Alopecia areata is a condition in which hair suddenly falls out in patches. Alopecia areata treatment aims to calm the process behind it and support regrowth, and it is planned together with a dermatologist. Usually one or a few round or oval bald patches with clear edges appear, and the skin in these patches typically looks smooth and healthy.

Alopecia areata is an autoimmune condition: the immune system mistakenly targets the hair follicles and stops the hair growth cycle. The follicle is not destroyed in this process, which is why hair has a chance to grow back.

It can affect not only the scalp but also the beard, eyebrows and eyelashes. It can start at any age, in women and men alike, and it is not contagious.

Hair loss often begins unnoticed, and a hairdresser or barber may be the first to spot the patch. Some people feel mild itching or tingling in the area before the hair falls out.

The exact cause of alopecia areata is not known. A genetic tendency combined with an imbalance in the immune system is thought to play a role. Some factors may trigger it or make it flare:

• Genetics: It is more common when other family members have had it.
• Other autoimmune conditions: It can occur alongside thyroid disease, vitiligo or some allergic conditions.
• Psychological and physical stress: Periods of intense stress may act as a trigger in some people.
• Illness: It may appear after an infection or a serious illness.

There are different types. The most common is a single patch or a few patches. In some people, hair loss runs in a band along the hairline, starting at the back of the neck and above the ears. More rarely, it affects the whole scalp (alopecia totalis) or all body hair (alopecia universalis).

Diagnosis is usually made by examination. The look of the bald patch, the hairs at its edges and any nail changes are assessed. Small pits in the nails are sometimes seen, and short broken hairs that taper toward the base at the edge of a patch are a helpful sign.

The scalp may be examined with dermoscopy, a magnifying device that helps tell alopecia areata apart from look-alike conditions such as a fungal infection or a hair-pulling habit. If needed, blood tests are requested to check thyroid function, iron levels and vitamins.

Diagnosis and treatment planning are carried out together with a dermatologist, especially when hair loss is widespread or progressing quickly. Before your appointment, note when the hair loss began and which medicines you take. In this process, Dr. Sevgi Ekiyor considers supportive treatments that are in line with the dermatologist’s recommendations.

There is no treatment that makes alopecia areata disappear for good. Treatment aims to reduce the immune system’s effect on the hair follicles and support regrowth. The choice depends on the number and size of patches, how long the condition has lasted and your age, and is made by your doctor.

Commonly used options include:

• Corticosteroids: Creams, lotions or, for small patches, injections directly into the area.
• Topical immunotherapy: Used for more widespread hair loss, under specialist supervision.
• Medicines that support hair growth: Some topical medicines can be used alongside other treatments.
• Systemic treatments: For widespread or stubborn cases, oral medicines may be considered after a dermatologist’s assessment.

If your doctor finds it suitable, treatments such as hair PRP / GRP may be considered as a supportive option to nourish the scalp and follicles. These do not replace medical treatment.

After steroid injections, the skin surface may temporarily thin or dip slightly, so doses and intervals are adjusted carefully. Treatment for areas such as the eyebrows and beard is planned separately, given how delicate they are. For other types of hair loss, see hair filler.

Because the follicle stays alive, hair has a chance to grow back. With a few small patches, hair sometimes regrows on its own within a few months, even without treatment, but this varies from person to person and cannot be predicted.

New hairs may be fine and colorless at first, sometimes white or light, and usually regain their normal thickness and color over time. Alopecia areata tends to recur: while hair grows back in one area, a new patch may appear elsewhere.

• Usually more favorable: A few small patches and a short history.
• Usually more stubborn: Widespread loss, long-standing loss, loss along the edges of the hairline, and onset in childhood.

Regular follow-up helps track how you respond and adjust the plan when needed. Because the change is visible, alopecia areata can affect confidence and mood. Hairstyles, wigs or eyebrow camouflage can help in the meantime, and psychological support can be a natural part of treatment.