What Is Alopecia Areata? Symptoms, Causes, Diagnosis, and Treatment
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What Is Alopecia Areata? Symptoms, Causes, Diagnosis, and Treatment

What Is Alopecia Areata? Symptoms, Causes, Diagnosis, and Treatment
Everyday Health
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Updated on August 8, 2025
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Alopecia areata is a type of hair loss that happens when your immune system attacks your hair follicles — “alopecia” means hair loss. But not all types of alopecia are autoimmune related.

“Alopecia areata is a form of nonscarring hair loss,” says Brooke Jackson, MD, a board-certified dermatologist and dermatologic surgeon in Durham, North Carolina. “It is considered an autoimmune disease, one in which your body fights itself.”

Currently, about 700,000 people in the United States have alopecia areata, but almost 7 million people have had it at one point in their lives. Alopecia can occur in childhood or adulthood, and women are more likely to get it than men.

Signs and Symptoms of Alopecia Areata

Sudden hair loss is the first and most common sign of alopecia areata. Some people also report feeling burning, itching, or tingling sensations before they lose their hair.

 But most people don’t have any noticeable symptoms other than hair loss, and they may be in good health overall.

When you have alopecia areata, you may notice your hair falling out of your scalp in round clumps, each up to the size of a quarter. This is due to inflammation around the hair follicles that makes them unable to support strands of hair.

The extent and location of alopecia areata can depend on both the severity and subtype. In some cases, only small patches of hair may be lost. A more severe type of alopecia areata, called alopecia areata totalis, may cause hair loss across the entire scalp, and alopecia areata universalis may cause hair loss from the brows and eyelashes as well.

In addition, 10 to 20 percent of people with alopecia areata experience changes to their nails. This may include dry and brittle nails, as well as red nails. Your nails may also have pits and feel extremely rough to the touch.

 These changes tend to be associated with more severe cases of alopecia areata, which can be accompanied by extensive hair loss.

What Is Alopecia Areata?

Board-certified dermatologist Kristen Lo Sicco, MD, discusses some of the specific features of this type of alopecia.
What Is Alopecia Areata?

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Causes and Risk Factors of Alopecia Areata

The exact cause of alopecia areata isn’t known. But it’s thought that this autoimmune disease occurs more frequently in people who have a family history of the condition or other autoimmune disorders, such as thyroid disease, lupus, or diabetes.

“In the case of alopecia areata, the body does not recognize the hair follicle as its own and mounts an immune response against what it believes is a foreign object, causing hair loss,” says Dr. Jackson.

Your genes, along with environmental factors, may also trigger the development of alopecia areata. But the condition is not contagious.

Alopecia areata may develop at any age, but most people with this autoimmune disease start having symptoms as a child or teenager.

 Also, the younger you are when diagnosed, the more severe and progressive the condition can be.

Using a New Alopecia Areata Severity Score to Expand Access to Care

SALT scores have long been used to determine severity of alopecia areata, but they often fall short in assessing the condition.
Using a New Alopecia Areata Severity Score to Expand Access to Care

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How Is Alopecia Areata Diagnosed?

Alopecia areata is primarily diagnosed with a physical exam. Your dermatologist will check for signs of hair loss on your scalp, face, and body, as well as changes in your nails. They may also order blood tests to determine whether you have other autoimmune diseases, such as thyroid issues, if the case warrants.

Even if your dermatologist suspects you have alopecia areata, they may use diagnostic tests to rule out other conditions. This may include pulling a few remaining hairs from your scalp to examine their shape under a microscope or punching out a small patch of skin to send to a lab for further analysis (called a skin biopsy).

Prognosis of Alopecia Areata

Alopecia areata can be unpredictable. While your hair may grow back, it’s not possible to determine whether the hair regrowth will be permanent or at risk of falling out again.

 Some people with alopecia areata have only one episode of hair loss in their lifetime.

Duration of Alopecia Areata

The exact duration of alopecia areata is unknown. Your hair may grow back, but the condition can also return. You may also develop other autoimmune diseases in the future, so it’s important for your doctor to monitor the condition and order regular lab tests.

The American Academy of Dermatology Association says that about half of all children and teens who have alopecia areata will start seeing hair regrowth within a year without treatment. On the other hand, it may be a lifelong condition for some people, with cycles of hair loss and hair regrowth.

Treatment and Medication Options for Alopecia Areata

Treatment for alopecia areata depends on the severity and type. Your dermatologist will most likely recommend a combination of medications and lifestyle changes that may help you feel better.

Medication Options

Alopecia areata can be treated with a combination of medications that either help reduce the immune system’s attack on hair follicles or promote hair regrowth. These include:

  • Corticosteroids Also simply known as steroids, medications such as prednisone may help reduce inflammation and your immune system’s attack on the hair follicles. These may be taken orally, applied topically, or injected, and the results may be gradual.
  • Minoxidil (Rogaine) It’s typically sold over the counter for male/female pattern baldness, but minoxidil may also help with hair regrowth in alopecia areata. It can take at least 12 weeks to see results and is often combined with other therapies for the best results.
  • JAK Inhibitors These oral medications, prescribed for rheumatoid arthritis and a number of other conditions, are considered a breakthrough in alopecia areata treatment. They may be particularly helpful for people with severe hair loss who haven’t had success with other therapies. There are three JAK inhibitors that have been approved for severe alopecia areata: baricitinib (Olumiant), ritlecitinib (Litfulo), and deuruxolitinib (Leqselvi).

Your dermatologist may also recommend other medications, based on the extent of hair loss. For example, some topical drugs can help promote eyebrow and eyelash regrowth.

Alternative and Complementary Therapies

Although there are no known alternative or complementary therapies that have proved effective for treating alopecia areata, some of these lifestyle changes could help you feel betterin general:

  • Eat a balanced diet.
  • Avoid fad diets and “yo-yo dieting,” which could lead to unrelated problems with hair loss.
  • Take time each day to relax to help reduce overall stress.
  • Experiment with different coverings, such as wigs, scarves, and hats to protect your head from the sun.
  • If the hair loss bothers you, experiment with using cosmetics to help camouflage it.

What Are Potential Complications of Alopecia Areata?

Dermatologist Kristen Lo Sicco, MD, explains.
What Are Potential Complications of Alopecia Areata?

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Complications of Alopecia Areata

Alopecia areata can lead to stress and anxiety over the unpredictability of the condition. It’s important to find support where you can, including from your doctor, family, and friends. You could also consider joining a support group, where you can connect with others going through similar experiences.

Other potential complications tied to alopecia areata include:

  • Illnesses and irritation from germs and particles getting in your eyes, nose, and ears
  • Increased risk of skin cancer
  • Sunburns

Demographics and Alopecia Areata

Alopecia areata can generally affect anyone,

 but emerging research is revealing possible disparities.
One study found that there’s a greater prevalence of alopecia areata among Asian Americans, Black Americans, and Hispanic Americans than white Americans.

 Another study found that eyelash involvement was highest in Black people with the condition.

 
There is also some new research that suggests hair color may play a greater role, with findings that alopecia is more common in people with black hair.

Related Conditions and Causes of Alopecia Areata

People with alopecia areata may also be at a higher risk of developing other autoimmune diseases. Examples include:

  • Addison’s disease
  • Atopic dermatitis (eczema)
  • Hay fever
  • Lupus
  • Psoriasis
  • Rheumatoid arthritis
  • Thyroid disease
  • Type 1 diabetes
  • Vitiligo

Alopecia Areata Resources

National Alopecia Areata Foundation (NAAF)

Since its founding in 1981, the NAAF has served people affected by alopecia areata, as well as their families, through a wealth of educational resources and advocacy opportunities. Additionally, the NAAF helps support research for potential new treatments. Learn more about their Alopecia Areata Treatment Development Program.

American Academy of Dermatology Association (AAD)

As the largest dermatologic association in the United States, the AAD offers information about hair and skin diseases, including educational resources about alopecia, written by experts. The AAD was founded in 1938 and has since become a valuable membership resource for dermatologists across the country.

Alternative Medicine

National Center for Complementary and Integrative Health (NCCIH)

If you’re interested in the latest science behind mind-body practices and herbal remedies related to health, consider bookmarking the NCCIH website. There aren’t any known alternative therapies that will cure alopecia areata, but a healthy diet and lifestyle may help you. For example, if your dermatologist recommends stress management, start at the NCCIH’s page on mind and body approaches to stress and anxiety.

Online Support Networks

NAAF Support Groups

The leading alopecia areata advocacy and education organization also offers worldwide support groups and networking opportunities. Here, you can find out how you can contact the NAAF for their most recent list of support groups, as well as events to help stay connected.

Children’s Alopecia Project (CAP)

As a nonprofit organization dedicated to helping children with alopecia and their families, CAP also offers several events where children can connect with their peers for support. Check out CAP’s latest offerings, including their summer camps.

Common Questions & Answers

Can alopecia areata be cured?
There’s no cure for alopecia areata, but treatments may help promote hair regrowth. Some people will have multiple cycles of hair loss, but others will have only one.
There’s no single cause of alopecia areata, but it’s thought to be triggered by a combination of genetics and environmental factors.
Stress isn’t a proven cause of alopecia areata, but it may trigger some hair loss. There’s still debate over whether stress could trigger an already existing autoimmune condition, because of the number of people who report losing their hair shortly after major and stressful life events.
Your dermatologist can help you determine whether you may get your hair back and the best approaches for helping that happen. Some people may see full hair regrowth after alopecia areata, but others will not. It’s also possible to experience hair regrowth, followed by another cycle of hair loss.
Overall, women and men develop alopecia areata in the same way, with potentially extensive hair loss. But men may be more likely to see facial hair loss, such as a patchy beard.

The Takeaway

  • When you have alopecia areata, inflammation around the hair follicles causes your hair to fall out in clumps.
  • Alopecia areata is primarily diagnosed with a physical exam in which your dermatologist will check for signs of hair loss on your scalp, face, and body, as well as changes in your nails.
  • The condition can be stressful, but there are a lot of resources available to help you if you’ve been diagnosed with it.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
  1. Alopecia Areata. Cleveland Clinic. August 30, 2023.
  2. Alopecia Areata. National Alopecia Areata Foundation.
  3. Ludmann P. Hair Loss Types: Alopecia Areata Signs and Symptoms. American Academy of Dermatology Association. August 30, 2023.
  4. Alopecia Areata. National Institute of Arthritis and Musculoskeletal and Skin Diseases. August 2024.
  5. Ludmann P. Hair Loss Types: Alopecia Areata Overview. American Academy of Dermatology Association. August 30, 2023.
  6. Ludmann P. Hair Loss Types: Alopecia Areata Diagnosis and Treatment. American Academy of Dermatology Association. August 22, 2024.
  7. Alopecia Areata (AA). American Academy of Family Physicians. July 2, 2021.
  8. FDA-Approved JAK Inhibitors. National Alopecia Areata Foundation.
  9. Sy N et al. Overall and Racial and Ethnic Subgroup Prevalences of Alopecia Areata, Alopecia Totalis, and Alopecia Universalis. JAMA Dermatology. April 2023.
  10. Hordinsky MK et al. Race and Ethnicity Sub-Groups of Alopecia Areata Patients Have Differing Clinical Characteristics: TARGET-DERM AA. Skin: The Journal of Cutaneous Medicine. November 2024.
  11. Kamal K et al. Association Between Natural Hair Color, Race, and Alopecia. Dermatology and Therapy (Heidelberg). August 2024.
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Jacquelyn Dosal

Jacquelyn Dosal, MD

Medical Reviewer
Castle Connolly Top Doctor

Jacquelyn Dosal, MD, is a board-certified dermatologist practicing at The Dermatology House in Park City, Utah. Her areas of expertise include acne, rosacea, integrative treatments of inflammatory skin diseases, as well as laser treatment of the skin and injectables.

Dr. Dosal writes cosmetic questions for the certifying exams for the American Board of Dermatology. She is also the deputy editor for the American Academy of Dermatology's podcast, Dialogues in Dermatology.

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Kristeen Cherney, PhD, is a freelance writer, essayist, author, and poet with more than 15 years of health writing experience for digital platforms such as Healthline, The Mighty, and LiveStrong. She’s covered nutrition, women’s and children’s wellness issues, as well as specialized topics ranging from diabetes and thyroid disease to anxiety, depression, asthma, allergies, and skin conditions.

With a doctorate in English (rhetoric and composition), Dr. Cherney focuses her academic scholarship on the intersection between disability and literacy. She also holds a Master of Arts in English and a Bachelor of Arts in communication.

Cherney has contributed to the books The Wiley Handbook on Violence in Education: Forms, Factors, and Preventions, Composing in Four Acts: Readings for Writers, and Georgia State University's Guide to First-Year Writing, as well as to scholarly journals like Praxis, the Journal of Teaching Writing, and the Journal of Dracula Studies.

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