A: For localized hair loss the most common causes are traction (due to tight braiding) and alopecia areata (an autoimmune disease that produces smooth round patches of hair loss).

Other than genetic (hereditary) thinning; generalized hair loss is most commonly caused by medications, anemia, and thyroid disease.

A: It is possible to have a hair restoration procedure into a single bald spot. However, it would be most beneficial to first determine the cause of the condition.

Bald spots caused by alopecia areata (an autoimmune disease) are best treated with injections of steroids into the scalp, rather than with a hair transplant. In fact, the transplanted hair can be rejected in patients with this condition.

Traumatic scars (i.e. from an accident) can be treated with follicular unit hair transplantation as the hair grows quite well in scar tissue, as long as the scar in scar tissue, as long as the scar is not thickened (hypertrophic).

A: “Alopecia” is just a generic term for any kind of hair loss.

It sounds like you have a specific condition called alopecia areata. Alopecia areata is an autoimmune disease that presents with the sudden appearance of well localized bald spot(s) on the scalp or other parts of the body. The underlying skin is always normal.

The treatment is injections with cortisone. Hair transplant surgery is not indicated for this condition.

You should see a dermatologist to confirm the diagnosis and treat.

Other diagnoses to consider are triangular alopecia (which would have been present since childhood) and traction alopecia (that is cased by constant tugging on the hair).

A: DLE or discoid lupus erythematosus is a type of autoimmune disease where the body produces an inflammatory reaction to components of the skin, causing it to scar and lose hair.

The skin in the area of hair loss generally has a smooth appearance with tiny empty hair follicles, redness, and altered pigmentation. These skin changes help to differentiate it from the more common condition alopecia areata where the underlying skin appears normal.

The diagnosis of DLE can be confirmed by biopsy. Because DLE may exhibit a property called Koebnerization, where direct trauma can make the lesions enlarge, surgical hair restoration risks making the condition worse and is, therefore, not indicated.

A: Alopecia areata is an autoimmune disease in which the body attacks its own hair follicles. It generally appears as round patches of smooth bald areas scattered in the scalp or beard. Less commonly, it can involve the entire scalp (alopecia totalis) or all facial and body hair (alopecia universalis). Unless the condition is well localized and totally stable, hair transplantation is not likely to be effective because the transplanted hair would be subject to the same problem.

We prefer that one have no new lesions for a minimum of two years before considering surgical hair restoration, although this does not insure that the procedure will be successful.

You may find more information on this relatively common condition at the National Alopecia Areata Foundation. For more information, visit these websites: www.alopeciaareata.com or www.naaf.org.