Seasonal patterns in alopecia areata, totalis, and universalis

To the Editor: Although seasonal patterns of pediatric alopecia areata (AA), totalis (AT), and universalis (AU) have been suspected clinically, there is limited research about whether disease flares follow a temporal pattern.1-3 Patients and families report increased hair loss during the winter, with cycles of regrowth in summer months. Through retrospective review of medical records, we sought to identify whether AA, AT, and AU flares show seasonal variation in pediatric patients and to characterize temporal patterns.