Caring for Your Hair and Scalp When You Have Alopecia Areata

How to Care for Your Hair and Scalp When You Have Alopecia Areata

Hint: It helps to take a gentle approach.
How to Care for Your Hair and Scalp When You Have Alopecia Areata
iStock
There’s nothing you did to cause your hair to fall out. (Alopecia areata is, after all, an autoimmune disease.) But there are things you can do to retain your remaining hair, as well as speed up the process of hair regrowth.

Along with taking medication, it’s a good idea to give your scalp some extra TLC by using gentle hair-care practices and mineral-rich shampoos, says Amy McMichael, MD, a professor of dermatology at Wake Forest University School of Medicine in Winston-Salem, North Carolina.

Keep reading for more smart strategies for taking care of your hair and scalp.

1. Wash Your Scalp Regularly

Washing your scalp helps keep your remaining hair healthy, says Dr. McMichael. Some people may only need to wash their hair every one to two weeks, whereas others may need to wash it daily, especially if they exercise often and sweat a lot.

If you’re in an active phase of alopecia areata, you’ll see more hair falling out when you wash. But that doesn’t mean hair washing is harmful. The strands you see on your hand or the shower floor were going to fall out soon anyway, because white blood cells already attacked those hair follicles. “That extra agitation [from washing] causes the hair to shed, so it’s very stressful to see it, but you’re not causing it,” says McMichael.

2. Soothe Itchiness With Anti-Dandruff Shampoo

Itchiness and irritation are common symptoms of alopecia areata. To soothe your scalp, McMichael recommends using an anti-dandruff shampoo that contains coal tar, ketoconazole, salicylic acid, selenium sulfide, or zinc.

These ingredients are all-stars for scalp cleansing, but they can dry out your hair, so use them sparingly, says McMichael. Try this strategy: “Wet your fingers, put the shampoo on your fingers, and shampoo it into the scalp. Then, use your regular shampoo for your hair and then rinse that out. And then follow up with your regular conditioner” says McMichael.

3. Comb With Care

When you want to protect every hair on your head, it helps to be gentle. “You shouldn’t be dragging combs or brushes through your hair from the root to the tip,” says McMichael. “Start at the bottom of the hair shaft and work your way up so that you don’t pull out tangles from the root.”

People with curly hair may be particularly prone to hair breakage from combing, she says. So, if this is the case for you, you may be better off wearing your hair curly instead of trying to comb it straight.

4. Wear Your Hair in a Looser Style

Braids can cover patches of hair loss very well, but make sure they’re not too tight, says McMichael. Wash your hair at least every two weeks while the braids are in, she says, and remove them after one month. Tight braids, cornrows, dreadlocks, ponytails, slicked-back buns, and styles that require you to wear rollers to bed can cause more hair loss from traction alopecia, which is caused by prolonged pulling on the hair follicles.

You can still blow-dry, color, and flat-iron your remaining hair, but do it in moderation, especially if your hair is already damaged. Using chemicals or heat can cause hair breakage for anyone, but styling the outside of your hair doesn’t generally damage the scalp, says McMichael.

If you use pomades or other products to smooth damaged hair, apply them to your hair, not to your scalp.

Making Wigs Accessible for People With Alopecia

Cranial prostheses, or wigs, are a critical piece of medical equipment for people with alopecia, but their access to them has faced many obstacles.
Making Wigs Accessible for People With Alopecia

5. Be Careful With Wigs and Hairpieces

If you wear a wig or hairpiece, make sure it fits comfortably and doesn’t cause irritation. “Try not to use glues, combs, or clips that are very tight or that rub your scalp, because that can actually cause more damage to the scalp,” says McMichael. “The hair won’t grow there, because the hair follicles will be damaged.”

6. Be Skeptical of Trendy, Over-the-Counter Products

Social media is flooded with ads for hair and scalp products that claim to support hair growth. But always ask your dermatologist before you slather anything new on your scalp.

“You don’t need to do special treatments to your scalp like oil applications,” says McMichael. “There are a lot of natural, oil-type things on the market that claim to make hair grow, and I can guarantee you that probably 99.9 percent of them are not going to be helpful. And they could actually be irritating to your scalp.”

A better idea is to seek treatment from your dermatologist, who can recommend medications such as topical or oral steroids, topical immunotherapy, or Janus kinase (JAK) inhibitors, which hinder JAK proteins to stop the immune system from attacking hair follicles.

The one over-the-counter treatment McMichael does recommend is minoxidil (Rogaine), a topical medicine that speeds the hair growth cycle. Look for a 5 percent concentration solution or foam to support hair regrowth. “Typically, we think of it as an adjunctive treatment, so not a single treatment to be used alone,” she says.

The Takeaway

  • Wash your scalp regularly, and consider using an anti-dandruff shampoo if your scalp is irritated or itchy.
  • Comb your hair gently, and choose hairstyles that won’t cause more hair loss or damage. If you use wigs or hairpieces, make sure they don’t irritate your scalp.
  • Minoxidil (Rogaine) can help regrow hair and is often used alongside other treatments, such as topical or oral steroids, topical immunotherapy, or Janus kinase (JAK) inhibitors.
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. National Institute of Arthritis and Musculoskeletal and Skin Diseases. August 2024.
  2. Ludmann P et al. Hairstyles That Pull Can Lead to Hair Loss. American Academy of Dermatology Association. November 6, 2024.
  3. Available Treatments. National Alopecia Areata Foundation.
  4. Patel P et al. Minoxidil. StatPearls. February 24, 2023.
Additional Sources
    Dr. Sanober Pezad

    Sanober Pezad Doctor, MD

    Medical Reviewer

    Dr. Sanober Pezad Doctor is a double board-certified dermatologist and internationally recognized leader in integrative and holistic dermatology. She is an anti-aging and regenerative medicine specialist and the founder of AGEnesis and Baby SkinWise.

    She earned her MD in dermatology, venereology, and leprology and a diplomate of national board (DNB) in dermatology. She is board certified in anti-aging and regenerative medicine from the American Academy of Anti-Aging Medicine (A4M). She's also a trained clinical homeopath through the Center for Education and Development of Clinical Homeopathy (CEDH).

    Sanober is the founder of AGEnesis: The Holistic Aging Blueprint, a science-backed, multidimensional protocol for healthy skin aging, and Baby SkinWise, the world’s first audiovisual skincare guide for parents. She also hosts the YouTube channel "Healthy Aging with Dr. Doctor," where she delivers educational content on evidence-based skincare, hair health, and integrative health practices.

    Sanober is a medical school gold medalist and recipient of multiple national and international awards. She is also the chief dermatology medical advisor for emerging clinical research in integrative skin and hair health, with more than 50 published scientific articles.

    Sanober is a proactive, compassionate medical practitioner with a thorough understanding of overall mind-body-spiritual wellness. She's also a key advocate for the healthy aging movement. She's a simple mommy to the core and strongly believes "prevention is better than cure." She's on a mission to make you and me into the healthiest version of ourselves.

    Julie Stewart

    Author

    Julie Stewart is an author and editor with more than a decade of experience in health, science, and lifestyle writing. Her articles have appeared online for Men’s Health, Women’s Health, EatingWell, Vice, AARP The Magazine, and Shape.