Can't Get Rid of Alopecia Areata?
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Alopecia Areata

What is Alopecia Areata and Who Gets It?

Alopecia areata is an autoimmune disease that causes hair loss for both adults and children. This can cause hair loss on the scalp as well as on the body, such as eyebrows, eyelashes and facial hair. This happens when the immune system mistakenly attacks the body’s hair follicles, causing them to fall out and stop growing.

It’s estimated that alopecia areata affects over 6.5 million people in the U.S. Often, those who have/had a blood relative with the disease have a greater chance of developing it. It usually begins during childhood and teenage years, however it can start at any age. It also affects all races and genders.

Signs and Symptoms

In addition to hair loss, people with alopecia areata may notice changes in their nails (splitting, thinning, white spots, roughness), itching or discomfort on areas of the skin losing hair (or that will begin losing hair) and eye irritation (if eyebrows and eyelashes are lost). 

Typically, those with alopecia areata are otherwise healthy and don’t develop other autoimmune diseases. However, having one autoimmune disease can increase the risk of developing another one. For example, alopecia areata can increase the risk of getting vitiligo, a condition that causes the skin to lose its color. Alopecia areata also increases the risk of developing allergic conditions like eczema, asthma or nasal allergies. 

Does Lost Hair Grow Back?

Since alopecia areata doesn’t destroy hair follicles, hair will likely regrow. But this varies from case to case. Hair can also fall out again even if it does regrow. The cycle of hair loss and growth is unpredictable. Some will only lose hair once and never have any more hair loss. Some will develop a few bald patches, while others may lose all or most of their head and body hair. Hair that regrows may be white or blond, and finer than before. This is usually temporary. Natural hair color and texture often return.

Diagnosing Alopecia Areata

A board-certified dermatologist can often diagnose the disease by inspecting the areas with hair loss. Sometimes removing a few hairs for biopsy (microscopic exam) may be necessary. Your scalp may also need to be examined with a dermatoscope. This can help provide a clear view of the hair follicles and assist in diagnosing. 

If an additional autoimmune disease is suspected, further testing may be needed. There are three types of alopecia areata you can be diagnosed with, based on the amount and distribution of hair loss:

  • Alopecia areata: This is the most common type and is characterized by round patches of hair loss, mainly on the scalp.
  • Alopecia totalis: Loss of all hair on the scalp.
  • Alopecia universalis: Loss of all hair on the body (most rare type). 

Suggested Treatment Options


Often, hair will regrow without treatment, although it can be slow. And many don’t get the regrowth they want or expect. There are treatment options that can help with alopecia areata. Depending on the amount and areas of hair loss, treatment plans can include:

  • Corticosteroids can help calm the immune system so it doesn’t attack hair follicles. When treating in adults, corticosteroids may be injected into the spots with hair loss. Several shots will be needed every four to six weeks. When successful, patients typically see hair regrowth within three months of the first injection. A corticosteroid cream may also be prescribed to apply daily to bare spots. Hair growth can being after three to four months after this treatment. A combination of topical and injectable corticosteroids have shown to be effective.
  • Minoxidil is a topical medication that comes in various strengths, with the 5% solution or foam being the most effective for alopecia areata. When successful, signs of hair growth usually start around 12 weeks.
  • Anthralin is a tar-like substance that also calms the immune system. It can be rubbed daily on areas needing regrowth and left on the skin for 15-20 minutes. If successful, hair growth is usually seen in treated areas in three to four months.
  • Topical Immunotherapy can be recommended for extreme hair loss and includes chemicals like squaric acid, dibutyl ester or diphencyprone. When applied to the skin, these cause an allergic reaction that triggers the body to wake the hair follicles, which can result in hair regrowth. If successful, regrowth can take up to three to four months.
  • Oral treatments may be recommended, including prednisone, methotrexate, cyclosporine or other immunomodulators. These can have side effects, so discuss with your dermatologist. 
  • New treatments are also being researched, including Janus kinase inhibitors, which can disrupt the immune response that causes the disease. In addition to treatments, covering your head with a wig, hat or scarf can help you feel more comfortable.

Corticosteroids

A corticosteroid works by suppressing the activity of the immune system and reducing the production of chemicals that create inflammation. Learn More

Intralesional Injection

Intralesional injection is a process whereby a corticosteroid is injected directly into a skin lesion or irregular growth. Learn More

Oral and Topical Medications

Dermatologists are experts in bacterial, viral and fungal infections in the skin and have a deep knowledge of how to best use antibiotics, antiviral and antifungal medications. Learn More

PRP

PRP, also known as platelet rich plasma, is a treatment used as a dermatological remedy on the face. Learn More

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