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Alopecia areata is an autoimmune disease that can result in hair loss. Several treatments exist to stop the immune system from attacking hair follicles. Finding the proper treatment for you might take trial and error.
Alopecia areata impacts an estimated
The condition can understandably be distressing. But there are many treatments that can help manage the symptoms of hair loss.
While this hair loss might not be noticeable at first, if you experience multiple instances of hair loss, the areas of alopecia areata may join together and become more visible.
Keep reading to learn about the most popular ways to treat alopecia areata.
When alopecia areata occurs, inflammatory cells infiltrate the hair follicle, which can result in hair loss. This hair loss often occurs on the scalp, but it can also affect , , and body hair.
“Alopecia areata can happen to anyone, at any age, and it doesn’t discriminate based on race or gender. Often, it presents as circular patches of complete hair loss. In more severe cases it can affect the entire scalp,” says Elizabeth Geddes-Bruce, a board certified dermatologist at Westlake Dermatology in Austin, Texas.
“It’s typically asymptomatic, meaning it’s not painful or itchy for most individuals. We aren’t sure why it happens. Some people think it may be triggered by a viral infection,” she says.
People with alopecia areata can lose a significant amount of hair on their head, face, and body, according to Dr. Lynne Napatalung, the medical director of dermatology at Pfizer. It often starts in adolescence or early adulthood.
The condition can result in total hair loss, known as alopecia universalis, and the hair might not grow back.
The National Alopecia Areata Foundation (NAAF) reports that the condition affects as many as 6.8 million people in the United States and 147 million people worldwide.
People living with alopecia areata have options when it comes to managing their condition — although there isn’t a one-size-fits-all approach. You might need to try a few treatments before finding one that works for you.
As alopecia areata is an , several treatments involve the use of .
Other forms of treatment involve stimulating hair growth. This works best for those with less severe hair loss.
“Most of the treatments involve keeping the immune system from attacking the hair follicles,” Geddes-Bruce says. “Treatments range from prescription topicals to prescriptions pills, in-office injections, and in-office topical therapies.” There are also a few over-the-counter options.
It’s important to remember that not all treatments work for every person. Sometimes, hair loss might occur again, even when treatment was previously successful.
The most important thing to do is consult a doctor to help decide which option is best for you.
“Since alopecia areata is unpredictable and impacts patients in different ways, every patient’s experience with specific treatments or products will vary,” Napatalung says. “That’s why it’s important that doctors and patients have an open and honest dialogue and work together on solutions to address individual needs.”
To make our selection of the best alopecia areata treatments, we consulted medical professionals and dermatologists for their recommendations.
We also consulted medical studies and resources to corroborate information about each treatment.
As alopecia areata can be a serious autoimmune condition, which affects people in a myriad of ways, we wanted to explore a range of treatment options.
It’s also worth noting that people often experience conditions differently and require support that is tailored to their needs, depending on the severity of their hair loss or their access to certain treatments.
Topical immunotherapy
- Best for: Extensive alopecia areata, including alopecia totalis and alopecia universalis
Topical immunotherapy involves applying chemicals directly to the scalp to cause an allergic reaction. In turn, this stimulates the immune system and aids hair growth.
Chemicals used in this way might include diphencyprone, dinitrochlorobenzene, and squaric acid dibutyl ester.
Pros
- This course of treatment is usually prescribed and directed under the medical care of a dermatologist.
- It can be very successful. According to , “Approximately 40 percent of patients treated with topical immunotherapy will regrow scalp hair after about 6 months of treatment.”
- If successful, continued use of the treatment should sustain hair regrowth.
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Cons
- The general side effects, including a potentially severe rash, can be uncomfortable and difficult to deal with. A
2010 study also found that topical immunotherapy sometimes caused “persistent dermatitis, painful cervical lymphadenopathy, generalized eczema, blistering, contact leukoderma, and urticarial reaction.” - Topical immunotherapy might not be widely available in your area.
- This form of treatment doesn’t work for everybody.
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Topical minoxidil
- Best for: Mild alopecia areata
Minoxidil, commonly known as Rogaine, is a topical treatment that’s easy to apply and can be easily purchased over the counter. Minoxidil works to help the hair grow faster once the follicle is no longer under attack by the immune system and is capable of producing hair.
Typically, topical minoxidil solutions come in strengths of 2 or 5 percent. You apply the treatment directly to the scalp, or any area it’s required, once or twice per day.
It works by encouraging blood flow to hair follicles, stimulating dormant follicles, and aiding hair growth.
You can also get minoxidil sent to you monthly. Consider subscribing to minoxidil drops through services like hims and Roman.
Pros
- It’s easy to purchase and apply.
- This treatment doesn’t cause many side effects if applied in recommended quantities.
- It’s relatively inexpensive, and possible to buy as a subscription if needed.
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Cons
- Minoxidil might not work on its own. But when applied in combination with topical corticosteroid medications, some people see improved results.
- It doesn’t work for extensive hair loss.
- If you use too much, minoxidil may cause more serious side effects, including chest pain, weight gain, headaches, and an irregular heartbeat.
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- Best for: Mild alopecia areata
Anthralin cream was originally used as a treatment for but was also found to be effective in the treatment of mild alopecia areata.
Known as a “scalp sensitizer,” anthralin creates an irritant reaction that stimulates the immune system and encourages hair growth.
You apply anthralin once per day directly to the scalp in areas where you want to encourage hair growth. You leave it on for a set period of time and then wash it off.
Pros
- If successful, hair regrowth is relatively quick. Studies have found that anthralin could encourage new hair growth within 2 to 3 months.
- It’s easy to apply at home.
- Anthralin is usually prescribed and monitored by a dermatologist.
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Cons
- As anthralin causes the skin on a person’s scalp to develop irritant dermatitis, some people might find this uncomfortable or difficult to manage.
- Anthralin is a
purple “tar-like” substance , which might stain bathtubs and bedsheets. - The treatment might cause a temporary, brownish discoloration of lighter skin tones and hair colors.
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- Best for: Mild alopecia areata
Corticosteroid injections are often used in the treatment of alopecia areata, as they work by modulating immune system activity and lowering inflammation.
People with alopecia areata develop hair loss when their immune systems attack the body’s natural processes. Corticosteroids work to prevent these attacks from happening.
Corticosteroids mimic , the hormone naturally produced by the body’s adrenal glands. They’re injected into the sites of hair loss to encourage new growth.
Pros
- Hair growth may happen in as little as 4 weeks.
- A dermatologist administers it every 4 to 6 weeks.
- Corticosteroid injections remain a popular, first-line treatment for alopecia areata.
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Cons
- Corticosteroids can cause side effects, such as thinning of the skin on the scalp and skin atrophy.
- This treatment is administered with a needle.
- It doesn’t prevent new hair loss from occurring.
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- Best for: Extensive alopecia areata, including alopecia totalis and alopecia universalis
While corticosteroid injections are more effective, you may be able to use the medication as a topical ointment or take it orally as a pill.
Much like its other forms, oral corticosteroids work by suppressing the immune system and inflammation in the body, which in turn encourages hair regrowth.
Pros
- They’re easy to take in tablet form under the guidance of a medical professional.
- This treatment has shown positive results in those with moderate to severe hair loss.
- Oral corticosteroids can be used in combination with other treatments under a doctor’s supervision.
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Cons
- There’s a wide range of potential side effects, including , weight gain, high blood pressure, , and muscle weakness.
- Long-term use of oral corticosteroids increases the risk of developing more severe side effects, meaning that treatment is only a short-term measure.
- Hair loss may reoccur once treatment ends.
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Rather than try to treat your hair loss at home, it’s best to visit a doctor if:
- you’re losing hair in patches
- you see more hair loss than usual while washing or styling your hair
- your hair loss is causing you anxiety or distress
- you notice that your hairline is receding
Your doctor should be able to help you figure out the cause of your hair loss and suggest treatment options. These may include an over-the-counter or prescription treatment, lifestyle changes, or other treatments.
Is there a permanent cure for alopecia?
Not currently. However, there are several treatment options that might slow down hair loss or even help your hair grow back faster.
Can your hair grow back if you have alopecia?
In some cases, yes. Hair may grow back, though it may also fall out again.
Can alopecia be prevented?
No. Alopecia is an autoimmune disorder that can be the result of several factors. These may include family history, other autoimmune conditions, skin conditions, and more. However, it’s not always possible to predict who will develop alopecia, which makes preventing it difficult.
Alopecia areata can be a challenging condition to manage, but continued scientific breakthroughs in the area suggest that the range of treatments will only increase in the future.
While an FDA-approved treatment doesn’t exist yet, new options, such as the oral Janus kinase inhibitor, might receive approval following clinical trials. This inhibitor is FDA approved for other indications, and dermatologists have used it safely orally and topically in recent years.
It’s important to talk with a doctor before trying any new treatment, since many cause side effects.
However, the growing range of treatment options for people with alopecia areata is certainly a positive thing.
Amy Mackelden is the weekend editor at Harper’s BAZAAR, and her bylines include Cosmopolitan, Marie Claire, ELLE, The Independent, Nicki Swift, Bustle, xoJane, and HelloGiggles. She’s written about health for MS Society, MS Trust, The Checkup, The Paper Gown, Folks, HelloFlo, Greatist, and Byrdie. She has an unhealthy love for the “Saw” movies and previously spent all her money on Kylie Cosmetics. Find her onInstagram.
