Alopecia Areata and Nail Defects

Skin Research Spotlight: "Nail Involvement in Alopecia Areata: A Questionnaire-Based Survey of Impact on Quality of Life and Review of the Literature"

Alopecia areata is a disease in which the immune system attacks the hair, leading to sudden hair loss in patients. Though hair is the first thing that comes to mind when thinking about this disease, alopecia areata also affects other parts of the body. A group of researchers investigated how often the nails were affected in those with alopecia areata to see which other aspects of alopecia treatments physicians should look at.

Not Uncommon for Alopecia Areata to Associate with Nail Changes

In the study, the researchers gave questionnaires to 256 people with alopecia areata, asking them about any nail changes that they experienced while having the disease. Of the respondents, 64.1% reported that their nails were affected by alopecia. In fact, the most frequent change in the patients’ nails was nail pitting or the appearance of indentations in the patients’ nails. Furthermore, 18% of the patients reported having trachyonychia, or the condition of having rough, sandpaper-like nails with ridges that run up and down the nail, splitting the nail. More rarely, 5% of patients reported having red spots on the crescent-shaped white area on the base of the nail known as the lunula. None of these patients underwent any treatments for this aspect of alopecia.

The researchers then noted a trend: the severity of a patient’s alopecia correlated to a greater impact on the patient’s nails. In particular, the presence of red spots on the crescent-shaped lunula was correlated with having more severe alopecia areata. However, the patients’ lives were not drastically changed by their nail conditions, though some patients did struggle more with putting on socks when the nail condition was on their toes.

Redefining What Alopecia Areata Treatments Entail

Based on the researchers’ findings, alopecia areata is more than just hair loss, the disease may also affect patients’ nails. Paying special attention to and taking extra care of one’s nails may be helpful in maintaining healthy nails and treating this aspect of alopecia areata.