Hair loss can be distressing, especially when it happens suddenly and without warning. One condition that causes this kind of hair loss is alopecia areata — an autoimmune disorder that affects people of all ages and backgrounds.
While the exact cause remains complex, understanding the course of the disease, the triggers and treatment options for alopecia areata can help you feel more informed and empowered in managing it.
1. What Is Alopecia Areata?
Alopecia areata is an autoimmune condition where the body’s immune system mistakenly attacks its own healthy hair follicles. This causes hair to fall out. There are different clinical presentations of the disease, such as patchy alopecia areata (one or more round patches), or even alopecia universalis (loss of hair not only on face and scalp but also on body).
Unlike pattern hair loss (androgenetic alopecia), which develops gradually, alopecia areata may appear suddenly – even in some rare cases overnight.
According to the National Institute for Health and Care Excellence (NICE), the condition has a lifetime incidence of 2.1% in the UK – that means 2 in 100 people will experience alopecia areata at some stage in their life.
2. Clinical Presentation of Alopecia Areata
Clinical presentation of alopecia areata can vary from person to person, but the most common forms include:
Patchy alopecia areata: Round or oval patches on the scalp or other places on the body that grow hair
Ophiasis: A specific pattern of hair loss, where hair falls out from the sides and lower back of the scalp. Alopecia areata ophiasis can be more difficult to treat
Diffuse alopecia areata: Sudden thinning of the hair all over the scalp rather than patches of hair loss. This condition is sometimes also referred to as ‘alopecia areata incognita’
Alopecia Totalis: Total loss of all scalp hair. For some people, the hair loss begins as typical alopecia areata patches. However, some people experience such rapid hair loss that patches are not seen before most of the scalp hair is lost
Alopecia Universalis: Hair loss across the entire scalp, face (including eyebrows and eyelashes) and the rest of the body (including pubic hair)
Nail involvement: People with alopecia areata may also have nail changes, such as ridges or pitting
3. What Triggers Alopecia Areata?
The development of alopecia areata stems from the autoimmune condition – where the immune system attacks hair follicles, leading to inflammation and hair loss.
Key factors include:
Genetic predisposition
Environmental triggers like infections or stress
Complex interaction of immune cells
It’s important to note: alopecia areata is not contagious, and it is not caused by poor diet or hair care.
4. Alopecia Areata Treatment Options
While there’s currently no cure for alopecia areata, there are treatments that can encourage regrowth and help manage symptoms.
Topical Medical Treatments
Corticosteroid creams and scalp applications
Dithranol cream
Contact sensitisation treatment
Prostaglandin analogs
Topical JAK inhibitors
Systemic (tablet or injection) treatments
Oral JAK inhibitors
Lifestyle & Supportive Care
Gentle scalp care: Avoiding tight hairstyles and harsh treatments
Stress management: Relaxation, meditation and exercise may help reduce flare-ups
Balanced diet: While not a cause, good nutrition supports overall hair and scalp health
Cosmetic & Confidence-Boosting Options
Wigs and hairpieces: High-quality, natural-looking wigs can restore confidence
Scalp micropigmentation: Creates the illusion of fuller hair
Psychological support
Community support: Connecting with others experiencing alopecia areata can provide emotional strength
5. Living with Alopecia Areata
Alopecia areata can be unpredictable – some people experience regrowth in a short period of time, while others may experience cycles of shedding and regrowth throughout life or some may not experience regrowth at all.
What’s important is that you’re not alone. Support is available and ongoing research is leading to more effective treatments.
Final Thoughts
Alopecia areata is an autoimmune condition that causes hair loss, but with the right support and treatments, many people see positive results. Understanding the triggers, the course of the disease, and the treatment options is key to managing the condition with confidence.
If you’re experiencing patchy or sudden hair loss, speak with a medical professional to explore the right treatment plan for you.
References
Sterkens A, Lambert J, Bervoets A. Alopecia areata: a review on diagnosis, immunological etiopathogenesis and treatment options. Clin Exp Med. 2021 May;21(2):215-230.
Barton VR, Toussi A, Awasthi S, Kiuru M. Treatment of pediatric alopecia areata: A systematic review. J Am Acad Dermatol. 2022 Jun;86(6):1318-1334.
Rudnicka L, Arenbergerova M, Grimalt R, Ioannides D, Katoulis AC, Lazaridou E, Olszewska M, Ovcharenko YS, Piraccini BM, Prohic A, Rakowska A, Reygagne P, Richard MA, Soares RO, Starace M, Vañó-Galvan S, Waskiel-Burnat A. European expert consensus statement on the systemic treatment of alopecia areata. J Eur Acad Dermatol Venereol. 2024 Apr;38(4):687-694.
Resources
Alopecia UK - Provides support, community and education to improve the lives of those affected by alopecia
Alopecia UK Service Directory - Looking for helpful products and services for those with alopecia