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Alopecia Areata: Causes, Symptoms, and Treatment Options

Understanding this condition can make a world of difference for those affected, providing clarity and guidance during a challenging time.

Short Summary

  • Alopecia Areata is an autoimmune condition involving hair loss in small, round patches, with three primary types.

  • Factors influencing Alopecia Areata include family history and genetics, autoimmune disorders, and environmental triggers such as stress or illness.

  • Treatment approaches for managing the condition involve various drugs/medications, lifestyle modifications, and coping methods such as cosmetic techniques & emotional support.

What is Alopecia Areata?

Alopecia areata single patch

Photo courtesy of DermNetNZ

Alopecia areata is an autoimmune condition characterized by hair loss in small, round patches, often referred to as "hair falls." This mysterious condition happens when alopecia areata occurs, as the immune system mistakenly attacks hair follicles, leading to bald patches on the scalp or body.

There are three primary types of alopecia areata:

  • Patchy Alopecia Areata

  • Alopecia Totalis

  • Alopecia Universalis

Patchy Alopecia Areata

Patchy alopecia areata is the most common form of the condition, while severe alopecia areata is a more aggressive variant. It is characterized by one or more coin-sized patches of hair loss on the skin or body. In many cases, hair regrows within a few months, but the condition can recur, leading to a cycle of hair loss and regrowth.

To treat mild, patchy alopecia areata, doctors often recommend steroid injections after confirming the diagnosis. These injections are typically repeated every one to two months to promote hair growth.

However, it is important to remember that each case of alopecia areata is unique, and what works for one person may not work for another.

Alopecia Totalis

Alopecia totalis is a rare but more severe form of patchy alopecia areata, also known as alopecia areata totalis, causing hair loss across the entire scalp. Like patchy alopecia areata, it is believed to be an autoimmune disorder in which the body's immune system erroneously attacks the hair follicles.

The primary indication of alopecia totalis is total hair loss across the whole scalp, sometimes accompanied by itching, burning, or tingling sensations.

Treatment for alopecia totalis may include topical corticosteroids, intralesional corticosteroids, topical minoxidil, and immunotherapy.

Alopecia Universalis

Alopecia areata universalis, also known as alopecia universalis, is the most severe form of alopecia areata, characterized by complete hair loss on the entire body, including eyebrows and eyelashes. This extreme form of hair loss is also caused by an autoimmune disorder targeting hair follicles.

The primary indication of alopecia universalis is the loss of all body hair, making it easily distinguishable from other forms of alopecia areata. Treatment options for alopecia universalis include corticosteroids, methotrexate, topical minoxidil, and phototherapy.

Factors Influencing Alopecia Areata

removing hair clump from shower drain

Several factors influence the development and onset of alopecia areata, including family history, genetics, and certain autoimmune disorders. Some individuals may develop alopecia areata due to these factors.

Environmental triggers such as stress or illness can also instigate the condition.

Family History and Genetics

Family history and genetics play a significant role in the development of alopecia areata. If a close family member has the disease, the risk of acquiring it is higher. Ethnicity also plays a role in the incidence of alopecia areata.

According to the Nurses' Health Study (NHS), the odds for a diagnosis for Black women were 2.72, and according to the Nurses' Health Study II (NHSII), the odds were 5.48. The odds for Hispanic women were 1.94 compared with white women.

Understanding the role of genetics and family history in alopecia areata can help individuals identify potential risk factors and take appropriate preventative measures. However, each case of alopecia areata is unique, and not everyone with a family history of the condition will necessarily develop it.

Autoimmune Disorders

Alopecia areata is an autoimmune disease in which the immune system mistakenly attacks hair follicles, leading to hair loss. Additionally, other autoimmune disorders such as thyroid disease, diabetes, and celiac disease have been linked to alopecia areata.

Many individuals with a familial history of alopecia areata also have a personal or familial history of other autoimmune disorders, such as atopy, a disorder characterized by heightened hypersensitivity, thyroiditis, and vitiligo. Understanding the connection between autoimmune disorders and alopecia areata can help individuals and healthcare professionals develop a more comprehensive strategy for managing and treating the condition.

Environmental Triggers

Environmental triggers, such as stress or illness, may be associated with alopecia areata. While there is limited scientific evidence supporting the notion that stress causes alopecia areata, extreme cases of stress could potentially initiate the condition. In most cases, however, no discernible trigger can be identified.

Understanding the role of environmental factors in triggering alopecia areata can help individuals identify potential risk factors and take appropriate preventative measures. Managing stress and maintaining overall health may be beneficial in reducing the risk of developing alopecia areata.

Recognizing Symptoms of Alopecia Areata

A man showing symptoms of hair loss

The indications of alopecia areata include abrupt patchy hair loss, which can regrow if follicles are not damaged, and alterations in fingernail and toenail appearance. Early detection and diagnosis of alopecia areata are crucial for effective treatment and management.

In some cases, diffuse alopecia areata can cause more widespread hair loss. It is essential to consult with a healthcare professional if you notice any changes in your hair or nails, as early intervention can significantly improve the outcome of treatment and management strategies.

Diagnosing Alopecia Areata

alopecia areata

Photo courtesy of DermNetNZ

Physicians perform an alopecia areata diagnosis by evaluating hair loss and can conduct a skin biopsy or blood test to exclude other autoimmune diseases. A scalp biopsy involves extracting a small sample of skin from the scalp for evaluation to eliminate other ailments that may be causing hair loss.

Blood tests may be ordered if the doctor suspects other autoimmune conditions or to verify the presence of abnormal antibodies. If you are experiencing hair loss, consult with a doctor to gain further understanding and ascertain what treatment options are available.

Treatment Approaches for Alopecia Areata

Doctor speaking with a patient

Various treatment approaches for alopecia areata are available, including drugs used for other conditions, medications used to treat psoriasis, topical sensitizers, and lifestyle modifications. Cortisone tablets and oral immunosuppressants such as methotrexate and cyclosporine have been known to be effective in treating alopecia areata. Medications used to treat psoriasis, such as minoxidil, anthralin, SADBE, and DPCP, can also be utilized for alopecia areata.

Topical sensitizers, such as onion or garlic juice, cooled green tea, almond oil, rosemary oil, honey, or coconut milk, can be applied to the scalp to promote hair growth. Making lifestyle changes can be beneficial for hair growth. This can include acupuncture, aromatherapy, ingestion of vitamins and supplements (including zinc and biotin), usage of essential and other oils (such as coconut, tea tree, and castor oil), and probiotics.

Coping with Alopecia Areata

A woman shaving her head due to hair loss

Living with alopecia areata can be challenging, but various coping strategies can help individuals manage the condition more effectively. These strategies include cosmetic techniques, protective measures, emotional support, and shaving your head.

Cosmetic Techniques

Wigs and makeup are the primary cosmetic techniques employed to address alopecia areata. Hair additions, such as pieces and extensions, and accessories like scarves, hats, bandanas, and turbans, can also help conceal hair loss. However, these are temporary solutions that must be performed regularly.

For those experiencing eyebrow hair loss, options such as eyebrow pencils, microblading, and eyebrow tattoos may be viable alternatives to consider. Experiment with various cosmetic techniques and find the solutions that work best for you.

Protective Measures

Protecting your scalp from sun damage and your eyes from harm if eyebrows and eyelashes are lost is essential when living with alopecia areata. Gentle hair care techniques, such as using a soft-bristled hairbrush and wide-toothed comb, can help minimize further hair loss.

Adopting a healthy diet and reducing stress levels are also protective measures for alopecia areata. By taking these steps, you can help safeguard your scalp and eyes while managing your condition more effectively.

Emotional Support

Seeking therapy, joining support groups, and participating in online forums are all available emotional support options for individuals with alopecia areata. It is crucial to find a support system to assist in managing the psychological effects of the condition. The National Alopecia Areata Foundation (NAAF) is an organization that facilitates connections between individuals affected by alopecia areata and those who can empathize with their condition.

If you or a loved one is struggling with the emotional impact of alopecia areata, do not hesitate to seek help and support from professionals, friends, family, and support groups.

Shaving Your Head

Shaving one's head is a way to cope with alopecia areata, as it can assist in minimizing the psychological impact of hair loss, facilitate the management of hair loss, and provide a sense of control over the situation. Consider the pros and cons of shaving your head and determine if it is the right choice for you.

When shaving your head, use an electric shaver or a sharp razor and take your time. Using a moisturizing cream or oil can help safeguard the skin and prevent razor burn. Keeping up with a shaved head may require regular shaving and styling, but it can provide several benefits over a head full of hair that you should consider.

To get started, read our article on the best electric head shavers.


Alopecia areata is a complex autoimmune condition that affects millions of people worldwide. Understanding the condition, its causes, symptoms, treatments, and coping strategies is essential for those affected by alopecia areata and their loved ones.

By staying informed and working closely with healthcare professionals, people with alopecia areata can take control of their condition and live fulfilling lives.

Remember, you are not alone, and support is available to help you navigate this challenging journey.

Frequently Asked Questions

What is the trigger for alopecia areata?

While the exact cause of alopecia areata is unknown, it is thought to be an autoimmune disorder triggered by a combination of genetics and environmental factors.

This suggests that alopecia areata may be caused by an immune system attack on the body's own hair follicles.

Can alopecia areata go away?

Yes, alopecia areata can go away with treatment. Many people with alopecia areata experience complete hair regrowth in 6-12 months, while some may experience permanent hair loss.

What causes alopecia to start?

Alopecia is often caused by changes in hormones, genetic factors, and the aging process. It commonly appears as a gradual thinning of the hair on top of the head in both men and women, though it is more common in men.

It can also present in other forms, such as complete hair loss or spots of baldness.

What are the causes of alopecia?

Alopecia can be caused by several factors, such as genetics, autoimmune diseases, nutritional deficiencies, hormonal changes, and certain medications. Stress, infections, and even hairstyling practices can also lead to alopecia.

Thus, there are many possible causes of this condition.

What is the prevalence of alopecia areata in the United States?

Studies suggest that the prevalence of alopecia areata in the United States is around 6.7 million people, or 2.2 percent of the population.

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