Alopecia Areata: Symptoms, Causes, and Treatments

Alopecia areata is a chronic autoimmune disease that causes sudden, patchy hair loss on the scalp, face, or other parts of the body when the immune system mistakenly targets healthy hair follicles. The alopecia areata causes environmental or physiological stimuli, like stress, illnesses, or hormonal changes, and a hereditary predisposition. The disorder affects patients of any age and gender. Celsus first documented scalp baldness in 30 CE, with the principal therapy being caustic chemicals. Infectious microorganisms, neurological abnormalities, physical damage, and endocrine issues were among the proposed theories. Corticosteroid chemicals were introduced in the 1950s, and the concept of autoimmune illness emerged in 1958.

The alopecia areata symptoms start from small, circular bald patches to more severe types, such as complete hair loss on the scalp (alopecia totalis) or complete hair loss on the body (alopecia universalis). Alopecia areata treatment options include topical immunotherapy, minoxidil, corticosteroid injections, and newer treatments such as Janus kinases (JAK) inhibitors, which reduce the immune response and promote regrowth, although there is no known cure. Research has shifted to identifying hair follicle-specific autoantibodies and lymphocytes, with genetic studies improving the field, according to a post in Jurong Innovation District (JID) Innovations dated 2025. Studies concentrate on immune cell types, atopy, dietary modulators, microbiota, genetics, and hair growth mechanisms. The term “alopecia areata meaning” refers to a sudden bald spot on a man’s head, which was introduced to the public and has become accepted.

What Is Alopecia Areata?

Alopecia areata is a disorder in which the body’s immune system unintentionally harms healthy hair follicles, resulting in sudden, uneven hair loss. Alopecia areata affects physically fit persons and is distinct from other skin diseases. Autoimmune hair loss disrupts normal hair growth, resulting in small, circular bald patches on the scalp, eyebrows, eyelashes, or beard. The “alopecia areata meaning” for others is total baldness. Treatments or remedies are helpful to worsen the cause, but the illness itself has no medications or surgery for prevention.

Patients’ hair loss severity and pattern vary from isolated patches to complete loss of hair on the scalp or the whole body. Understanding the alopecia areata definition is critical because early detection and care decrease the psychological effects and prevent progression. Early medical intervention improves basic health and the efficacy of obtainable treatments.

How Common Is Alopecia Areata?

Alopecia areata is a common condition that starts between the ages of 10 and 20, affecting 1 in every 1,000 people. Alopecia areata symptoms appear before the age of 40 in more than 80% of people who have the illness, according to the National Alopecia Areata Foundation in 2024. The disease happens to young adults and children. The alopecia areata in women and men causes psychological stress. It occurs when the immune system mistakenly attacks hair follicles, which results in patchy hair loss on the scalp and other parts of the body.

What Does Alopecia Areata Look Like?

Alopecia areata looks like oval or round baldness on the scalp, and it affects the beard, brows, eyelashes, and body parts with hair. Bald patches are smooth and free from redness, scaling, or irritation, giving the skin a healthy appearance despite hair loss. A noticeable indicator of active hair loss is the appearance of short, broken hairs called “exclamation mark hairs,” shorter and thinner hair, at the border of the bald areas. A patient has one or two minor “patchy hair loss,” while others have larger instances of extensive baldness. The patches grow, combine, or move over time, and new spots appear in some areas while regrowth occurs in others.

What Does Hair Look Like Before and After Having Alopecia Areata?

The hair looks like before and after having alopecia areata with obvious bald spots. Normal hair has a normal texture, volume, and growth pattern before developing alopecia areata, with no visible bald spots or thinning. No warning signs or symptoms before hair loss, which occurs rapidly in small, circular spots once Alopecia areata starts. Hair in the affected body part continues to fall out or regrow in unexpected ways over time. Regrowth happens after Alopecia areata, and the new hair looks thinner, whiter, or finer at first before returning to its typical thickness and color. The pattern of hair loss and regeneration differs. Constant episodes of hair loss and regrowth, while others completely heal.

What Are the Signs and Symptoms of Alopecia Areata?

The early-stage signs of alopecia areata are extensive hair loss and round patches on the scalp. Early symptoms are crucial for immediate medical care and disease management.

The signs and symptoms of alopecia areata are listed below.

• Patches of Hair Loss: The appearance of patches of hair loss, which are small, round, smooth bald spots that arise quickly on the scalp or other parts of the body, like the beard or eyebrows, is one of the noticeable symptoms. The skin around the patches appears healthy, and they come out without redness, scarring, or flaking.
• Exclamation Mark Hairs: The presence of “exclamation mark hairs”, which are short, broken hairs that are broader at the tip and narrower at the base. The hairs appear at the edges of bald patches and are considered a key diagnostic sign of alopecia areata. They show that hair follicles are being aggressively attacked by the immune system, which weakens them from the inside out.
• Changes in Nails: Changes in the nails occur in conjunction with changes in the hair. Pitting or the tiny dents in the nail surface, ridges, or a rough texture, are signs of nail abnormalities that occur in up to 20% of people with alopecia areata. The nail abnormalities indicate larger involvement or occur before hair loss.
• Burning or Tingling Sensation: People complain of a burning or tingling sensation on their scalp or in areas where they are experiencing hair loss. The symptoms are common, but an indication of underlying inflammation or increased nerve sensitivity in the affected hair follicles. The symptoms help guide early identification and increase the efficacy of therapeutic efforts, mainly when they occur together.

The alopecia areata symptoms in females are the same as the alopecia areata symptoms in males, regardless of gender and age.

What Are the Common Symptoms of Alopecia Areata?

The common symptoms of alopecia areata are listed below.

• Unexpected, Spotty Hair Loss: Alopecia areata differs from other forms of hair loss due to distinctive symptoms. The abrupt appearance of small, round bald patches on the scalp, accompanied by unanticipated, patchy hair loss, is one of the most prevalent early symptoms. The bald patches appear unexpectedly, and at times overnight. A study in The British Journal of Dermatology (2015) suggests that the pattern is indicative of localized autoimmune activity targeting the hair follicles.
• Loss of Hair Beyond the Scalp: Hair loss starts from the scalp, beard, eyelashes, and eyebrows. Bald patches have smooth, skin-toned areas with little scarring or inflammation, indicating alopecia areata. The disease is distinguished from scarring alopecias, which result in irreversible follicle damage, by the lack of damage, as research published in The Journal of the American Academy of Dermatology (JAAD) (2017).
• Bald Spots with Smooth Skin: Hair loss that extends beyond the scalp and affects the beard, eyebrows, eyelashes, and body hair is another noticeable sign. 30% of people lose hair in areas other than the scalp, according to the National Alopecia Areata Foundation (NAAF). It indicates a severe or extensive version of the disorder, such as alopecia totalis or universalis. The bald spots on head are smooth, which sets it apart from other forms of hair loss, such as scarring alopecia or fungal infections.
• Hair Loss and Regrowth Cycles: Hair grows back on its own, falls out again, or reappears first with a white or gray hue before changing back to its original color. Patients go through cycles of hair loss and regrowth, with new hair growing back whiter or finer than before, only to fall out later. The erratic nature of autoimmune activity, which fluctuates or waxes and wanes over time, is reflected in such cycles. The relapsing-remitting course is typical and varies widely from person to person, as stated in UpToDate articles, which emphasizes the necessity of individualized monitoring and medication plans.

The common alopecia areata symptoms do not vary according to age, gender, demographics, genetics, or underlying health conditions.

What Are the Severe Symptoms of Alopecia Areata?

The severe symptoms of alopecia areata are listed below.

• Severe and Quick Hair Loss: Rapid hair loss occurs in prominent clumps that quickly cover substantial portions of the body or scalp. Severe alopecia areata symptoms have an essential effect on a person’s physical appearance and emotional health and are indicative of a more aggressive or extensive course of the autoimmune condition. Severe and fast hair loss, in which a substantial portion of scalp hair falls out quickly, is one of the most concerning symptoms. Alopecia types that are more chronic or resistant to therapy are linked to this progression. Patients with rapid-onset alopecia are prone to experience recurrent or persistent disorders like alopecia totalis or universalis, per a 2018 study published in JAMA Dermatology.
• Severe Nail Abnormalities: A severe symptom that includes nail pitting (minor dents), longitudinal ridging, onycholysis or nail detachment, brittleness, and rough texture. Advanced cases are characterized by severe nail abnormalities, such as nail pitting, ridging, crumbling, or the growth of trachyonychia, rough, sandpaper-like nails. The indications appear in up to 20% of patients, although the rate is higher in severe cases of alopecia areata. Nail involvement is a sign of hair loss and indicates the level of autoimmune activity, according to the American Academy of Dermatology (AAD).
• Complete Hair Loss: Complete hair loss on the scalp implies a transition from patchy hair loss to total scalp involvement. The most severe forms are referred to as alopecia totalis, that is, complete hair loss on the scalp, and alopecia universalis, which is complete loss of all body hair. Less than 5% of the total occurrences of alopecia areata involve the types, according to research published in The Journal of Investigative Dermatology (2015). The types of alopecia areata develop in people who have early-onset or rapidly developing symptoms.
• Complete Loss of Body Hair: The characteristic of complete loss of body hair, Alopecia universalis, is the most severe and uncommon type of alopecia areata. The disorder causes complete hair loss from the scalp, and from the beard, eyebrows, eyelashes, underarms, and other body parts. It is caused by a severe autoimmune reaction in which the body’s immune system targets every hair follicle, stopping the creation of new hair. Alopecia Universalis, in contrast to patchy alopecia areata, is a systemic form of the disease that requires intensive or multimodal treatment methods. Alopecia universalis affects fewer than 1% of all patients with alopecia areata, but it is associated with a reduced chance of spontaneous regrowth, according to a 2018 study published in JAMA Dermatology. Alopecia areata evolves from patchy or totalis, or it appears unexpectedly. Hereditary susceptibility and autoimmune disorders, such as vitiligo or thyroid illness, are widespread among people with severe type, according to research.

The symptoms of severe alopecia areata do not change based on age, gender, demographics, genetics, or underlying health conditions. The severity of the disease is comparable to common symptoms due to sudden baldness. Recognizing the severe symptoms earlier and seeking immediate medical evaluation is critical, as aggressive or targeted treatments help reduce the extent of hair loss and improve long-term results.

What Are the Rare Symptoms of Alopecia Areata?

The rare symptoms of alopecia areata are listed below.

• Hair Color: Patients with alopecia areata regrow hair in a white or gray color, regardless of their original hair shade, a phenomenon associated with hair follicles producing less melanin. Melanocyte dysfunction linked to autoimmune activity is the cause of pigmentary changes in regrown hair, according to a 2019 study published in The Journal of the European Academy of Dermatology and Venereology. The effect is visible during the early phases of regeneration.
• Black Dots: Small black pinhead-like particles noticeable in bald patches signify damaged hair shafts near the scalp’s surface. The black dots indicate acute hair follicle damage and characteristic trichoscopic findings in active alopecia areata. The dots are a defining feature of active alopecia areata in cases that are advancing quickly, according to an article published in the National Center for Biotechnology Information in 2023 entitled “Trichoscopy in Alopecia Areata and Trichotillomania in Skin of Colour: A Comparative Study.”
• Mouth-like Openings: Yellow spots that resemble open “mouth-like” follicular openings are detected under a dermatoscope. Yellow spots are more common in chronic or treatment-resistant cases, according to an article, Yellow Dots in Trichoscopy: Relevance, Clinical Significance, and Peculiarities, published in the National Center for Biotechnology Information in 2017.
• Scalp Burning or Pain (Trichodynia): Patients with alopecia areata experience discomfort, burning, or sensitivity on their scalps in areas of hair loss. A 2020 study published in the National Center for Biotechnology Information entitled “Presence of Trichodynia Symptoms in Hair Diseases and Related Factors” linked trichodynia to nerve sensitivity and local inflammation surrounding afflicted follicles, which occurs before noticeable hair loss.

The rare signs of alopecia areata are the same regardless of age, gender, demographics, genetics, or underlying health conditions.

What Are the Causes of Alopecia Areata?

The causes of alopecia areata are listed below.

• Stress: Extreme physical or emotional stress sets off or increases autoimmune reactions, which cause or worsen episodes of hair loss in people who are genetically prone to alopecia areata. Stress alters hormone levels and immunological function, which in turn affect the health of hair follicles.
• Infections: Alopecia areata is triggered by bacterial and viral infections in patients who elicit an aggressive immunological response. Autoimmune responses are triggered by viruses such as cytomegalovirus and Epstein-Barr Virus (EBV), and upper respiratory infections.
• Environment: Alopecia areata develops in genetically predisposed people as a result of exposure to environmental chemicals, pollution, or allergens. The environment causes inflammation around hair follicles and impacts the immune system’s activity.
• Changes in Hormones: The immune system is influenced by hormonal fluctuations that occur during pregnancy, puberty, menopause, or thyroid disorders. The changes are associated with the development or exacerbation of alopecia areata in women.
• Family History and Genetics: Genetics is a significant factor in determining health outcomes because Alopecia areata is inherited in about 10-20% of people. The genes involved in immunological control, such as HLA genes, are more common when people are afflicted.
• Autoimmune Reaction: The leading cause of alopecia areata is an autoimmune reaction in which the body’s immune system unintentionally targets the hair follicles, resulting in hair loss. The immunological attack leaves no scars, implying that the follicles are alive and capable of regrowing.
• Other Autoimmune Disorders: Patients with other autoimmune diseases, such as thyroid disease, vitiligo, lupus, or type 1 diabetes, have an increased risk of developing alopecia areata. The overlapping nature of diseases suggests a common underlying immunological dysregulation.

Are the Causes of Alopecia Areata different for Males and Females?

Yes, the causes of alopecia areata are different between males and females. Hormonal imbalance is the distinct cause of female alopecia areata. The start or severity of the disease is influenced by hormonal changes brought on by pregnancy, menstruation, and menopause. Each cause affects hair growth cycles and immune system function, making people more susceptible to autoimmune reactions, and shows symptoms starting or worsening during postpartum or perimenopause. No other unique alopecia areata causes in females have been found, except for hormonal changes.

The causes are most gender-specific due to genetic susceptibility, family history of autoimmune illnesses, environmental triggers such as infections or physical trauma, and emotional or psychological stress. Female patients with alopecia areata disorder, including rheumatoid arthritis, pemphigus, type I diabetes, and Hashimoto’s disease, appear and progress faster than male patients, according to a research, Gender Differences in Alopecia Areata, published in April, 2024. Alopecia areata causes in males are common symptoms regardless of gender and age.

What Triggers Alopecia Areata?

Understanding and identifying the factors that trigger the severity of alopecia areata attacks, which aim to manage and reduce the condition’s unpredictable nature, makes prevention challenging.

The factors that trigger alopecia areata are listed below.

• Severe Emotional Stress: High levels of psychological stress, like trauma, bereavement, anxiety, or significant life changes, disturb immune system balance and induce or exacerbate autoimmune reactions, including hair loss. Alopecia areata is not directly triggered by stress, although it is a known trigger in people who are genetically prone to it.
• Viral or Bacterial Infections: Epstein-Barr virus (EBV), the flu, and other common diseases cause the immune system to become overstimulated. The patchy hair loss results from the immune response’s incorrect targeting of hair follicles.
• Physical Trauma: Local causes of hair loss include wounds to the skin or scalp, surgery, or ongoing stress, such as tight hairstyles. The Koebner effect occurs when trauma triggers symptoms in autoimmune-prone areas.
• Hormonal Changes: Hormone fluctuations during adolescence, pregnancy, childbirth, or menopause affect immune function and contribute to or exacerbate alopecia areata in women.
• Allergies or Atopy: Patients with a personal or family history of allergy diseases, such as eczema, asthma, or hay fever (atopy), are at a higher risk of developing alopecia areata. The immune system becomes irregular as a result of persistent immunological reactions.
• Diet and Nutritional Deficiencies: Inadequate intake of vital minerals, such as iron, zinc, biotin, vitamin D, and several B vitamins, impairs immunological function and damages hair health. Alopecia areata is associated with poor nutrition, which creates an internal environment that leads to immune system dysfunction.

Can Lifestyle Habits cause Alopecia Areata?

No, lifestyle habits cannot cause alopecia areata, but they worsen its severity. The immune system’s stability is influenced by factors such as long-term emotional stress, sleep deprivation, inactivity, and poor nutrition. Smoking and excessive alcohol intake are linked to increased inflammation and oxidative stress, which worsen autoimmune diseases. The actions trigger or worsen pre-existing symptoms, but they are not the underlying reasons. A balanced lifestyle that promotes immunological health through healthy eating, stress reduction, regular exercise, and sufficient sleep is crucial in controlling or minimizing the recurrence of alopecia areata.

The specific lifestyle habits that trigger alopecia areata are listed below.

• Smoking: A lifestyle that improves inflammation and oxidative stress.
• Alcohol Consumption: A lifestyle that worsens autoimmune diseases.
• Lack of Exercise: A lifestyle with sufficient physical activity is crucial for maintaining a healthy immune system.
• Poor Sleep Patterns: A lifestyle that affects the immune system, enough sleep and rest are essential for a healthy life.

Knowing what to eat for a healthy diet helps decrease the risk of disease, including stress management and gentle hair care practices.

Can Alopecia Areata Lead to Permanent balding?

Yes, alopecia areata can lead to permanent baldness if taken for granted. Alopecia Areata worsens and results in longer-lasting or severe hair loss. Permanent baldness occurs when the disease progresses to severe forms, such as alopecia totalis, which is characterized by the total loss of scalp hair, or alopecia universalis, which is characterized by the loss of all body hair. Hair follicles completely lose the ability to produce new hair if they are left inactive for a long time or are vulnerable to repeated immune system attacks. Permanent balding is rare, but signs of balding occur in chronic hair loss. Early detection lowers the risk of permanent hair loss and increases the chance of hair regrowth.

Can you Die from Alopecia Areata?

No, you cannot die from alopecia areata. The autoimmune disorder is not life-threatening, but it causes hair loss on the scalp, face, or body when the immune system unintentionally targets the hair follicles. Alopecia areata causes severe emotional distress and impacts a person’s quality of life. The illness is categorized as non-scarring and non-systemic, which means that it doesn’t damage the skin or spread throughout the body in a way that risks life or cause death.

Alopecia areata is limited to affecting the skin and hair and does not pose a direct threat to the system. The statement is according to the National Alopecia Areata Foundation (NAAF) and a review published in the Journal of Investigative Dermatology Symposium Proceedings by Hordinsky and Ericson in 2004. Alopecia is associated with other autoimmune diseases, such as thyroid disorders or vitiligo, which require medical treatment. It is not life-threatening, but it has a significant psychological and social impact. Awareness about alopecia symptoms helps early detection and proper treatment.

What Are the Treatments for Alopecia Areata?

The treatments for alopecia areata are listed below.

• Cognitive Behavioral Therapy (CBT): A structured, evidence-based treatment for alopecia areata that aims to identify and modify problematic thought patterns and behaviors. CBT is used to treat anxiety, depression, stress, and other mental health conditions. It does not cure the disease, but it is effective in addressing the psychological and emotional effects of hair loss.
• Medication: Alopecia areata treatments consist of drugs that either block the immune system’s attack on hair follicles or stimulate hair regeneration. Corticosteroids and minoxidil, help manage the immune response and stimulate hair restoration, although results vary. A dermatologist’s regular monitoring is crucial for effective treatment management, reducing side effects, and facilitating early intervention, which produces better results.
• Stress Reduction: Stress reduction is a crucial component of comprehensive alopecia areata therapy. It helps maintain immune system balance, stops flare-ups, and increases the efficacy of medicinal treatments, even though it doesn’t directly heal the illness. Stress management through behavioral, psychological, and lifestyle therapies improves physical and emotional well-being for people suffering from an autoimmune disorder.
• Immunotherapy: Immunotherapy is a highly effective treatment for severe or treatment-resistant alopecia areata. It offers a significant chance of hair regrowth for patients with severe hair loss, but it is not a cure. The process is extensive and needs commitment, but it improves outcomes when initiated early and overseen by a skilled dermatologist.
• Platelet-rich plasma (PRP) Injections: PRP injections are a promising non-surgical treatment for early-stage or patchy alopecia areata, with few side effects. It has a success rate in promoting regrowth and improving scalp health, although it is not successful in cases of severe or chronic hair loss. Patients get therapy from a trained dermatologist or trichologist for the best results.

How Effective Is Hair Transplant for Treating Alopecia Areata?

Hair transplant for treating alopecia areata is 75% to 90% effective for people who have total baldness or a severe form of the disease. Hair transplant surgery is ideal for hair restoration when sudden bald spots on the scalp persist after the condition has stabilized. Alopecia areata is an autoimmune condition characterized by unusual, patchy hair loss. Alopecia patients develop persistent spots of baldness after prolonged inactivity or unsuccessful medical interventions.

Hair transplantation includes relocating healthy hair follicles from the back or sides of the scalp, which are unaffected by hair loss, and implanting them in areas of baldness. The transplanted follicles grow properly in their new place and are resistant to autoimmune attacks. There is a risk of future immunological episodes affecting transplanted hair, as alopecia areata is an unstable condition.

Turkey has emerged as one of the top destinations for excellent and cost-effective hair transplant surgeries for patients thinking about overseas treatment. The country is known for its innovative techniques, highly skilled surgeons, and competitive prices. Vera Clinic is one of the top hair transplant clinics in Turkey, with modern facilities, experienced medical staff, and customized therapy programs that have earned worldwide recognition.

What to Expect Before and After an Alopecia Areata Hair Transplant

The things to expect before and after an Alopecia Areata hair transplant are patient evaluations from a dermatologist or hair restoration specialist. The first step is to certify that the alopecia areata is stable and non-active, which means no new bald spots have appeared in at least 6 to 12 months. Doctors perform scalp biopsies or immune system tests to rule out persistent inflammation that affects transplant success. The surgeon examines the “donor area,” which is the sides or back of the head, during the consultation to ensure there are viable hair follicles there that are “harvested.” Patients are recommended to refrain from smoking, drinking alcohol, and using blood thinners before the treatment to prevent complications.

The donor and recipient areas have mild swelling, redness, and discomfort following the transplant. Tiny scabs develop where the grafts were inserted, but they go off within 7 to 10 days. New hair growth begins within 3 to 4 months, with full results showing approximately 9 to 12 months after the treatment. New autoimmune activity causes future hair loss in transplanted follicles, while transplanted hairs are permanent. Patients continue topical therapies or lifestyle modifications that boost immunological function to lower the risk. Patients must manage their expectations, as a hair transplant improves one’s appearance and self-esteem. The outcome varies depending on the extent of prior damage and the body’s response to the treatment. Regular follow-ups with the clinic are required for alopecia areata hair transplant before and after to evaluate development and address concerns that arise early.

When to See a Dermatologist for Alopecia Areata?

See a dermatologist for alopecia areata when a sudden hair loss becomes visible, appearing in well-defined patches on the scalp, eyebrows, beard, or other areas of the body. The symptoms of alopecia areata necessitate immediate medical attention, with mild, patchy hair loss that goes away on its own. It involves spreading bald spots, complete scalp hair loss, and whole body hair loss. Consult a dermatologist if nail abnormalities, such as pitting, ridging, or brittleness, show in a severe form of the condition.

A professional assessment is crucial if a patient has a family history of autoimmune diseases or if the hair loss is accompanied by scalp discomfort, burning, or itching. Early detection and treatment stop the progression of hair loss to more severe types and help slow or reverse it. A dermatologist recommends medical and psychological support options if the hair loss is causing mental discomfort, anxiety, or an improvement in quality of life.

When to take a Hair Consultation for Alopecia Areata?

Take a hair consultation for alopecia areata when visible patches appear on the scalp. Understanding the underlying reasons and progression of alopecia is made easier with a hair consultation if symptoms worsen or last longer. Consider making an appointment with a hair or scalp expert if experiencing patchy hair loss that occurs quickly, bald spots that are widening, or if the condition affects more than one area of the body. A consultation is crucial in severe cases of whole-body hair loss or total scalp hair loss to determine the severity and customize a treatment strategy.

A comprehensive examination of the scalp is necessary to identify further warning indicators, such as abrupt shedding, obvious irritation, itching, redness, or nail abnormalities, which indicate a more severe autoimmune reaction. A thorough hair assessment, which includes digital imaging, trichoscopy, or scalp biopsies, addresses contributing variables such as hormone imbalances, immunological triggers, nutritional deficiencies, or underlying dermatological conditions. Better treatment plans, such as hair transplant consultation, yield long-term results from early detection.

How is Alopecia Areata Diagnosed?

Alopecia areata is diagnosed by the procedures listed below.

• Trichoscopy: The trichoscopy procedure is a type of dermatoscope examination that focuses on the scalp, helping to differentiate alopecia areata of other kinds of hair loss. The diagnostic technique is a non-invasive diagnostic procedure that enlarges and visualizes the structures of the hair and scalp using a video dermatoscope. The method of trichoscopy diagnosis distinguishes characteristics such as vellus hair, exclamation mark hair, and black and yellow spots.
• Scalp Biopsy: A scalp biopsy involves extracting a small piece of scalp tissue, around 4 mm, to be studied under a microscope. The procedure detects alopecia areata diagnosis when visual signs are unclear or abnormal, and severe. Using a scalp biopsy is recommended for chronic cases or when scarring is suspected. The diagnostic procedure is used when lupus, lichen planopilaris, or other dermatoses are part of the examination.
• Blood Tests: Blood tests help evaluate underlying autoimmune or systemic disorders that coexist with or contribute to alopecia areata. Patients with a family history of autoimmune disease or severe hair loss require a blood test. The diagnostic procedure is used for laboratory tests, such as vitamin D, B12, iron levels, and thyroid.

Can Home Remedies Treat Alopecia Areata?

No, home remedies cannot treat alopecia areata. The natural remedies for alopecia areata manage symptoms while maintaining the health of the scalp and hair. Alopecia is an autoimmune disorder that requires medical examination and clinical therapies like corticosteroids, immunotherapy, or topical drugs. The treatments, which include avoiding harsh hair products, reducing stress through relaxation techniques, keeping a nutrient-rich diet, and massaging the scalp with essential oils, improve the conditions for hair regrowth. Alopecia areata home remedies are used as alternative methods to improve scalp circulation, lessen inflammation, and improve general well-being. Alopecia areata patients must see a dermatologist before using home remedies to avoid postponing appropriate treatment.

Home remedies that treat alopecia areata are listed below.

• Aloe Vera: The aloe vera plant is known for its calming and anti-inflammatory effects, which help to alleviate scalp discomfort.
• Essential Oils: Applying essential oils like lavender, peppermint, and rosemary to the scalp promotes circulation.
• Scalp Massage: Regular scalp massage improves blood flow and soothes the scalp.
• Balanced Nutrition: Diets high in biotin, zinc, vitamin D, iron, and protein boost healthy hair growth.
• Onion or Garlic Juice: The sulfur content from onions or garlic juice improves circulation and follicular stimulation.

What are the Signs of Regrowth After Alopecia Areata Treatment?

The signs of regrowth after alopecia areata treatment are listed below.

• Reduced Hair Fall: A noticeable decrease in shedding or the cessation of growing bald patches occurs in people before regrowth, indicating that the autoimmune attack is reducing.
• Improved Scalp Condition: The alopecia areata regrowth signs involve poor scalp health and baldness.  A healthier scalp with reduced redness, flaking, or irritation is an early indication that treatment is effective and the follicles are healing.
• White and Fine Hair: The appearance of thin, soft, colorless hair in bald places is one of the early signs of healing. The vellus hair is visible at first and resembles peach fuzz.
• Minimized Bald Patches: Noticeable spots or patches are gradually covered with fine hairs.
• Slow Regrowth of Pigmented Hair: The delicate white hairs thicken and regain their natural color. Hair follicles stabilize and function regularly once alopecia areata hair regrowth occurs.

What are the Things to Avoid when you have Alopecia Areata?

The things to avoid when you have alopecia areata are listed below.

• High Stress Levels: Stress contributes to autoimmune responses, which lead to increased hair loss or flare-ups. Utilize relaxation techniques, such as meditation, concentration, or therapy, to manage emotional stress.
• Smoking and Drinking Too Much Alcohol: Excessive drinking and smoking reduce blood flow to the scalp and contribute to oxidative stress, impairing hair follicle health.
• Strong Chemicals: Harsh chemicals found in hair bleaching, perming, and straightening irritate the scalp, damage hair shafts, and cause inflammation.
• Using Harsh Shampoos and Hair Products: Ingredients that aggravate sensitive scalps and worsen dryness or inflammation include sulfates, parabens, and powerful alcohols. Use mild, fragrance-free, and sulfate-free shampoos.
• Tight Hairstyles: Hairstyles, such as cornrows, buns, ponytails, and braids, result in hair loss and damage by causing traction on hair follicles.
• Heat Styles: Excessive use of heating hair devices, such as blow dryers, flat irons, and curling wands, dries out the scalp and weakens fragile regrowth hair, leading to breakage.
• Not Visiting Dermatologists or Self-Diagnosing: Alopecia Areata requires a precise diagnosis and close monitoring. Improper or delayed treatment results in permanent hair loss or triggers the illness.
• Poor Nutrition: Nutrient deficiencies, including vitamin D, iron, zinc, and biotin, worsen hair loss and compromise immune function. Eat a healthy, balanced diet or ask a medical professional about supplements.
• Scratching the Scalp: Repeated rubbing of the scalp, irritation, or trauma to the scalp causes inflammation or scarring, which prevents hair regeneration.

What are the different Types of Alopecia Areata?

The different types of alopecia areata are listed below.

• Alopecia Totalis: A type of alopecia areata in which the entire scalp has no hair, a characteristic of a severe form of alopecia areata. A smooth, bare scalp with no visible hair, brow, or eyelash loss.
• Alopecia Areata Universalis: The type of alopecia in which there is a complete hair loss across the entire body, including the scalp, eyebrows, eyelashes, beard, and body hair. A type of alopecia that is associated with changes in the nails.
• Diffuse Alopecia Areata: An uncommon type of alopecia in which hair loss manifests as widespread thinning throughout the scalp instead of distinct areas. Hair thinning resembles androgenetic hair loss or telogen effluvium, either slowly or abruptly.
• Ophiasis Alopecia: A type of alopecia areata characterized by hair loss that forms a band across the sides and lower back of the scalp. Thinning or baldness in a horseshoe pattern on the frontal and temporal scalps.
• Sisaipho Alopecia Areata: The opposite of ophiasis, in which the back and sides of the scalp are spared and the top of the scalp suffers baldness or thinning in the crown or vertex region.
• Reticular Alopecia Areata: A type of alopecia in which a net-like baldness is alternated with areas of hair due to hair loss. The patches of hair loss are uneven and merge throughout the scalp.

1. Alopecia Totalis

Alopecia totalis is a severe autoimmune hair loss disorder that causes every strand of hair on the scalp to fall out. The alopecia totalis disorder exhibits a more intense immune response and is resistant to therapy, whereas alopecia areata results in limited bald patches. The type of alopecia that is worse than patchy alopecia but is less severe than alopecia universalis, which causes full hair loss over the body, including brows, eyelashes, and body hair. The cause of alopecia totalis is unknown, but it appears to be attributable to a genetic predisposition, autoimmune malfunction, and the environment, including acute stress or disease.

Complete baldness of the scalp without any redness or scarring is a noticeable symptom. People with alopecia totalis notice nail irregularities, including pitting or ridging. Significant effects are observed on the hair, including total hair loss and a reduced chance of natural regrowth. Treatments, including corticosteroids, immunotherapy, or JAK inhibitors, are necessary because they are insufficient or temporary. Alopecia totalis’s look and chronic nature have a significant psychological impact, influencing social confidence and self-esteem.

Confident young woman with Alopecia Areata Totalis, displaying complete scalp hair loss.

2. Alopecia Areata Universalis

Alopecia areata universalis is the most severe and rare form of alopecia, characterized by complete hair loss throughout the entire body, including the scalp, eyebrows, eyelashes, and facial hair. A disorder develops when the immune system targets hair follicles throughout the body, causing widespread and rapid hair loss. Alopecia universalis affects fewer than 1% of people with alopecia areata, making it rarer than other types, such as alopecia totalis.

Alopecia universalis has a lower chance of spontaneous regeneration and extensive hair loss than other forms. A type of alopecia that shows resistance to treatment, necessitating severe measures like systemic immunosuppressants or a JAK inhibitor. The disorder develops as a result of viral infections, psychological stress, and other autoimmune diseases. It is not transmissible because it is an internal autoimmune disorder that is not caused by germs, fungi, or viruses.

Complete hair loss is the most noticeable symptom, which affects the person’s appearance and causes social disengagement, anxiety, and mental anguish. Its detrimental effects are aggravated by the loss of protective hair, such as eyelashes, eyebrows, and nasal hair, which leave people more vulnerable to dust, irritations, and infections. A multifaceted approach to management, involving medical treatment with psychosocial assistance, is necessary due to the severity of hair loss in alopecia areata universalis.

Close-up of a person with Alopecia Areata Universalis showing complete loss of scalp hair and eyebrows.

3. Diffuse Alopecia Areata

Diffuse alopecia areata is a less common form of alopecia areata, identified by sudden and extensive hair loss throughout the entire scalp, as opposed to the distinct bald spots associated with conventional alopecia areata. A type of alopecia areata which is more challenging to identify because it resembles other forms of hair loss, such as androgenetic alopecia or telogen effluvium. Diffuse alopecia disease is common in women if untreated, and it is an early indicator of severe hair loss.

Diffuse Alopecia Areata appears differently from other forms of alopecia. Diffuse alopecia is characterized by thinning, which is a loss of hair density. Typical alopecia areata results in obvious circular bald spots, whereas alopecia totalis or universalis involves the total loss of scalp or body hair. The causes include stress, autoimmune activity, genetic susceptibility, and underlying medical disorders. It is induced by harmful infections or hormonal changes in women.

Diffuse alopecia areata is not infectious because it is caused by an immune system defect in which the body assaults its hair follicles. The impacts on hair affect the appearance and styling, including noticeably thinner strands, decreased volume, and rapid shedding. Early detection of diffuse alopecia areata through dermatological evaluation and scalp analysis is critical.

Thinning hair on the crown of the head shows subtle and gradual hair loss, typical of diffuse alopecia areata.

4. Ophiasis Alopecia

Ophiasis alopecia is an unusual type of autoimmune disorder and is known for a band-like pattern of hair loss along the sides and lower back of the scalp, following the shape of the skull. The Greek word for “snake,” from which the term “ophiasis” is derived, describes the serpentine appearance of the hair loss pattern. It accounts for a small portion of cases, but its distinctive pattern helps differentiate it from other forms of alopecia.

Ophiasis alopecia is distinct from other types of alopecia in terms of location, but in terms of severity and chronicity. Ophiasis tends to spread slowly and is more persistent than conventional alopecia areata, which manifests as round or oval bald patches that regrow. The causes are similar to other forms of alopecia areata, which are autoimmune and occur when the immune system unintentionally targets hair follicles. Causes include underlying autoimmune illnesses, physical or emotional stress, and hereditary predisposition. The main symptom is symmetrical, snake-like hair loss that occurs gradually, leaving no scars or irritation behind.

Ophiasis Alopecia is not infectious, as external exposure does not cause it. The disorder has a profound, detrimental impact on hair health and self-esteem. The long-term nature of the illness causes psychological discomfort, and the hair loss affects regions that are visible and challenging to hide. Early detection of ophiasis alopecia, combined with treatments such as immunotherapy or corticosteroids, is crucial for slowing the development and promoting potential regrowth, as it is resistant to treatment.

Back view of a person with distinctive Ophiasis Alopecia showing band-like hair loss around the scalp margins.

5. Sisaipho Alopecia Areata

Sisaipho Alopecia Areata is a rare and distinct type of alopecia areata described by hair loss in the center of the scalp, while sparing the sides and occipital (back) region. The word “sisaipho” is “ophiasis” spelled backwards, which is interesting because it represents the opposite pattern of hair loss from ophiasis alopecia. Sisaipho affects the top and crown of the scalp, while ophiasis affects the hairline and the perimeter of the scalp. It creates a pattern that resembles androgenetic alopecia, which results in misdiagnosis. Alopecia type is documented in medical records due to its unusual form, with its prevalence unknown.

Sisaipho has an alternate course than common types, such as alopecia totalis, and it is challenging to identify early on in patients with longer hair that hides thinning patches. Progressive hair loss or thinning in the center of the scalp, with a smooth, non-scarring appearance, is the primary symptom of sisaipho alopecia areata. Sisaipho has an autoimmune origin, similar to other forms of alopecia areata, in which the immune system attacks hair follicles. The precise causes are being studied. Coexisting autoimmune disorders, environmental factors, psychological stress, and genetics trigger the disease.

Alopecia areata is not contagious because an infectious pathogen does not cause it. The exposure on the crown and top of the head has significant adverse effects on hair and confidence. Another type of hair loss that causes severe mental distress if regrowth is slower or incomplete. Individual responses vary, and treatment options include topical immunotherapy, corticosteroids, and newer medications like JAK inhibitors. Initiating successful management and increasing the chances of hair regeneration requires early diagnosis and treatment.

Top view of a person with pronounced Sisaipho Alopecia Areata showing central scalp hair loss with preserved margins.

6. Reticular Alopecia Areata

Reticular alopecia areata is a rare type characterized by a distinctive pattern of hair loss across the scalp that resembles a net or lace. Reticular alopecia produces scattered thinning spots that blend into broader regions of insufficient hair, which consists of distinct round or oval bald patches. A thorough dermatological evaluation is necessary, which complicates treatment. Reticular alopecia is uncommon due to its modest and extensive expression.

The distinct bald patches that distinguish other varieties of alopecia areata, such as patchy, ophiasis, or totalis, differ from reticular alopecia. The fundamental reasons are similar and arise from autoimmunity, in which the immune system attacks the hair follicles. The causes include genetic predisposition, stress, autoimmune illnesses, or environmental factors. The primary symptom of reticular alopecia areata is gradual, web-like hair thinning, which is accompanied by smooth, non-inflammatory scalp skin.

Reticular alopecia areata is not infectious because it is caused by the immune system rather than bacteria, viruses, or fungi. The widespread thinning results in a loss of hair volume and density, which has a profoundly negative impact on a person’s appearance and confidence. The significance of early detection and treatment options, such as topical or systemic immunomodulators, is permanent and does not respond well to conventional treatments.

Back view of a scalp with patchy Reticular Alopecia Areata showing interconnected areas of hair loss.

How does Alopecia Areata differ from other Types of Hair Loss?

Alopecia areata differs from other types of hair loss in terms of underlying mechanisms, nature, development, pattern, and cause. Alopecia areata is an autoimmune disease in which healthy hair follicles are mistakenly attacked by the body’s immune system, resulting in sudden, patchy hair loss. Androgenetic alopecia, known as male or female pattern baldness, is a hormone-related condition that develops gradually over time in a predictable pattern.

Alopecia areata causes smooth, spherical bald spots on the scalp or other body parts, whereas telogen effluvium, which is provoked by stress, sickness, or hormonal changes, causes widespread shedding across the entire scalp without identifiable patches. Alopecia areata is a non-scarring condition that allows for regrowth, while scarring alopecias, such as lichen planopilaris or frontal fibrosing alopecia, cause permanent hair loss along with inflammation and scarring.

Alopecia areata develops inside without external stressors on the hair shaft, while traction alopecia is caused by chronic physical stress or strain on the hair, such as tight hairstyles. Alopecia areata affects people of any age, but other forms, such as androgenetic alopecia or senile alopecia, age-related thinning, develop gradually as people age. Understanding alopecia and its various types of hair loss is essential for a precise diagnosis and suitable care.

The overview comparison of alopecia areata and other types of hair loss is shown in the table below.