For many people, alopecia areata is a transient problem, in which small patches of hair loss recover spontaneously within a few months. But for others, the reality is rather different. An Italian study showed that one third of patients with scalp hair loss of 25 to 50% still had active patchy disease at long-term follow-up, with a further third having progression to alopecia totalis or alopecia universalis, terms that vividly capture the extreme extent of disease and from which recovery is rare.1 For many patients with severe disease, medical treatments do not work, and they face difficulty in coping with . . .
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