Editing Alopecia areata (section)

== Signs and symptoms ==
[[File:Alopecia areata.jpg|thumbnail|Alopecia areata]]

Typical first symptoms of alopecia areata are small bald patches. The underlying skin is unscarred and looks superficially normal. Although these patches can take many shapes, they are usually round or oval.<ref name="Fitz2">{{cite book | vauthors = Freedberg IM, Fitzpatrick TB | title = Fitzpatrick's dermatology in medicine | publisher = McGraw-Hill, Medical Pub. Division | location=New York |year=2003 |isbn=978-0-07-138076-8}}{{Page needed|date=September 2010}}</ref> Alopecia areata most often affects the scalp and beard, but may occur on any part of the body with hair.<ref name=merck/> Different areas of the skin may exhibit hair loss and regrowth at the same time. The disease may also go into remission for a time, or may be permanent. It is common in children.{{citation needed|date=August 2020}}

The area of hair loss may [[paresthesia|tingle]] or be mildly painful.<ref name=aocd>{{cite web | work = American Osteopathic College of Dermatology | url = http://www.aocd.org/skin/dermatologic_diseases/alopecia_areata.html | title = Alopecia Areata | archive-url = https://web.archive.org/web/20071213205902/http://www.aocd.org/skin/dermatologic_diseases/alopecia_areata.html | archive-date=13 December 2007 }} Dermatologic Disease Database. Aocd.org. Retrieved on 3 December 2007.</ref> The hair tends to fall out over a short period of time, with the loss commonly occurring more on one side of the scalp than the other.<ref name=draelos/>

Exclamation point hairs, narrower along the length of the strand closer to the base, producing a characteristic "exclamation point" appearance, are often present.<ref name=draelos>{{cite web | vauthors = Draelos ZD | date = 30 August 2007 | url = http://www.medicinenet.com/alopecia_areata/article.htm | title = Alopecia Areata | archive-url = https://web.archive.org/web/20071208050019/http://www.medicinenet.com/alopecia_areata/article.htm | archive-date=8 December 2007 | work = MedicineNet.com | access-date = 2 December 2007 }}</ref> These hairs are very short (3–4&nbsp;mm), and can be seen surrounding the bald patches.<ref name="Mounsey2009" />

When healthy hair is pulled out, at most a few should come out, and ripped hair should not be distributed evenly across the tugged portion of the scalp. In cases of alopecia areata, hair tends to pull out more easily along the edge of the patch where the follicles are already being attacked by the body's immune system than away from the patch where they are still healthy.<ref>{{cite journal | vauthors = Wasserman D, Guzman-Sanchez DA, Scott K, McMichael A | title = Alopecia areata | journal = International Journal of Dermatology | volume = 46 | issue = 2 | pages = 121–131 | date = February 2007 | pmid = 17269961 | doi = 10.1111/j.1365-4632.2007.03193.x | s2cid = 57279630 }}</ref>

Nails may have pitting or [[trachyonychia]].<ref name=merck/> Onychoptosis defluvium, also known as alopecia unguium, is casting off the nail seen in association with alopecia areata.<ref name="Fitz2003">>{{cite book | vauthors = Freedberg IM, Eisen AZ, Wolff K, Austen KF, Goldsmith LA, Katz S |title=Fitzpatrick's dermatology in general medicine |date=2003 |publisher=McGraw-Hill, Medical Pub. Division |location=New York |isbn=0-07-138076-0 |edition=6th}}</ref>{{rp|660}}