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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Partly. A doctor can recognise alopecia areata on photos, treat small patches and arrange tests; steroid injections and the newer tablets are given by a dermatologist.
- What it is: an autoimmune condition in which the immune system attacks the hair follicles, causing smooth, round bald patches. It does not scar, so the hair can grow back.
- How common: up to 1 in 50 people have it at some point in their lives, often first as a child or young adult.
- Regrowth: hair often grows back on its own within months, but new patches are common. About 5 to 10 in 100 people lose all their scalp or body hair.
- Emergency: alopecia areata is not an emergency. Call 112 for swelling of the face, lips or throat, or difficulty breathing, after a new medicine or treatment.
Bald patches on their own are not an emergency. Do not book a video appointment if you have swelling of the face, lips, tongue or throat or difficulty breathing after a new medicine or treatment, or a scalp patch that is hot, swollen and very painful with a high temperature and feeling very unwell. Call 112 or go to an emergency department.
Can an online doctor treat alopecia areata?
Partly. Alopecia areata is recognised from how the patches look and how they started, which a doctor can see on clear photos and on camera. The doctor can treat small patches with a steroid cream, lotion or foam and minoxidil, arrange blood tests for the conditions that often come with it, and check the patches are not ringworm, hair pulling or scarring hair loss, which need different care. Steroid injections into the patches, contact immunotherapy and the newer JAK inhibitor tablets are given and monitored by a dermatologist, so extensive or fast-spreading hair loss means a referral.
How an online consultation helps with alopecia areata
- The diagnosis checked: Ringworm, hair pulling, tight hairstyles and scarring hair loss can all leave patches, and each needs different care.
- Treatment for small patches: A steroid cream, lotion or foam, sometimes with minoxidil, and when to expect new hair.
- The right tests: Thyroid and other blood tests when your story points to them, at a laboratory near you.
- A referral when it is needed: To a dermatologist for injections, extensive hair loss or JAK inhibitor tablets.
What the doctor checks in an online consultation for bald patches
The doctor asks about the warning signs first, then about the patches, your nails and your health. The doctor asks about:
- Warning signs: a patch that is red, scaly, swollen, painful or weeping, a high temperature or feeling unwell, which point to an infection rather than alopecia areata.
- The patches: when you first noticed them, how many there are, how big, and whether they are growing or new ones are appearing.
- Other hair: your beard, eyebrows, eyelashes and body hair.
- Your nails: small dents (pitting), ridges or roughness.
- Your health and your family: thyroid problems, vitiligo, eczema, asthma or hay fever, and alopecia areata in a relative.
- What came before: an illness, a stressful event or a new medicine in the months before the patches started.
- Pulling or styling: whether you pull or twist your hair, or wear tight braids, extensions or ponytails.
- How it is affecting you: bald patches can be very upsetting, and support matters as much as treatment.
Before the call, take clear photos of each patch in bright daylight, close up and from further away, with the hair parted around the edge. Photograph your nails and your eyebrows too. On the call, the doctor may ask you to show a patch on camera.
What is alopecia areata?
Alopecia means hair loss. Alopecia areata is the type that causes smooth, round patches of hair loss, usually on the scalp, but also in the beard, eyebrows, eyelashes or anywhere else hair grows. It is an autoimmune condition: the immune system attacks the hair follicles and stops them growing hair. The follicles are not destroyed, so the hair can grow back.
It is the second most common type of hair loss after pattern hair loss. About 1 in 1,000 people have it at any time, and up to 1 in 50 have it at some point in their lives. It affects men, women and children of all ethnic backgrounds, and it often starts in childhood or as a young adult. It is not contagious, and it does not usually affect your general health.
Swipe sideways to compare →
| Type | What you notice | How often |
|---|---|---|
| Patchy alopecia areata | One or more round or oval bald patches, usually on the scalp | The most common type |
| Alopecia barbae | Round patches in the beard or moustache | Common in men, alone or with scalp patches |
| Ophiasis | A band of hair loss around the sides and back of the head, along the hairline | Uncommon |
| Diffuse alopecia areata | Even thinning across the scalp, rather than patches | Uncommon, and easily mistaken for shedding |
| Alopecia totalis | Loss of all the hair on the scalp | Up to about 5 in 100 people with alopecia areata |
| Alopecia universalis | Loss of all the hair on the scalp, face and body | About 1 in 100 |
The alopecia guide covers every type of hair loss, including the much more common male pattern baldness and female pattern hair loss.
What does alopecia areata look like?
Alopecia areata usually starts as one or more smooth, round bald patches about the size of a coin, often found by a hairdresser or partner. The skin in the patch looks normal, without redness, scaling or scarring.
- Smooth, round or oval patches with normal-looking skin.
- Short, broken hairs that are narrower at the root, called exclamation mark hairs, often at the edge of a patch.
- Sometimes tingling, itching or a slight change in colour of the skin before or as the hair falls out.
- New hair that grows back white or fair at first, then usually regains its colour.
- Nail changes, such as small dents, ridges or rough nails, in about 10 to 40 in 100 people, more often with extensive hair loss.
Alopecia areata in the beard
Alopecia barbae is alopecia areata in the beard: one or more round, smooth patches, sometimes noticed when shaving. It is treated in the same way as patches on the scalp, and the doctor checks for a fungal infection of the beard, which can look similar but is red, scaly or bumpy.
Eyebrows and eyelashes
Alopecia areata can thin or remove the eyebrows and eyelashes, sometimes on their own. Losing eyelashes can let dust into the eyes, so glasses or sunglasses help outdoors. Eyebrows can be filled in with make-up, eyebrow pencils, tattooing or microblading, and some steroid treatments can be used on the eyebrows by a dermatologist.
What causes alopecia areata, and what triggers it?
Alopecia areata happens when immune cells attack the base of the hair follicles. Why the immune system does this is not fully understood. Genes and the environment both play a part. You are more likely to have it if:
- a close relative has alopecia areata
- you have eczema, asthma or hay fever
- you have another autoimmune condition, such as thyroid disease or vitiligo
- you have Down syndrome
Is alopecia areata genetic?
Partly. It runs in some families, and several genes are involved, but most children of a parent with alopecia areata never have it, and there is no genetic test for it.
Does stress cause alopecia areata?
It may trigger it in some people. Many people notice their first patches after a stressful time or an illness, but large studies have never proven that stress causes alopecia areata. Hair loss itself is stressful, so support matters.
Is alopecia areata contagious?
No. It cannot spread by touch, by sharing a hairbrush or through the air.
Is it alopecia areata or something else?
Other conditions can leave patches of hair loss, and some need treatment quickly. The doctor looks for these differences:
Swipe sideways to compare →
| Condition | What the patch looks like | Where to read more |
|---|---|---|
| Alopecia areata | Smooth, round, with normal skin and exclamation mark hairs | This page |
| Scalp ringworm | Scaly, itchy patches with broken hairs, sometimes a painful, swollen lump; more common in children | Scalp ringworm |
| Hair pulling | Irregular patches with broken hairs of different lengths | Trichotillomania |
| Tight hairstyles | Thinning along the hairline or where hair is pulled tight | Traction alopecia |
| Scarring hair loss | Shiny skin without follicle openings, often with redness, scaling or burning at the edge | Frontal fibrosing alopecia |
| Syphilis | Many small, patchy areas of thinning that look moth-eaten, with other signs of syphilis | Syphilis |
Sudden shedding from all over the scalp is more often telogen effluvium than diffuse alopecia areata.
Will my hair grow back?
Often, yes. Because alopecia areata does not scar, hair can grow back in any patch, and in many people it regrows on its own within months. New patches are common, though, and the condition can come and go for years.
About 5 to 10 in 100 people with alopecia areata go on to lose all their scalp hair or all their body hair, and recovery from that is less likely. Hair is less likely to regrow when:
- it started at a young age
- a large area is affected, or hair has been lost for longer than a year
- the hair loss runs in a band around the sides and back of the head (ophiasis)
- the nails are affected
- there is a family history of alopecia areata, or you have eczema, asthma, hay fever or another autoimmune condition
How to stop alopecia areata from spreading
No treatment has been shown to prevent new patches. Treating patches early can help hair grow back where it has been lost, and a dermatologist can treat fast-spreading or extensive hair loss. Hair care does not cause or spread alopecia areata, so you can wash, brush, cut and colour your hair as usual.
Can alopecia areata be cured?
Not yet. Treatments help hair grow back, but none switches off the immune reaction for good, and hair loss can return when treatment stops.
Which alopecia areata treatment might the doctor recommend?
Treatment depends on how much hair is affected, how long it has been lost, your age and how you feel about it. Doing nothing is also a reasonable choice for a small patch. This is the framework the doctors use:
Swipe sideways to compare →
| What you have | Likely first step | Suitable for online care? | When in-person care is needed |
|---|---|---|---|
| One or a few small patches | Watching and waiting, or a strong steroid cream, lotion or foam | Yes | Not usually needed |
| Patches that keep growing, or are slow to regrow | Steroid injections into the patches | Partly | For the injections, every 4 to 6 weeks |
| Patches in the beard or eyebrows | A steroid cream or injections, depending on the area | Partly | For injections, and for the eyebrows |
| Half or more of the scalp affected | Specialist treatment, such as contact immunotherapy or JAK inhibitor tablets | Partly | A dermatologist decides and monitors treatment |
| Patches with redness, scaling, pustules or a sore lump | A different diagnosis, such as ringworm | Partly | Promptly, for an examination and samples |
Found a bald patch? A doctor can check what it is and plan treatment in one consultation.
See available times →Treatment options for alopecia areata
No treatment works for everyone, and new hair takes time: new growth usually starts 4 to 12 weeks after a treatment begins.
Watching and waiting
A small patch often regrows on its own, so many people choose to wait and take photos every few weeks.
Steroid creams, lotions and foams
A strong steroid applied to the patches calms the immune reaction in the skin. The doctor explains how often to use it, for how long, and the side effects to look out for, such as thinning of the skin. If the doctor prescribes, use the prescription at a pharmacy near you.
Steroid injections
Injections of a steroid into the patches are often the most effective treatment for patches on the scalp, eyebrows or beard. They are given by a dermatologist or a trained doctor in person, usually every 4 to 6 weeks, and stopped once the hair has grown back.
Minoxidil
Minoxidil can help hair grow back, usually alongside a steroid, but it does not change the immune reaction. The minoxidil page explains how it is used. It is not used in pregnancy or while breastfeeding.
Contact immunotherapy
For extensive hair loss, a dermatologist can paint a chemical such as diphencyprone onto the scalp to cause a mild, deliberate allergic rash, which can trigger regrowth. It is given in a specialist clinic over many months, and it can cause a severe rash, itching, swollen glands and patches of lighter skin.
JAK inhibitor tablets
JAK inhibitors are tablets that block the immune signals behind alopecia areata. Ritlecitinib is approved for severe alopecia areata in people aged 12 and over, and baricitinib and deuruxolitinib in adults. In trials of ritlecitinib, almost a quarter of people had 80% or more of their scalp hair back after 24 weeks, and over 40 in 100 after a year. They work best when the hair loss has not lasted for many years. They are started and monitored by a dermatologist, they are expensive, and their long-term safety and what happens after stopping are still being studied.
Other treatments
Steroid tablets can bring hair back quickly, but the hair often falls out again when they stop, and side effects limit their use. Light treatment and platelet-rich plasma (PRP) injections are sometimes offered, with less evidence.
Wigs, hairpieces and camouflage
Many people feel more confident with a wig, a hairpiece, a scarf or hat, or by shaving their head. Synthetic wigs last about 6 to 9 months and real-hair wigs about 3 to 4 years. Make-up, eyebrow pencils, tattooing and false eyelashes can help with eyebrows and eyelashes.
Living with alopecia areata
Alopecia areata does not usually harm your physical health, but it can affect how you feel about yourself, and stress, anxiety and low mood are common. Talking to friends and family, joining a support group, and online communities run by alopecia charities help many people. If your mood is low or you feel anxious most days, the doctor can help with that too: see anxiety and depression.
Protect bald patches from the sun with a hat or sunscreen, and keep a few photos over time, so you can see changes.
Special situations
Pregnancy and breastfeeding
Minoxidil and JAK inhibitor tablets are not used in pregnancy, so tell the doctor if you are pregnant, breastfeeding or planning a pregnancy. Some steroid treatments can still be used.
Thyroid problems
Thyroid disease is more common in people with alopecia areata. If you are tired, feel the cold or heat more, or your weight has changed, the doctor can arrange a thyroid test.
Children
Mobi Doctor consultations are for adults aged 18 and over. A child who is unwell needs a paediatrician or a local doctor in person, and emergency signs in a child mean 112.
When alopecia areata is treated online, and when you need in-person care
Treated online: recognising alopecia areata on photos and camera, steroid creams, lotions and foams and minoxidil for small patches, blood tests for thyroid and other conditions, following regrowth on photos, and support.
In-person care: steroid injections, contact immunotherapy and JAK inhibitor tablets with a dermatologist, extensive or fast-spreading hair loss, patches in the eyebrows needing injections, and any patch that is red, scaly, sore or scarred.
When to get in-person care
Call 112 or go to an emergency department now for:
- swelling of the face, lips, tongue or throat after a new medicine or treatment
- difficulty breathing or swallowing
- a hot, swollen, very painful patch of scalp with a high temperature and feeling very unwell
Get medical advice the same day for:
- a bald patch that is painful, boggy or leaking pus
- hair loss with a high temperature, swollen glands in the neck or feeling generally unwell
- a widespread rash or blisters after starting a new treatment on your scalp
How Mobi Doctor works
- Book a time that suits you: daily 7am–11pm CEST. You can see a doctor over video, usually within 15 minutes. No subscription, and the exact price is shown before you pay.
- Speak to a licensed doctor about your bald patches: share clear photos of each patch, your nails and eyebrows, and say when the patches started and whether they are growing.
- Leave with a plan: what to do, what to use and for how long, and which signs mean you should be seen in person. If the doctor prescribes, use the prescription at a pharmacy near you.
No sign-up needed
Not sure it’s alopecia areata? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
Tap the body — an area or a point — to browse symptoms anywhere
Similar symptoms, different condition? Scalp Ringworm can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about alopecia areata
What is alopecia?
Alopecia is the medical word for hair loss. There are many types: the most common is pattern hair loss, and alopecia areata is the type that causes round, smooth bald patches.
What causes alopecia areata?
In alopecia areata the immune system attacks the hair follicles and stops them growing hair. Genes play a part, and it is more common in people with eczema, asthma, thyroid disease or vitiligo. Why it starts in a particular person is not fully understood.
Can alopecia areata go away?
Yes, often. In alopecia areata, hair can grow back in any patch, and in many people it regrows on its own within months. New patches are common, and the condition can come and go for years.
What are the triggers of alopecia areata?
No single trigger of alopecia areata has been proven. Many people notice patches after a stressful time or an illness, and it runs in some families. It is more common with other autoimmune conditions.
How is alopecia areata treated?
Small patches of alopecia areata are often left to regrow or treated with a strong steroid cream, lotion or foam. Steroid injections, contact immunotherapy and JAK inhibitor tablets, given by a dermatologist, are used for more extensive hair loss.
What is the best treatment for alopecia areata?
The best treatment for alopecia areata depends on how much hair is affected. For a few patches, steroid injections or a strong steroid applied to the skin work best. For severe hair loss, JAK inhibitor tablets have the strongest evidence, and a dermatologist decides on them.
Is alopecia genetic?
Partly. Alopecia areata runs in some families and several genes are involved, but most people with a parent who has it never get it. Pattern hair loss is more strongly inherited.
How do you stop alopecia areata from spreading?
No treatment has been shown to prevent new patches of alopecia areata. Treating patches early can help regrowth, and a dermatologist can treat fast spreading or extensive hair loss.
Can alopecia areata be prevented?
No treatment or lifestyle change has been shown to prevent alopecia areata or to stop new patches, because the immune attack is not under your control. What helps is treating patches early, since regrowth is more likely when treatment starts while the patch is new, managing stress and illness, which some people notice before a new patch, and getting thyroid function checked, as thyroid disease often goes with it. Protect bare patches from sunburn with a hat or sunscreen.
Can alopecia areata be cured?
Not yet. Treatments for alopecia areata help hair grow back, but none switches off the immune reaction for good, so hair loss can return after treatment stops; the follicles are not destroyed, which is why regrowth remains possible even after years. Many people have one episode and no more, while others have patches that come and go.
Is alopecia areata contagious?
No. Alopecia areata is an autoimmune condition, not an infection, so it cannot be passed on by touch, by sharing a hairbrush, pillow or hat, or through the air, and it is safe to be around children, partners and pets. The only thing that runs between people is the genetic tendency, which is why it sometimes appears in more than one member of a family.
Is alopecia areata cancer?
No. Alopecia areata is an autoimmune condition, not cancer, and it does not usually affect your general health. Some cancer treatments cause hair loss, but that is a different type.
Can an online doctor help with alopecia areata?
Partly. A doctor can recognise alopecia areata from photos, treat small patches, arrange tests and check for look-alike conditions. Injections and the newer tablets are given by a dermatologist.
- Alopecia areata, DermNet, New Zealand, updated July 2024.
- Alopecia areata, Cleveland Clinic (US), updated 30 August 2023.
- Understanding alopecia areata, Alopecia UK, updated 6 February 2026.
- Ritlecitinib for treating severe alopecia areata in people 12 years and over (TA958), NICE, National Institute for Health and Care Excellence (UK), 27 March 2024.
- Hair loss, NHS, National Health Service (UK), reviewed 24 January 2024.
- Women and hair loss: coping tips, NHS, National Health Service (UK), reviewed 24 January 2024.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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