Alopecia Areata can present in many different forms. Most frequently it develops as a single patch of hair loss a centimeter or two in diameter (Alopecia Arealis). This patch of hair loss may develop in any hair bearing region but most frequently it develops on the scalp. The first patch may develop anywhere on the scalp and where the first patch of hair loss develops is not significant in predicting the future course of alopecia areata. Future hair loss is impossible to predict for any one individual. About 65% of people with alopecia areata just have one or two patches of hair loss and these often resolve with time. However, some people may later develop more extensive or persistent patterns of alopecia. The first one or two patches may expand in size and/or other patches of hair loss may develop. Alopecia Areata may last many years with some regrowth, or it may cycle through expression and remission as the disease runs an unpredictable course. It may only last for a short period of time and normal hair growth can be quickly re- established within months. At first, any hair regrowth tends to be of very fine, unpigmented hair later resuming normal color and texture. Regrowth may occur in one region of the scalp while the hair loss develops in another area. Some people with Alopecia Areata may experience changes in hair color during, or after, an episode of hair loss and sometimes these color changes can be permanent. Alopecia areata may be manifest as one of several distinct patterns of hair loss:

Alopecia areata may develop in the occipital scalp region (Alopecia Ophiasis). When this happens the alopecia usually does not spread to affect other areas of the scalp. Unfortunately, development of alopecia areata ophiasis is associated with long term persistence and resistance to treatment. In all cases of Alopecia Ophiasis hair grow with difficulty, the greater the area affected, the more difficult to achieve good results. The hair loss may develop into total terminal scalp hair loss (Alopecia Subtotalis) characterized by slow progression of the disease - all long hair fall out with only short at the parietal-temporal area and vellus hair remaining. Sometimes thinning affects eyebrows and eyelashes.  Next stage is a complete overall scalp and face hair loss (Alopecia Totalis). And the worst stage is a complete body hair loss (Alopecia Universalis). While extensive hair loss Alopecia Subtotalis usually develops gradually, some individuals can have simultaneous hair loss all over the scalp or body leading to Alopecia Totalis or Alopecia Universalis in just a couple of weeks. Extensive hair loss only affects a minority of people with around 7% of Alopecia Areata affected people believed to express Alopecia Totalis or Alopecia Universalis. According to statistics approximately about 10% of patients recover from these severe forms of Alopecia Areata,  in addition if the hair loss began before puberty, an expectancy of positive outcome of treatment is even higher. A few individuals may experience a diffuse form of initiation of Alopecia Areata (Alopecia Diffusa). This can be quite difficult to distinguish from other diffuse forms of hair loss such as Telogen Effluvium. However, with time a differential diagnosis can be made as Telogen Effluvium is a limited form of hair loss, it develops over a few months and then stops, whereas diffuse Alopecia Areata tends to be progressive. It is possible to have special forms of Alopecia Areata that are just limited to the eyebrows and/or eyelashes (Alopecia Cilium). When Alopecia Areata first develops in these regions it rarely spreads to the rest of the scalp. However, the reverse is not true. If Alopecia Areata first appears on the scalp, it may later spread to affect the eyelash and eyebrow areas. It is also possible for men to have Alopecia Areata limited to the beard area (Alopecia Barbae). Also people with Alopecia Areata may also develop an aberrant nail formation, disruption of growth may involve all of the nails or just one and nail dystrophy may vary from a diffuse, fine pitting to severe alteration in certain cases.