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Alopecia Areata (Spot Baldness): What It Is, Why It Happens and How to Treat It

Kristin Hall

Medically reviewed by Kristin Hall, FNP

Written by Our Editorial Team

Last updated 10/14/2020

Most people become aware of hair loss after noticing an extra few strands of hair on their pillow or hairbrush. 

If you have alopecia areata, however, you’ll usually notice hair loss by looking in the mirror. An autoimmune disease, alopecia areata causes your hair to fall out in small, round, coin-sized patches

Alopecia areata is also known as spot baldness due to the spot-like hair loss pattern it causes over time. 

Alopecia areata can affect both men and women. Unlike other forms of hair loss, it’s not caused by hormones or stress. Instead, alopecia areata occurs when your immune system attacks your hair follicles, preventing your hair from growing normally.

Below, we’ve explained what alopecia areata is and how it can affect your hair. We’ve also listed the most effective treatments for regrowing hair and restoring your hairline after dealing with hair loss from alopecia areata.

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What Is Alopecia Areata?

Alopecia areata is an autoimmune disease that causes hair loss. Unlike some forms of hormonal hair loss or hair loss caused by dietary issues, the hair loss most people experience from alopecia areata isn’t spread evenly across your scalp.

Instead, alopecia areata causes small patches of your hair to fall out. Hair loss from alopecia areata can range from a single small patch of hair loss on the scalp to complete bodily hair loss.

Most of the time, alopecia areata only causes small sections of your hair to fall out. In serious cases, the small patches of hair loss caused by alopecia areata can merge, leading to almost total hair loss. 

This is known as alopecia areata totalis. It’s also possible for alopecia areata to target the hair on your body — including your eyebrows, beard, eyelashes, etc. — a condition known as alopecia areata universalis.

Men and women can both be affected by alopecia areata. Unlike hormonal hair loss, which is more common in men than women, alopecia areata tends to affect both sexes evenly. Around seven million adults in the United States are affected by alopecia areata to some degree. 

Alopecia areata patterns can differ greatly between people. Some people experience hair loss on their crown or bald spot on the back of their head, while others notice patches of missing hair around the temples or hairline.

If you’ve noticed patchy hair loss that you think might be caused by alopecia areata, there’s no need to panic. 

Unlike hormonal hair loss, the hair you lose from alopecia areata can usually be regrown in the future. 

In fact, most cases of alopecia areata resolve themselves in six to 12 months, but every individual situation is different and may have different outcomes. If you have concerns about hair loss, you should reach out to your healthcare provider.

Why Does Alopecia Areata Happen?

Alopecia areata is an autoimmune disease, meaning it develops when your immune system starts to attack your hair follicles.

Like other autoimmune diseases, alopecia areata causes your immune system to mistakenly view your hair follicles as a foreign, potentially unhealthy substance. This results in an attack similar to the way your body would target a harmful virus or bacteria. 

Right now, researchers believe that alopecia areata is partly genetic. If your parents or other family members have arthritis, diabetes or other autoimmune diseases, you might be more at risk of developing alopecia areata. 

You might also have a higher risk of developing alopecia areata if you have other autoimmune conditions, such as eczema or psoriasis. 

Despite this, there isn’t any definitive scientific data showing exactly what causes your immune system to target your hair follicles. 

Unlike hormonal hair loss, which usually starts slowly and gradually gets worse over time, the hair loss from alopecia areata can be sudden and unpredictable. People with alopecia areata often notice hair falling out in spots over the course of several days or weeks.

Because alopecia areata is an autoimmune disease, diagnosing it can be a complicated process. 

Sometimes, if your alopecia areata is severe and obvious, your healthcare provider might be able to provide a diagnosis based on visual examination alone. 

If the root cause of your hair loss is less obvious, you might need to complete a blood test or scalp biopsy to detect the specific autoimmune issue. 

How to Treat Alopecia Areata

Luckily, once you’ve worked out that you have alopecia areata, it is treatable. A wide range of treatments are available for alopecia areata, from topical treatments designed to fuel new hair growth, to corticosteroids and other anti-inflammatory medications.

Before we get into the best treatments for alopecia areata, it’s important to cover what doesn’t work. 

Because alopecia areata isn’t hormonal, hair loss treatments that target DHT aren’t effective at preventing hair loss via alopecia areata. This means that saw palmetto, finasteride and other DHT-targeting topical or oral treatments will have no effects on alopecia areata. 

Luckily, most medications designed to promote healthy hair growth and reduce inflammation do work on alopecia areata. These include:

  • Minoxidil. Widely known as Rogaine®, minoxidil is a topical medication that promotes the growth of new hair. Minoxidil works by encouraging your hair follicles to enter the growth phase of the hair cycle, stimulating hair growth and reversing some amount of hair loss. Minoxidil works on all hair follicles, meaning it’s equally as effective for regrowing hair on the body and face as it is for hair on the scalp. Our guide to minoxidil explains how you can use minoxidil to recover lost hair and promote healthy, long-term hair growth.

  • Corticosteroids. When your immune system attacks your hair follicles, it can cause an extreme amount of inflammation. Some corticosteroids are used to treat alopecia areata, as these medications can be effective at limiting inflammation. Like other anti-inflammatory drugs, corticosteroids can have a range of side effects and generally aren’t used as a long-term treatment.

  • Immunosuppressants. Some immunosuppressant medications can block the actions of your immune system on your scalp, helping to preserve more of your hair and slow down future hair loss.

Like other types of hair loss, treating alopecia areata can take quite a lot of time. Depending on the length of your hair, it can take anywhere from a few months to several years to regrow lost hair and restore your previous hairline.

In the meantime, products like wigs and hair extensions can help you cover up bald spots and make the spot baldness from alopecia areata less visible. If you have only minor hair loss, it’s also often possible to style your remaining hair to cover bald patches and thin areas. 

If alopecia areata has affected your eyebrows or eyelashes, treatments like eyelash extensions and microblading can provide temporary relief and help you maintain your normal appearance while you wait for your hair to grow back.

Above all, it’s important to be patient when you’re treating alopecia areata. Spot baldness can come and go, meaning there’s a good chance you’ll experience several ups and downs before your hair grows back in full. 

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Learn More About Female Hair Loss

Dealing with hair loss can be an extremely stressful experience, especially if your hair loss is obvious and visible. Luckily, a range of treatments are available for everything from hormonal hair loss to temporary, stress-related balding.

Our Female Hair Loss 101 guide lists the main reasons why you could lose hair as a woman, as well as the most effective treatments available. You can also learn more about treating hair loss in our guides to minoxidil and saw palmetto, too.

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

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