Table of ContentsView AllTable of ContentsSymptoms of Alopecia AreataCausesRisk FactorsDiagnosisTreatmentCoping
Table of ContentsView All
View All
Table of Contents
Symptoms of Alopecia Areata
Causes
Risk Factors
Diagnosis
Treatment
Coping
Although the condition attacks hair follicles, it doesn’t destroy them, so there is no scarring and hair will re-grow over time. Children, teens, and adults can be affected and genetics play a part in who develops it. Even though alopecia areata usually resolves itself, some treatment options exist, as well as coping strategies when hair loss causes anxiety and embarrassment.
People who have this condition are, for the most part, otherwise healthy.Alopeciaareata is not a sign or symptom of a more serious or underlying condition.
The most common symptoms of alopecia areata include:
Reproduced with permission from © DermNet New Zealand and © Raimo Suhonenwww.dermnetnz.org2023.
“Exclamation-mark” hairs may be seen at the margin of the patch. These are broken, short hairs that taper at the base. Pulling slightly on these hairs causes them to fall out.
Note: Some cases may cause widespread hair loss including total baldness (alopecia totalis) and loss of all body hair (alopecia universalis).
Nail SymptomsUp to 20% of people with the condition also develop finger- or toenail symptoms:Softer or brittle nailsPinpoint dents or ridges across the nailNails that feel rough or “sandpaper-like"Red coloration of the nail bed
Nail Symptoms
Up to 20% of people with the condition also develop finger- or toenail symptoms:Softer or brittle nailsPinpoint dents or ridges across the nailNails that feel rough or “sandpaper-like"Red coloration of the nail bed
Up to 20% of people with the condition also develop finger- or toenail symptoms:
Can Herbs Help With Hair Growth?
Alopecia areata is an autoimmune disorder, which means the body’s immune system, for unknown reasons, attacks the hair follicles causing hair loss.
The “life” of a hair has three phases: anagen (growth), catagen (maturity), andtelogen(death, or falling out). Normally, all hair goes through these stages at random and the growing hairs on the rest of the head outnumber the hairs that fall out.
Alopecia areata’s inflammatory immune response triggers a premature telogen or late catagen stage within the hair follicles.
Alopecia areata is fairly common, with up to 2% of the population experiencing it at some point.
The condition can occur at any age. However, the vast majority of people who develop alopecia areata are under 30, and many are children and teenagers. Early-onset alopecia areata, defined as occuring between ages 5 and 10, tends to be most severe.
Certain factors make a person more likely to develop the condition:
Your healthcare provider may also do some blood tests to look for autoimmune diseases and to rule out other diseases that may mimic alopecia areata, such as:
Alopecia areata can’t be cured. However, in the majority of patients, the hair will regrow completely within one year without any treatment.
That said, because hair loss can be embarrassing and cause anxiety, the condition can be treated. It’s important to note that treatment isn’t always necessary or advisable. The decision to treat alopecia areata depends on many factors, including the age of the person affected, the severity of the hair loss, and where the hair loss is occurring.
The most common course of action is simple observation. If the patch of hair loss is small, it is reasonable to observe it and allow the hair to regrow on its own.
Topical steroids.This is a first-line treatment for both children and adults. Applying a strong topical steroid such as Diprolene (betamethasone) or clobetasol to the patch may stimulate hair regrowth. It may take several months for the hair to grow back using this method.
Steroid injection.This is considered the treatment of choice for adults with alopecia areata of the scalp or eyebrows. A healthcare provider will inject a steroid such as triamcinolone acetonide or Celestone (betamethasone) into the affected skin.
Initial regrowth of hair can be seen in four to eight weeks, with treatments being repeated every four to six weeks. The main side effect of any steroid use is thinning of the skin. These injections are not used in children younger than 10 years old.
Rogaine or Theroxidil (minoxidil).This hair growth drug has shown cosmetically acceptable results in 30% of cases. This medication is applied topically to affected areas and comes in either a foam or a solution.
Minoxidil does not stop the disease process, so stopping applications after hair has started to grow back may cause the hair to fall out again.
Because minoxidil is relatively safe, it’s considered a good treatment choice for young children.
Topical contact sensitizers.This type of treatment is designed to produce acontact dermatitis, or irritation, at the site in order to stimulate hair growth. The most common irritant used is called anthralin.
Oral Steroids.Medications such as prednisone are not used as first-line treatment but they may be prescribed in severe cases of widespread hair loss, as in the case of alopecia totalis or universalis.
Taking a short course of oral steroids for about six weeks can regrow hair. Because of the risk of side effects, oral steroids should not be taken long term. Also, once oral steroids are stopped the new hair may fall out again.
After oral steroids are stopped most people are switched over to another treatment to continue hair regrowth.
Breakthrough Therapy designation allows for expedited development and review of drugs that show early evidence of possibly treating certain conditions.
In research, they’ve shown short-term promise in treating alopecia, and depending on the study cited, between 50% and 91% of people showed significant improvement.
Discuss these risks with your healthcare provider to determine if JAK inhibitors are a safe option for you.
Natural Remedies for Alopecia Areata
The sudden and unpredictable nature of this type of hair loss can be difficult to cope with, especially for children and teens. People of all ages can experience a loss of self-esteem, or even depression or anxiety that may be severe enough to require the help of a therapist.
Helpful coping strategies for alopecia areata include:
Cloves for Hair Growth: Alternative Remedy or Just a Spice?
A Word From Verywell
Alopecia areata is a challenging condition. In many people, it resolves spontaneously with complete hair growth, but they must deal with rapid and noticeable hair loss in the meantime. Talk to your healthcare provider not just about potential treatments, but cosmetic options to reduce embarrassment and anxiety.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05El-Taweel A, El-Esawy F, Abdel-Salam O.Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients.Dermatol Res Pract. 2014;2014:1-6. doi:10.1155/2014/848763Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP.Alopecia areata.Nat Rev Dis Primers. 2017 Mar 16;3:17011. doi:10.1038/nrdp.2017.11Wang S, Ratnaparkhi R, Piliang M, Bergfeld WF.Role of family history in patchy alopecia areata.Dermatol Online J. 2018 Oct 15;24(10). pii: 13030/qt0n19r7ps.Thompson JM, Park MK, Qureshi AA, Cho E.Race and Alopecia Areata amongst US Women. J Investig Dermatol Symp Proc. 2018;19(1):S47-S50. doi:10.1016/j.jisp.2017.10.007Putterman E, Castelo-soccio L.Seasonal patterns in alopecia areata, totalis, and universalis. J Am Acad Dermatol. 2018;79(5):974-975. doi:10.1016/j.jaad.2018.06.029Hordinsky MK.Alopecia areata: The clinical situation.J Investig Dermatol Symp Proc.2018 Jan;19(1):S9-S11. doi:10.1016/j.jisp.2017.10.015Food and Drug Administration.Breakthrough therapy.Food and Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Additional ReadingPeloquin L, Castelo-Soccio L.Alopecia areata: An update on treatment options for children.Paediatr Drugs. 2017 Oct;19(5):411-422. doi:10.1007/s40272-017-0239-zStrazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis.J Am Acad Dermatol.2018 Jan;78(1):1-12. doi:10.1016/j.jaad.2017.04.1141Strazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: An appraisal of new treatment approaches and overview of current therapies.J Am Acad Dermatol.2018 Jan;78(1):15-24. doi:10.1016/j.jaad.2017.04.1142Trüeb RM, Dias MFRG.Alopecia areata: Acomprehensive review of pathogenesis and management.Clin Rev Allergy Immunol. 2018 Feb;54(1):68-87. doi:10.1007/s12016-017-8620-9
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05El-Taweel A, El-Esawy F, Abdel-Salam O.Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients.Dermatol Res Pract. 2014;2014:1-6. doi:10.1155/2014/848763Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP.Alopecia areata.Nat Rev Dis Primers. 2017 Mar 16;3:17011. doi:10.1038/nrdp.2017.11Wang S, Ratnaparkhi R, Piliang M, Bergfeld WF.Role of family history in patchy alopecia areata.Dermatol Online J. 2018 Oct 15;24(10). pii: 13030/qt0n19r7ps.Thompson JM, Park MK, Qureshi AA, Cho E.Race and Alopecia Areata amongst US Women. J Investig Dermatol Symp Proc. 2018;19(1):S47-S50. doi:10.1016/j.jisp.2017.10.007Putterman E, Castelo-soccio L.Seasonal patterns in alopecia areata, totalis, and universalis. J Am Acad Dermatol. 2018;79(5):974-975. doi:10.1016/j.jaad.2018.06.029Hordinsky MK.Alopecia areata: The clinical situation.J Investig Dermatol Symp Proc.2018 Jan;19(1):S9-S11. doi:10.1016/j.jisp.2017.10.015Food and Drug Administration.Breakthrough therapy.Food and Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.Additional ReadingPeloquin L, Castelo-Soccio L.Alopecia areata: An update on treatment options for children.Paediatr Drugs. 2017 Oct;19(5):411-422. doi:10.1007/s40272-017-0239-zStrazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis.J Am Acad Dermatol.2018 Jan;78(1):1-12. doi:10.1016/j.jaad.2017.04.1141Strazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: An appraisal of new treatment approaches and overview of current therapies.J Am Acad Dermatol.2018 Jan;78(1):15-24. doi:10.1016/j.jaad.2017.04.1142Trüeb RM, Dias MFRG.Alopecia areata: Acomprehensive review of pathogenesis and management.Clin Rev Allergy Immunol. 2018 Feb;54(1):68-87. doi:10.1007/s12016-017-8620-9
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05El-Taweel A, El-Esawy F, Abdel-Salam O.Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients.Dermatol Res Pract. 2014;2014:1-6. doi:10.1155/2014/848763Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP.Alopecia areata.Nat Rev Dis Primers. 2017 Mar 16;3:17011. doi:10.1038/nrdp.2017.11Wang S, Ratnaparkhi R, Piliang M, Bergfeld WF.Role of family history in patchy alopecia areata.Dermatol Online J. 2018 Oct 15;24(10). pii: 13030/qt0n19r7ps.Thompson JM, Park MK, Qureshi AA, Cho E.Race and Alopecia Areata amongst US Women. J Investig Dermatol Symp Proc. 2018;19(1):S47-S50. doi:10.1016/j.jisp.2017.10.007Putterman E, Castelo-soccio L.Seasonal patterns in alopecia areata, totalis, and universalis. J Am Acad Dermatol. 2018;79(5):974-975. doi:10.1016/j.jaad.2018.06.029Hordinsky MK.Alopecia areata: The clinical situation.J Investig Dermatol Symp Proc.2018 Jan;19(1):S9-S11. doi:10.1016/j.jisp.2017.10.015Food and Drug Administration.Breakthrough therapy.Food and Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
Alessandrini A, Starace M, Bruni F et al.Alopecia areata incognita and diffuse alopecia areata: clinical, trichoscopic, histopathological, and therapeutic features of a 5-year study.Dermatol Pract Concept. 2019:272-277. doi:10.5826/dpc.0904a05
El-Taweel A, El-Esawy F, Abdel-Salam O.Different trichoscopic features of tinea capitis and alopecia areata in pediatric patients.Dermatol Res Pract. 2014;2014:1-6. doi:10.1155/2014/848763
Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP.Alopecia areata.Nat Rev Dis Primers. 2017 Mar 16;3:17011. doi:10.1038/nrdp.2017.11
Wang S, Ratnaparkhi R, Piliang M, Bergfeld WF.Role of family history in patchy alopecia areata.Dermatol Online J. 2018 Oct 15;24(10). pii: 13030/qt0n19r7ps.
Thompson JM, Park MK, Qureshi AA, Cho E.Race and Alopecia Areata amongst US Women. J Investig Dermatol Symp Proc. 2018;19(1):S47-S50. doi:10.1016/j.jisp.2017.10.007
Putterman E, Castelo-soccio L.Seasonal patterns in alopecia areata, totalis, and universalis. J Am Acad Dermatol. 2018;79(5):974-975. doi:10.1016/j.jaad.2018.06.029
Hordinsky MK.Alopecia areata: The clinical situation.J Investig Dermatol Symp Proc.2018 Jan;19(1):S9-S11. doi:10.1016/j.jisp.2017.10.015
Food and Drug Administration.Breakthrough therapy.
Food and Drug Administration.FDA requires warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
Peloquin L, Castelo-Soccio L.Alopecia areata: An update on treatment options for children.Paediatr Drugs. 2017 Oct;19(5):411-422. doi:10.1007/s40272-017-0239-zStrazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis.J Am Acad Dermatol.2018 Jan;78(1):1-12. doi:10.1016/j.jaad.2017.04.1141Strazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: An appraisal of new treatment approaches and overview of current therapies.J Am Acad Dermatol.2018 Jan;78(1):15-24. doi:10.1016/j.jaad.2017.04.1142Trüeb RM, Dias MFRG.Alopecia areata: Acomprehensive review of pathogenesis and management.Clin Rev Allergy Immunol. 2018 Feb;54(1):68-87. doi:10.1007/s12016-017-8620-9
Peloquin L, Castelo-Soccio L.Alopecia areata: An update on treatment options for children.Paediatr Drugs. 2017 Oct;19(5):411-422. doi:10.1007/s40272-017-0239-z
Strazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: Disease characteristics, clinical evaluation, and new perspectives on pathogenesis.J Am Acad Dermatol.2018 Jan;78(1):1-12. doi:10.1016/j.jaad.2017.04.1141
Strazzulla LC, Wang EHC, Avila L, et al.Alopecia areata: An appraisal of new treatment approaches and overview of current therapies.J Am Acad Dermatol.2018 Jan;78(1):15-24. doi:10.1016/j.jaad.2017.04.1142
Trüeb RM, Dias MFRG.Alopecia areata: Acomprehensive review of pathogenesis and management.Clin Rev Allergy Immunol. 2018 Feb;54(1):68-87. doi:10.1007/s12016-017-8620-9
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