as to the front and back. Right now, there is a very big (2-3 inches across) bald area on the left side of his ear. I heard that the usual, normal balding pattern is on the forehead, but haven't heard this type of balding. I was wondering what could have caused this and how can we treat it (if it can be treated). Thanks!

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Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thanks for your question. This sounds like a condition called alopecia areata, which is basically hair loss that occurs in patches. To better help you, I consulted with Dr. Jeffrey Benabio, a dermatologist in San Diego and author of The Derm Blog, who shared this information:

Alopecia areata is an autoimmune disease that causes patches of hair loss. It is common and can occur at any point in life. The hair loss happens quickly and creates round patches of smooth skin with few or no hairs left. It usually happens on the scalp, but can occur anywhere you have hair including the face, arms, legs and even eyebrows. Rarely all the hair can fall out -- a condition called alopecia totalis if it occurs on the scalp and alopecia universalis if it involves the entire body.

It's not known what triggers alopecia areata other than that the hair loss is caused by one's immune system attacking the roots of the hairs. Stress might be a trigger for some, but for many people alopecia happens spontaneously -- that is, without a known cause.

To treat this condition it's important to calm the inflammation that is happening under the skin. The best treatment is to inject a small amount of steroid into the area of hair loss to stop the process. Once the inflammation resolves, the hairs grow back. Unfortunately it can take months (even years!) for the new hairs to grow as long as the other hairs that never fell out.

If you have further questions, be sure to contact your doctor or a dermatologist. Good luck!

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