Fortunately, alopecia areata is not a life-threatening or physically painful disease. But because it affects the appearance, particularly among young people at a sensitive stage of social development, there can be psychological fallout as well as hair fallout. There is some concern if the nasal hair, eyebrows and eyelashes also fall out, because dust, dirt and other debris have a clearer path to affecting those organs. But wearing sunglasses and using moisturizing sprays to keep the nasal passages lubricated will help deflect those issues.
Parents are often concerned that they may pass on the disease to offspring. Alopecia areata is tricky to predict, unlike some other problems. Because there are a set of genes necessary to develop alopecia, not everyone has all of them, and in fact, it is believed to be highly unlikely that a child would get all of them. Studies on twins have also found that even though one twin may have alopecia areata, there is only a 55 percent chance that the other twin will be afflicted.
This has led some researchers to believe that beyond genetics, there may be environmental or psychological triggers in the onset of alopecia areata. Although stress can make hair fall out, there is no definitive research yet to suggest that it may trigger alopecia. It may be that alopecia areata works in conjunction with other body organs, like the thyroid, to induce the condition. There also may be an issue with exposure to chemicals, lack of certain vitamins or the possibility that alopecia areata is a side effect of some other disease like arthritis, an as-yet-undiscovered virus may induce the condition. For now, all there is speculation tied to genetics, but research continues.
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) has an alopecia areata registry that collects information on the condition and provides information on the latest research available. The organization and others also offer support groups and counseling to those afflicted with the disease.
Hair Today, Back Tomorrow? Alopecia Treatments
Beyond the causes of the disease, the biggest question for those afflicted with alopecia areata is whether they will ever get their hair back.